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3.
J Spec Oper Med ; 21(1): 113-114, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33721318

RESUMO

Leishmaniasis is a parasitic infection that can involve the skin, mucosal membranes, and internal organs. Soldiers are at highrisk of leishmaniasis when conducting operations in endemic regions. Medical providers should have a low threshold to consider Leishmaniasis as the cause of persisting skin lesions.


Assuntos
Leishmaniose Cutânea , Militares , Humanos , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/terapia , Pele
4.
Rev Soc Bras Med Trop ; 54: e0305-2020, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33759916

RESUMO

Cutaneous leishmaniasis (CL) involves several differential diagnoses as it lacks a gold standard diagnostic test. Its diagnosis is easier in endemic regions; however, many cases come from travelers to endemic areas. A 22-year-old patient, who had recently visited Oaxaca, Mexico, developed two asymptomatic ulcers weeks later on the left auricle and the nose. Leishmania mexicana was identified using polymerase chain reaction. The patient was treated with imiquimod 5% cream three times/week, providing favorable results after 12 weeks, without relapse 2 months after therapy. To our knowledge, this is the first case of CL due to L. mexicana effectively treated with imiquimod.


Assuntos
Leishmania mexicana , Leishmaniose Cutânea , Leishmaniose Mucocutânea , Adulto , Humanos , Imiquimode , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/tratamento farmacológico , México , Adulto Jovem
5.
Rev Soc Bras Med Trop ; 54: e0514-2020, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33759920

RESUMO

A 31-year-old male patient developed an ulcer on the glans penis that evolved for three months without healing. We diagnosed it as leishmaniasis using polymerase chain reaction. No immunosuppression or associated diseases were observed. The patient was treated with meglumine antimoniate that cured the lesion in a month post-treatment. Here, we report this case of cutaneous leishmaniasis lesion at the unusual location of glans penis in an immunocompetent individual. The lesion likely developed due to the bite of a vector, highlighting the need for considering cutaneous leishmaniasis among differential diagnosis of sexually transmitted diseases in areas endemic for leishmaniasis.


Assuntos
Antiprotozoários , Leishmaniose Cutânea , Compostos Organometálicos , Adulto , Antiprotozoários/uso terapêutico , Brasil , Genitália , Humanos , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/tratamento farmacológico , Masculino , Meglumina/uso terapêutico , Antimoniato de Meglumina/uso terapêutico , Compostos Organometálicos/uso terapêutico , Reação em Cadeia da Polimerase
6.
Rev Soc Bras Med Trop ; 54: e0772-2020, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33759929

RESUMO

Leishmaniasis is a tropical infectious disease caused by Leishmania spp. protozoa and is transmitted by insects from the Phlebotominae subfamily. It can manifest as cutaneous leishmaniasis, a painless ulcer that can develop into a more serious systemic affliction as the protozoa spreads lymphatically or hematogenously, depending on the host's immunity. In this case series, the authors present a rare form of genital mucocutaneous leishmaniasis, with consideration of epidemiologic characteristics, clinical presentation, differential diagnosis, and treatments offered.


Assuntos
Leishmania , Leishmaniose Cutânea , Leishmaniose Mucocutânea , Animais , Diagnóstico Diferencial , Genitália , Leishmaniose Cutânea/diagnóstico , Leishmaniose Mucocutânea/diagnóstico , Úlcera
7.
Rev Soc Bras Med Trop ; 53: e20200255, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33331607

RESUMO

INTRODUCTION: In the Belém Metropolitan Region (BMR), Pará State, Brazil, American cutaneous leishmaniasis (ACL) is endemic; however, very little is known regarding its causative agents. Therefore, we used our standard diagnostic approach combined with an RNA polymerase II largest subunit (RNAPOIILS)-polymerase chain reaction (PCR) followed by analysis of restriction fragment length polymorphism (PCR-RFLP) to identify Leishmania spp. ACL agents in this region. METHODS: Thirty-two Leishmania spp. isolates from patients with ACL in the BMR during 1995-2018 were analyzed. Leishmania spp. DNA samples were amplified using the primers RPOR2/RPOF2, and the 615-bp PCR products were subjected to enzymatic digestion using TspRI and HgaI endonucleases. RESULTS: ACL etiological agents in the BMR comprised Leishmania (Viannia) lindenbergi (43.7%) followed by Leishmania (Viannia) lainsoni (34.4%), Leishmania (Leishmania) amazonensis (12.5%), and Leishmania (Viannia) braziliensis (9.4%). CONCLUSIONS: To our knowledge, the results of the study revealed for the first time that L. (V.) lindenbergi and L. (V.) lainsoni are the main ACL agents in BMR.


