scholarly journals Imported cutaneous leishmaniasis: molecular investigation unveils Leishmania major in Bangladesh

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Md Anik Ashfaq Khan ◽  
Rajashree Chowdhury ◽  
Rupen Nath ◽  
Sören Hansen ◽  
Progga Nath ◽  
...  
Keyword(s):  
Skin Biopsy ◽  
Cutaneous Leishmaniasis ◽  
Leishmania Donovani ◽  
Leishmania Major ◽  
Migrant Worker ◽  
Human Mobility ◽  
Skin Lesions ◽  
Careful Consideration ◽  
Molecular Tests ◽  
Imported Cases

Abstract Background The main clinical forms of leishmaniasis in Bangladesh are visceral leishmaniasis and post-kala-azar dermal leishmaniasis, which are caused by Leishmania donovani. Imported cutaneous leishmaniasis (CL) is emerging globally due mainly to increased human mobility. In recent years, several imported CL cases have also been reported in Bangladesh. Sporadic atypical cases of CL can be challenging for diagnosis and clinical management, while occurrence of infection on a frequent basis can be alarming. We report of a case of a Bangladeshi temporary-migrant worker who, upon return, presented development of skin lesions that are characteristic of CL. Methods A serum sample was collected and tested with an rK39 immunochromatographic test. Nucleic acid from skin biopsy derived culture sample was extracted and screened with a real-time PCR assay which targets the conserved REPL repeat region of L. donovani complex. The internal transcribed spacer 2 region of the ribosomal RNA gene cluster was amplified and sequenced. Results The suspect had a history of travel in both CL and VL endemic areas and had a positive rK39 test result. Based on clinical presentation, travel history and demonstration of the parasite in the skin biopsy, CL was diagnosed and the patient underwent a combination therapy with Miltefosine and liposomal amphotericin B. While typical endemic species were not detected, we identified Leishmania major, a species that, to our knowledge, has never been reported in Bangladesh. Conclusions Proper monitoring and reporting of imported cases should be given careful consideration for both clinical and epidemiological reasons. Molecular tests should be performed in diagnosis to avoid dilemma, and identification of causative species should be prioritized.

scholarly journals Expression of Inducible Nitric Oxide Synthase in Skin Lesions of Patients with American Cutaneous Leishmaniasis

2002 ◽  
Vol 70 (8) ◽  
pp. 4638-4642 ◽  
Author(s):  
Muna Qadoumi ◽  
Inge Becker ◽  
Norbert Donhauser ◽  
Martin Röllinghoff ◽  
Christian Bogdan
Keyword(s):  
Nitric Oxide ◽  
Nitric Oxide Synthase ◽  
Cutaneous Leishmaniasis ◽  
Leishmania Donovani ◽  
Leishmania Major ◽  
Parasite Burden ◽  
Skin Lesions ◽  
And Function ◽  
Oxide Synthase

ABSTRACT Cytokine-inducible (or type 2) nitric oxide synthase (iNOS) is indispensable for the resolution of Leishmania major or Leishmania donovani infections in mice. In contrast, little is known about the expression and function of iNOS in human leishmaniasis. Here, we show by immunohistological analysis of skin biopsies from Mexican patients with local (LCL) or diffuse (DCL) cutaneous leishmaniasis that the expression of iNOS was most prominent in LCL lesions with small numbers of parasites whereas lesions with a high parasite burden (LCL or DCL) contained considerably fewer iNOS-positive cells. This is the first study to suggest an antileishmanial function of iNOS in human Leishmania infections in vivo.

scholarly journals Complicated cutaneous leishmaniasis caused by an imported case of Leishmania tropica in Japan: a case report

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Hiroyuki Kitano ◽  
Chizu Sanjoba ◽  
Yasuyuki Goto ◽  
Kazumasa Iwamoto ◽  
Hiroki Kitagawa ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Skin Lesions ◽  
Leishmania Tropica ◽  
Case Presentation ◽  
Imported Case ◽  
Imported Cases ◽  
History Of ◽  
Hematoxylin And Eosin ◽  
Polymerase Chain ◽  
Positive Results

