Tehran University of Medical Sciences Iranian Journal of Parasitology 1735-7020 13 4 2018 12 22 655 660 EN De Godoy NATALIA SOUZA DE Laboratory of Investigation in Medical Parasitology, Clínicas Hospital, Faculty of Medicine, University of São Paulo, São Paulo, Brazil AND Dept. of Infectious and Parasitic Diseases, Clínicas Hospital, Faculty of Medicine, University of São Paulo, São Paulo, Brazil Aiello VERA DEMARCHI Laboratory of Pathological Anatomy, Hearth Institute, Faculty of Medicine, University of São Paulo, São Paulo, Brazil de Souza REGINA MAIA Laboratory of Investigation in Medical Parasitology, Clínicas Hospital, Faculty of Medicine, University of São Paulo, São Paulo, Brazil Okay THELMA Laboratory of Seroepidemiology and Immunobiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil Braz LUCIA MARIA ALMEIDA Laboratory of Parasitology, Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil 2017 06 09 2017 09 20 Patients coinfected with Leishmania/HIV can develop atypical forms of visceral leishmaniasis (VL), making it indispensable to identify the etiological agent. We are presenting a postmortemspecie definition by ITS1-PCR-RFLP in a larynx tissue of a patient presented coinfectionLeishmania/HIV. This patient was from a leishmaniasis endemic region in São Paulo(SP), Brazil, and was diagnosed clinically with mucocutaneous leishmaniasis. Before a rK39immunochromatographic test positive, a tiny stored paraffin-embedded larynx tissue wasobtained post-mortem and submitted to 3 conventional PCR assays: kDNA (K20/K22 and RV1/RV2), and ITS1 (LITSR/ L5.8S). The last one was followed by RFLP (HaeIII) andanalyzed by 4% Metaphor agarose gel electrophoresis. Leishmania genus and Leishmania(Leishmania) subgenus were defined by kDNA-PCR, with K20/K22 (120 bp) and RV1/RV2(145 bp), respectively. ITS1-PCR-RFLP identified L. (L.) infantum chagasi species visualizedby the restriction patterns of 180, 70 and 50 bp. This case draws attention to the necessityfor a clear identification of the etiological agent causing infection, especially in endemicregions of cutaneous and visceral leishmaniasis, and particularly in patients with comorbidities who often present atypical forms of the disease. L. (L.) infantum chagasi, which is usuallyresponsible for VL, had changed its clinical spectrum for mucocutaneous. Unequivocalidentification was carried out by ITS-PCR-RFLP, therefore confirming rK39 result. Thesetechniques, which complemented each other, have a convenient cost-benefit ratio thatmakes them suitable to be applied in developing countries. https://ijpa.tums.ac.ir/index.php/ijpa/article/view/1616 https://ijpa.tums.ac.ir/index.php/ijpa/article/download/1616/893