<html><head><style> body {height: 100%; color:#000000; font-size:12pt; font-family:Times New Roman;}</style></head><body>Dear Igor,<br>With or without symptoms, if the presence of Leishmania is actually confirmed we would treat leishm aniasis since the reactivation is likely with the progression of the lymphoma. We would treat leishmaniasis before chemotherapy for lymphoma, if possible.<br>Regards,<br>Hiro<br><br><br>Profa. Dra. Hiro Goto<br>Laboratório de Soroepidemiologia e Imunobiologia<br>Instituto de Medicina Tropical de São Paulo, USP<br>Av. Dr. Enéas de Carvalho Aguiar, 470, prédio II, quarto andar<br>05403-000 - São Paulo, SP<br>Tel. +55-11-3061 7023, 3061 7056 ou 3061 7027<br>Fax. +55-11-3061-8270<br><br>----- Igor Thiago Queiroz <igorthiago@usp.br> escreveu:<br>><div style="-webkit-text-size-adjust: auto;">Dear all.</div><div style="-webkit-text-size-adjust: auto;">We have an adult male patient, which presented some symptoms like fever, malaise, abdominal pain and weight loss for 15 days, and fever has disappeared posteriorly. </div><div style="-webkit-text-size-adjust: auto;">On physical exam he presented mild splenomegaly. Bone marrow aspirate showed some Leishmania sp.</div><div style="-webkit-text-size-adjust: auto;">However, we decided not to treat this patient because he was symptomless after few days of hospitalization and he was discharged.</div><div><span style="-webkit-text-size-adjust: auto;">Some days later, we received bone marrow </span><span style="background-color: rgba(255, 255, 255, 0); -webkit-text-size-adjust: auto;">immunophenotyping</span><span style="-webkit-text-size-adjust: auto;"> compatible with Lymphoma.</span></div><div style="-webkit-text-size-adjust: auto;">What should we do now? Treat this patient for leishmaniasis before therapy for cancer? With Ambisome? Or should we expect the patient has some leishmaniasis symptoms before specific treatment?</div><div style="-webkit-text-size-adjust: auto;"><br></div><div style="-webkit-text-size-adjust: auto;"><br><div><font style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469);">Abraços,</font></div><div><font style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469);"><strong><br></strong></font></div><div><font style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469);"><strong>Prof. Dr. Igor Thiago</strong></font><font style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469);"> Borges de </font><font style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469);"><strong>Queiroz</strong></font><font style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469);"> e Silva</font><span style="background-color: rgba(255, 255, 255, 0);"><br>Infectologista do Hospital Giselda Trigueiro - SESAP - Natal/RN</span></div><div><span style="background-color: rgba(255, 255, 255, 0);">Professor de Infectologia da Universidade Potiguar (UnP) | Laureate International Universities</span></div><div><span style="background-color: rgba(255, 255, 255, 0);"><a href="mailto:igorthiago@usp.br" target="_blank">igorthiago@usp.br</a></span></div><div><a href="mailto:igorthiago@hotmail.com" target="_blank">igorthiago@hotmail.com</a></div><div>+55 (84) 9608-7999</div></div><br><br>--<br><br>> <br>><em> This email was sent by icb.usp.br </em><br>> ­­ </body></html>