Abstract Background Leishmaniasis is not endemic in Japan, and imported cases are rare. However, there are increasing concerns regarding imported cases of cutaneous leishmaniasis from endemic countries to Japan. This report describes a case of imported cutaneous leishmaniasis that was diagnosed and treated in Japan. Case presentation A 53-year-old Pakistani man presented with skin lesions on both malleoli of his right ankle and the dorsum of the left foot. The skin lesions manifested as erythematous nodules surrounding an ulcer in the center of the lesion. The lesions of the malleoli of his right ankle each measured 3 × 3 cm, and the lesion on the top of his left foot measured 5 × 4 cm. He had been living and working in Japan but had a history of a visit to Pakistan for about 2 months in 2018. The skin lesions were biopsied. Giemsa and hematoxylin and eosin staining of biopsy samples showed amastigotes of Leishmania in macrophages, and the presence of Leishmania was confirmed by skin tissue culture. Polymerase chain reaction using biopsy specimens identified Leishmania parasites, and DNA sequence analysis revealed that the species was Leishmania tropica. The patient was treated with intravenous liposomal amphotericin B for 6 days. The erythema disappeared, and the erythematous nodules resolved within 3 weeks. Conclusion This is the first report of imported cutaneous leishmaniasis caused by L. tropica from Pakistan, and it is interesting that all three testing modalities showed positive results in this case.

PCR performance for the diagnosis of cutaneous leishmaniasis caused by Leishmania viannia complex using biopsy samples, compared with exudate samples from skin lesions on filter paper

2020 ◽  
Vol 114 (10) ◽  
pp. 721-724
Author(s):  
Yahanda Gisela Apaza-Castillo ◽  
Elsa Gladys Aguilar-Ancori ◽  
Mercedes Maritza Quispe-Flórez ◽  
Max Carlos Ramírez-Soto ◽  
Rosa Luz Pacheco-Venero
Keyword(s):  
Skin Lesion ◽  
Diagnostic Accuracy ◽  
Skin Biopsy ◽  
Cutaneous Leishmaniasis ◽  
Filter Paper ◽  
Sampling Methods ◽  
Skin Lesions ◽  
Kappa Coefficient ◽  
Clinical Suspicion ◽  
Diagnostic Concordance

Abstract Background Cutaneous leishmaniasis (CL) is generally diagnosed by molecular methods, including PCR, using biopsy samples, skin scrapings and clinical exudates. In this study, we assessed the PCR performance for diagnosis of CL using skin of biopsy samples vs PCR of skin lesion exudate samples on filter paper and compared the diagnostic concordance of PCR using both sampling methods. Methods We assessed the PCR performance using 80 skin biopsy samples and 80 filter paper samples containing exudates from skin lesions obtained from 74 patients with clinical suspicion of CL in Cusco, Peru. Results : PCR using skin biopsy samples had superior diagnostic accuracy compared with filter paper PCR (62.5% [50/80] vs 38.7% [31/80], respectively; p˂0.005) and the diagnostic concordance between both sampling methods was ‘moderate’ (kappa coefficient=0.50, 95% CI 0.98 to 1.0). Conclusions PCR using biopsy samples remains the standard for diagnosis of CL.

scholarly journals Investigation of Leishmania cutanenous Antigens in blood Specimens

2021 ◽  
Vol 26 (2) ◽  
pp. 1-8
Author(s):  
Aliaa Alnaimy ◽  
Ali B. M. Al-Waaly
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Teaching Hospital ◽  
Leishmania Major ◽  
Skin Lesions ◽  
Immunoglobulin M ◽  
Leishmania Parasite ◽  
Major Type ◽  
Serum Samples ◽  
Serological Tests ◽  
Blood Specimens

The study was conducted on 444 patients suffering from skin lesions of different ages and genders that were diagnosed by dermatologists as cutaneous leishmaniasis for people reviewing and throughout the days of the week for the department of epidemiology and transitional diseases who attended to hospitals in the city of Baghdad, namely (Al-Shaheed Dari Al Fayyad Teaching Hospital , Al-Shaheed Al Sadr Hospital , Al-Numan Teaching Hospital, Al-Karama Teaching Hospital) for the study period from October 1, 2019 until the end of March 2020. The methods of molecular diagnostics showed that multiplex pcr examined40 random samples of the parasite  that were collected throughthis technique from blood samples taken from the ulcers of infectedpeople to reveal the DNA parts of the Leishmania parasite. Specialprefixes for the Leishmania parasite species showed that 28 positive samplescontain the parasite's DNA and 12 negative samples, of which 11 are forthe Leishmania tropica type (27.5%) and 17 samples for the Leishmania major type(42.5%) at the molecular weight 1150 base pair. 30 serum samples were taken from patients diagnosed with cutaneous leishmaniasis for serological tests. The current study showed a significant decrease in immunoglobulin G for patients with cutaneous leishmaniasis by 1205.100 ± 210.155 , The current results also showed a significant decrease in the level of immunoglobulin M in patients with cutaneous leishmaniasis by 90.366 ± 26.181

scholarly journals Changes in the microbiological diagnosis and epidemiology of cutaneous leishmaniasis in real-time PCR era: A six-year experience in a referral center in Barcelona