Assuntos
Leishmania braziliensis , Leishmania , Leishmaniose Cutânea , Brasil/epidemiologia , Humanos , Leishmania/genética , Leishmania braziliensis/genética , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/epidemiologia , Polimorfismo de Fragmento de Restrição , Estados Unidos
8.
Rev Soc Bras Med Trop ; 54: e00472020, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33338104

RESUMO

INTRODUCTION: The objective of this study was to evaluate the performance of filter paper (FP) for lesion scraping collection in a polymerase chain reaction (PCR) for cutaneous leishmaniasis (CL) diagnosis. METHODS: Lesion scrapings from 48 patients were collected and analyzed for PCR. RESULTS: PCR with FP detected up to three Leishmania braziliensis promastigotes. Considering the direct search by microscopy or PCR of samples collected in STE buffer as standards, the sensitivity of PCR with FP was 100%. CONCLUSIONS: FP can be useful for CL diagnosis in remote regions, allowing high sensitivity in the detection of the parasite by PCR.


Assuntos
Leishmania braziliensis , Leishmaniose Cutânea , DNA de Protozoário/genética , Humanos , Leishmania braziliensis/genética , Leishmaniose Cutânea/diagnóstico , Microscopia , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade
9.
Rev Soc Bras Med Trop ; 53: e20200006, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33111906

RESUMO

INTRODUCTION: We diagnose cases of cutaneous leishmaniasis (CL) among indigenous peoples of the state of Roraima, Brazil, and discuss some aspects of its epidemiology. METHODS: Skin imprints, and lesion exudate samples collected on filter paper were examined using parasitological and molecular techniques, respectively. RESULTS: Of 30 indigenous individuals, representing several ethnic groups, with suspected cases of CL, 27 (90%) tested positive for Leishmania spp. by PCR, and 21 (70%) by parasitological microscopy. CONCLUSIONS: Cutaneous leishmaniasis is indistinctly present among indigenous peoples from different regions of the state of Roraima. Individuals from seven of the ten existing ethnic groups in the state tested positive for CL, demonstrating the need for further investigation of the disease among these ethnic groups.


Assuntos
Leishmania , Leishmaniose Cutânea , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Povos Indígenas , Lactente , Recém-Nascido , Leishmania/genética , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/epidemiologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Adulto Jovem
10.
PLoS Negl Trop Dis ; 14(8): e0008507, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32841279

RESUMO

BACKGROUND: Cutaneous leishmaniasis is one of the most neglected tropical diseases increasing in its public health importance. In Ethiopia over 28 million people are living at risk of infection. METHOD: Institution based cross-sectional study was conducted at Borumeda Hospital from February to May 2019. A total 205 leishmaniasis suspected patients were included by systematic random sampling technique. Socio demographic characteristics were collected using pre-tested questionnaires. Parasitological investigation was done from skin slit sample by using Geimsa staining method. Species identification was done by PCR-RFLP. Data were entered in to EpiData version 3.1 and analyzed using SPSS version 20 software. P-value of ≤ 0.05 was considered as statistically significant. RESULT: A total of 205 participants consisting 59% male and 41% female included in this study. The mean age (±SD) of the study participants was 31.9 (±14.29). The overall prevalence of cutaneous leishmaniasis was 22.4% (46/205). The prevalence in males (13.7%) was higher than in females (8.8%). It was more prevalent in the age group 16-45years old (15.6%). Clinically, 60% of patients' hade single lesion with 1.55 average number of lesions. About 30.7% of patients' had indurated plaque type of lesion. Most of the lesions were found on head and face (59%). House near to farmland, presence of hyrax in the village and presence of other cutaneous leishmaniasis cases in the neighborhood were independent predicator of cutaneous leishmaniasis prevalence. L.aethopica was found to be the etiologic agent of cutaneous leishmaniasis in the study participants. CONCLUSION: The prevalence of cutaneous leishmaniasis was 22.4%, this alerts the need of intervention. It is statistically associated with house near to farm land, presence of other cutaneous leishmaniasis cases in the neighborhood and presence of hyrax in village. Head and face were the most common sites of lesion.


Assuntos
Leishmania/genética , Leishmania/isolamento & purificação , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/parasitologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , DNA de Protozoário/análise , Etiópia/epidemiologia , Feminino , Humanos , Leishmaniose Cutânea/diagnóstico , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Prevalência , Adulto Jovem
11.
An Bras Dermatol ; 95(5): 641-644, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32768199

RESUMO

Genital lesions are an unusual presentation of American cutaneous leishmaniasis. Conditions such as disseminated cutaneous leishmaniasis and HIV infection may be associated with genital involvement. The authors present five cases of American cutaneous leishmaniasis with genital lesions and discuss the clinical and epidemiological aspects observed in this case series.


