Visceral Leishmaniasis in an AIDS Patient on Successful Antiretroviral Therapy: Failure of Parasite Eradication Despite Increase in CD4+ T-Cell Count but Low CD8+ T-Cell Count

An unusual cutaneous relapse of visceral leishmaniasis (initially mistaken for eruptive histiocytomas) was seen in an AIDS patient despite good virological and CD4+ T-cell responses to highly active antiretroviral therapy. Splenectomy and the patient's low CD8+ T-cell count are discussed as possible causes of failed disease control.