2021 ◽  
Vol 15 (11) ◽  
pp. e0009884
Author(s):  
Aroa Silgado ◽  
Mayuli Armas ◽  
Adrián Sánchez-Montalvá ◽  
Lidia Goterris ◽  
Maria Ubals ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Real Time ◽  
Real Time Pcr ◽  
Skin Lesions ◽  
Tertiary Hospital ◽  
Molecular Techniques ◽  
Cutaneous Lesions ◽  
Imported Cases ◽  
Epidemiological Characteristics

Background Leishmaniasis is a neglected disease caused by different species of the protozoa Leishmania spp. Cutaneous lesions are the most common clinical manifestation. This disease is prevalent in tropical and subtropical areas, including the Mediterranean basin. In Spain, Leishmania (L.) infantum is the only endemic species, but imported cases are often diagnosed. Different classical parasitological methods can be performed for cutaneous leishmaniasis (CL) diagnosis; but currently molecular techniques serve as a relevant tool for the detection and characterization of Leishmania parasites. We aimed to evaluate clinical and epidemiological characteristics of CL diagnosed patients by real-time PCR in a tertiary hospital over a six-year period. Methodology/Principal findings Clinical, epidemiological and microbiological data were retrospectively collected and analyzed. In our study, CL was confirmed in 59 (31.4%) out of 188 patients by real-time PCR, showing an increase over recent years: 11 cases of CL between 2014 and 2016 and 48 between 2017 and 2019. Real-time PCR was performed on skin swabs and/or biopsies samples, with a positivity of 38.5% and 26.5%, respectively. Results were 100% concordant when biopsy and skin swab were performed simultaneously. L. (L.) infantum was the most frequent species detected (50%), followed by L. (L.) major (45%) and Viannia subgenus (5%), which were detected only in imported cases. L. (L.) major was almost entirely detected in travelers/migrants from Morocco. Multiple and atypical skin lesions were more common in imported cases than in autochthonous cases (44.4% vs. 21.8%). Conclusions/Significance An increase in both autochthonous and imported CL cases has been observed in past years in our hospital. Molecular techniques assist in improving CL diagnosis and characterization of the Leishmania species, mainly in imported cases.

First Autochthonous Case of Emerged Zoonotic Cutaneous Leishmaniasis in Mazandaran Province, Northern Iran: kDNA-PCR Evidence Base

2020 ◽  
Vol 20 ◽  
Author(s):  
Fatemeh Niksolat ◽  
Rabeeh Tabaripour ◽  
Lotfollah Davoodi ◽  
Mahdi Fakhar
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Leishmania Major ◽  
Skin Lesions ◽  
Needle Aspiration ◽  
Evidence Base ◽  
Mazandaran Province ◽  
Northern Iran ◽  
Zoonotic Cutaneous Leishmaniasis ◽  
Smear Preparation ◽  
History Of

: In the last decade, several cases of cutaneous leishmaniasis (CL) have been recorded by the provincial health center of Mazandaran Province, northern Iran. However, there is no documented report of autochthonous CL in the province yet. The patient, a 59-year-old female, known case of diabetes mellitus, lived in rural area of Kiasar district (in eastern part of the Mazandaran) with 5 skin lesions suspected of having vasculitis, without history of traveling to the endemic areas of CL, was admitted to Imam Khomeini teaching hospital, Sari. To rule out CL, fine needle aspiration (FNA) procedure was used aseptically for the patient. Laboratory investigations showed Leishman bodies (amastigotes) by direct smear preparation and species identification confirmed Leishmania major (L. major) by polymerase chain reaction (PCR) molecular method. Accordingly, this is the first documented report of autochthonous CL in Mazandaran Province. Overall, due to the abundance of probable rodent reservoir hosts and confirmation of infection of sandflies (Phlebotomus papatasi) with L. major in the Kiasar district, where our patient was living there, it seems that CL emerged in the eastern part of the province. Therefore, further studies on rodents and sandflies fauna in terms of emerging leishmanial infection in the area is recommended.

scholarly journals Central Asian Rodents as Model Animals for Leishmania major and Leishmania donovani Research