Assuntos
Infecções por HIV , Leishmania braziliensis , Leishmaniose Cutânea , Leishmaniose Mucocutânea , Genitália , Humanos , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/epidemiologia , Estados Unidos
13.
Am J Trop Med Hyg ; 103(2): 909-916, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32602430

RESUMO

The aims of this study were to describe a smartphone app aimed at healthcare professionals who work in areas endemic for visceral and tegumentary leishmaniases, and to report the user's perception of the app in these areas. The software, called LeishCare®, has the following features: data registration, image filter to record the evolution of skin lesions using photos, calculation of a score set to identify the risk of death from visceral leishmaniasis, and guides to the diseases. LeishCare® was made available to healthcare professionals in endemic municipalities in Brazil, and the perception of potential users was evaluated at baseline and after 6 and 12 months. In the first meeting, 96 (94.1%) of the 102 professionals who knew the app reported positive expectations for its use. The installation of LeishCare® on the individual device and the evaluation of user perception were completed at 6 months with 16 users and at 12 months with 20 users. More than 90% of the professionals evaluated in both assessments found the information of the app useful. The features related to the calculation of visceral leishmaniasis severity score, and the guides to leishmaniases were the most frequently accessed. Users reported competence gain attributed to the app for all items evaluated. In conclusion, LeishCare® was found to be a promising tool to help healthcare professionals in endemic areas with leishmaniasis management.


Assuntos
Leishmaniose Cutânea/terapia , Leishmaniose Visceral/terapia , Aplicativos Móveis , Smartphone , Atitude do Pessoal de Saúde , Brasil , Comportamento do Consumidor , Gerenciamento Clínico , Diagnóstico Precoce , Intervenção Médica Precoce , Doenças Endêmicas , Humanos , Disseminação de Informação , Leishmaniose Cutânea/diagnóstico , Leishmaniose Visceral/diagnóstico , Fotografação , Medição de Risco , Software
14.
Am J Trop Med Hyg ; 103(4): 1496-1501, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32618254

RESUMO

In the United States, phlebotomine sand flies carrying Leishmania (Leishmania) mexicana are endemic along the southern border. However, relatively little is known about the enzootic and zoonotic transmission of L. (L.) mexicana within the United States, and autochthonous cases of the consequent disease are rarely reported. We investigated an atypical case of cutaneous leishmaniasis (CL) caused by L. (L.) mexicana in a patient from central Texas which did not respond to a typical antileishmanial chemotherapy. We also investigated sand fly vectors around the patient's residence. PCR followed by DNA sequencing was used for determination of Leishmania spp., sand fly species, and host blood meal source. The L. (L.) mexicana genotype from the patient was identical to one found in a positive sand fly. Moreover, this genotype presented the same single-nucleotide polymorphisms as other historical CL cases acquired in Texas over the last 10 years, but distinct from those originating in Mexico and Central America. Three sand fly species were identified among the samples analyzed (n = 194), the majority of which were Lutzomyia (Dampfomyia) anthophora (n = 190), of which four specimens tested positive for Leishmania and two blood-fed specimens showed the presence of a human blood meal. This study highlights the complexity of clinical management of CL in a setting where the disease is infrequently encountered. The detection of human blood in Lu. (D.) anthophora is the first documentation of anthropophagy in this species. This is the first report of wild-caught, naturally infected sand flies found in association with an autochthonous case of human leishmaniasis and the specific strain of Leishmania (Leishmania) mexicana in the United States.


Assuntos
Insetos Vetores/parasitologia , Leishmania mexicana/isolamento & purificação , Leishmaniose Cutânea/diagnóstico , Phlebotomus/parasitologia , Idoso , Animais , Humanos , Leishmania mexicana/genética , Leishmaniose Cutânea/parasitologia , Leishmaniose Cutânea/patologia , Masculino , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Texas
15.
PLoS Negl Trop Dis ; 14(7): e0008221, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32614818

RESUMO

Leishmaniasis remains a public health concern around the world that primarily affects poor folks of the developing world spanning across 98 countries with mortality of 0.2 million to 0.4 million annually. Post kala-azar dermal leishmaniasis (PKDL) is the late skin manifestation of visceral leishmaniasis (VL). It has been reported that about 2.5% to 20% of patients recovered from VL develop PKDL having stilted macular or nodular lesions with parasites. In the Indian subcontinent (ISC), it manifests a few months after recovery from VL, though in Africa it can occur simultaneously with VL or a little later. New cases of PKDL are also observed without prior VL in the ISC. These individuals with PKDL represent an important but largely neglected reservoir of infection that perpetuates anthroponotic Leishmania donovani transmission in the ISC and can jeopardize the VL elimination program as these cases can infect the sand flies and spread the endemic. Therefore, it becomes imperative to eradicate PKDL as a part of the VL elimination program. With the limited treatment options besides little knowledge on PKDL, this review stands out in focusing on different aspects that should be dealt for sustained VL elimination.


