In an analysis of 63 hospitalized cases with
visceral leishmaniasis, the clinical or post-mortem diagnosis of
bacterial infection was performed in 33; 13 (39.3%) patients had respiratory
infection, 4 (12.1%) had skin
infection, 4 had
urinary tract infection, 3 (9.0%) showed
ear infection and 2 (6.6%) had
infection of the oral cavity. It is worth mentioning that in 7 (21%) cases there was
infection in multiple sites. Gram positive and/or Gram negative organisms were isolated from 10 patients. In only two (autopsied) cases,
infection with less common organisms was recorded, one with disseminated
candidiasis and another with disseminated
tuberculosis. Death occurred in 9 of the 63 cases, and in 8 of these, concomitant
bacterial infection of importance was documented. Patients who had
serum globulins lower than 4 g% had significantly more
infection (p less than 0.05) than patients with
globulin levels higher than 4 g%; there was no significant difference when the number of leucocytes and neutrophils in patients with associated
infection was compared with those in patients without
bacterial infection. The present study demonstrates that
bacterial infection frequently occurs in patients with
visceral leishmaniasis, and indicates an unfavourable prognosis. Even though the mechanism of increased susceptibility to
infection in this condition was unclear, the widespread range of
infections and of infective agents, suggests a multifactorial process.