2020 ◽  
Vol 8 (9) ◽  
pp. 1440
Author(s):  
Barbora Vojtkova ◽  
Tatiana Spitzova ◽  
Jan Votypka ◽  
Tereza Lestinova ◽  
Iveta Kominkova ◽  
...  
Keyword(s):  
Standard Model ◽  
Leishmania Donovani ◽  
Leishmania Major ◽  
Skin Lesions ◽  
Rodent Species ◽  
Sand Fly ◽  
Phodopus Sungorus ◽  
Self Healing ◽  
Natural Sand ◽  
Disease Spectrum

The clinical manifestation of leishmaniases depends on parasite species, host genetic background, and immune response. Manifestations of human leishmaniases are highly variable, ranging from self-healing skin lesions to fatal visceral disease. The scope of standard model hosts is insufficient to mimic well the wide disease spectrum, which compels the introduction of new model animals for leishmaniasis research. In this article, we study the susceptibility of three Asian rodent species (Cricetulus griseus, Lagurus lagurus, and Phodopus sungorus) to Leishmania major and L. donovani. The external manifestation of the disease, distribution, as well as load of parasites and infectiousness to natural sand fly vectors, were compared with standard models, BALB/c mice and Mesocricetus auratus. No significant differences were found in disease outcomes in animals inoculated with sand fly- or culture-derived parasites. All Asian rodent species were highly susceptible to L. major. Phodopus sungorus showed the non-healing phenotype with the progressive growth of ulcerative lesions and massive parasite loads. Lagurus lagurus and C. griseus represented the healing phenotype, the latter with high infectiousness to vectors, mimicking best the character of natural reservoir hosts. Both, L. lagurus and C. griseus were also highly susceptible to L. donovani, having wider parasite distribution and higher parasite loads and infectiousness than standard model animals.

scholarly journals L. (L.) chagasi in aids and visceral leishmaniasis (kala-azar) co-infection

2008 ◽  
Vol 50 (4) ◽  
pp. 251-254 ◽  
Author(s):  
Ana Maria Roselino ◽  
Maria Fernanda Chociay ◽  
Roberto Silva Costa ◽  
Alcyone Artioli Machado ◽  
José Fernando de Castro Figueiredo
Keyword(s):  
Visceral Leishmaniasis ◽  
Skin Biopsy ◽  
Leishmania Donovani ◽  
Skin Lesions ◽  
Post Treatment ◽  
Kala Azar ◽  
Tegumentary Leishmaniasis

Concomitant skin lesions in visceral leishmaniasis (VL) or kala-azar are rare, being more common the description of post-kala-azar dermal leishmaniasis occurring post treatment of kala-azar. Skin lesions caused by Leishmania donovani are frequently seen in the aids-VL co-infection. In Brazil cutaneous or mucosal forms of tegumentary leishmaniasis concomitant with aids are more commonly registered. Here we present a case of aids-VL co-infection, with unusual cutaneous and digestive compromising attributed to L. (L.) chagasi, with special attention to ecthymatous aspect of the lesion, allied to the absence of parasite on the histological skin biopsy.

scholarly journals American cutaneous leishmaniasis: presentation and problems of patient management

1988 ◽  
Vol 21 (4) ◽  
pp. 165-172 ◽  
Author(s):  
Jeffrey D. Chulay ◽  
Charles N. Oster ◽  
Patrick B. McGreevy ◽  
Larry D. Hendricks ◽  
Richard D. Kreutzer
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Incubation Period ◽  
Patient Management ◽  
Leishmania Donovani ◽  
Skin Lesions ◽  
Medical Attention ◽  
Leishmania Braziliensis ◽  
Leishmania Mexicana ◽  
American Cutaneous Leishmaniasis ◽  
The Mean

We report our experience with the diagnosis and treatment of 60 patients with American cutaneous leishmaniasis. They were infected in Panama (55), Brazil (4) or Colombia (I). Among 35 patients with a 3 week exposure in Panama, the mean maximum incubation period was 33 days (range 4-81 days). Diagnosis was delayed an average of 93 days after onset of skin lesions, due to the patient's delay in seeking medical attention (31 days), medical personnel's delay in considering the diagnosis (45 days), and the laboratory's delay in confirming the diagnosis (17 days). Forty-four patients (73%) developed ulcers typical of cutaneous leishmaniasis. Sixteen additional patients (27%) had atypical macular, papular, squamous, verrucous or acneiform skin lesions that were diagnosed only because leishmanial cultures were obtained. Of the 59 patients treated with pentavalent antimonial drugs, only 34 (58%) were cured after the first course of treatment. Lesions which were at least 2 cm in diameter, ulcerated, or caused by Leishmania braziliensis were less likely to be cured after a single course of treatment than were lesions smaller than 2 cm, nonulcerated or caused by Leishmania mexicana or Leishmania donovani.

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