Immune restoration disease associated with Leishmania donovani infection following antiretroviral therapy for HIV infection.

Immune restoration disease following antiretroviral therapy for human immunodeficiency virus infection can cause significant morbidity and mortality. We describe the dramatic clinical course of an human immunodeficiency virus-infected patient who developed severe immune restoration disease associated with Leishmania donovani infection in a non-endemic area of the world. It highlights the need to consider previous travel history when screening for opportunistic infections before starting antiretroviral therapy, and demonstrates the effectiveness of corticosteroid therapy for life-threatening immune restoration disease.