Assuntos
Leishmaniose Cutânea/etiologia , Leishmaniose Visceral/complicações , Gluconato de Antimônio e Sódio/efeitos adversos , Biomarcadores , Predisposição Genética para Doença , Humanos , Memória Imunológica , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/genética , Leishmaniose Cutânea/prevenção & controle , Leishmaniose Visceral/tratamento farmacológico
16.
Ann Parasitol ; 66(2): 251-254, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32592548

RESUMO

Ouagadougou, the capital city of Burkina Faso, was recognized as a focus of zoonotic cutaneous leishmaniosis in April 2000. Leishmania major was the only strain isolated in this focus. We conducted a prospective study to detect L. major in rodents, animals which are described as reservoir of the parasite. Rodents were caught in five city areas from November 2005 to October 2006. Giemsa stained smears were realized from the cutaneous lesions when present after macroscopic examination of external lesions. The spleen of each rodent was sterilely removed and split into 3 parts for microscopic examination of smears, culture on NNN media and PCR, respectively. A total of 101 rodents belonging to 9 genera were trapped. All the direct examinations and cultures were negative. By using PCR of lesions and spleen samples, three animals were found infected by L. major: one out of 24 (4.2%) Mastomys natalensis; one out of 8 (12.5%) Taterillus sp. and one out of three Cricetomys gambianus. This is the first detection of L. major in rodent species in Burkina Faso. Further studies are needed to confirm their role as reservoirs of L. major.


Assuntos
Reservatórios de Doenças , Leishmania major , Leishmaniose Cutânea , Reação em Cadeia da Polimerase , Doenças dos Roedores , Roedores , Animais , Burkina Faso , Reservatórios de Doenças/parasitologia , Leishmania major/genética , Leishmaniose Cutânea/diagnóstico , Estudos Prospectivos , Doenças dos Roedores/parasitologia , Roedores/parasitologia , Baço/parasitologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-32578727

RESUMO

We report the case of a patient with cutaneous leishmaniasis who showed a rapidly progressing ulcerative lesion after traveling to multiple countries where different Leishmania species are endemic. Diagnosis of Leishmania tropica, an exotic species in Mexico was established by using serological and molecular tools.


Assuntos
Doenças Transmissíveis Importadas/diagnóstico , Leishmania tropica , Leishmaniose Cutânea/diagnóstico , Doença Relacionada a Viagens , Adulto , Doenças Transmissíveis Importadas/parasitologia , Humanos , Leishmania tropica/genética , Leishmania tropica/imunologia , Leishmaniose Cutânea/parasitologia , Masculino
18.
Clin Dermatol ; 38(2): 140-151, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32513395

RESUMO

Cutaneous leishmaniasis (CL) is called "the great imitator," because it can mimic almost all types of dermatoses. This similarity may sometimes lead to misdiagnosis, resulting in inappropriate treatment and morbidities. Atypical forms occur due to the interaction between parasitic factors and the host immune response. Secondary infection or mistreatment of CL can also alter the natural course, resulting in bizarre and misdiagnosed cases. Atypical leishmaniasis should be considered in longstanding and painless lesions that may simulate erysipelas, dermatitis, verruca, herpes zoster, paronychia, and sporotrichosis. Less commonly, sarcoidosis, deep mycosis, basal and squamous cell carcinoma, cutaneous lymphoma, or pseudolymphomalike lesions may need to be considered in the differential diagnosis. A high index of suspicion is required to consider a diagnosis of CL, especially in nonendemic or newly endemic regions. Smear, histopathologic examination, culture, and polymerase chain reaction serve as important tools to differentiate CL from its clinical and histologic look-alikes. CL is discussed from various perspectives, with emphasis on CL and its broad differential diagnosis.


Assuntos
Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/patologia , Pele/patologia , Diagnóstico Diferencial , Erros de Diagnóstico , Técnicas e Procedimentos Diagnósticos , Humanos , Leishmania/genética , Leishmania/isolamento & purificação , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/parasitologia , Reação em Cadeia da Polimerase
20.
PLoS One ; 15(5): e0232829, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32379842

RESUMO

The diagnosis of American tegumentary leishmaniasis (ATL) still requires the design of more effective tools. Leishmania (Viannia) braziliensis is the causal agent of the 90% of Argentinean ATL cases. Considering the current knowledge, an ELISA based crude antigen (CA) for the diagnosis was designed. Ninety-nine subjects diagnosed as ATL, 27 as no-ATL, and 84 donors from non-ATL-endemic areas were included in this study. The current ATL diagnosis was based four techniques, dermal smear microscopic examination (parasitological test), PCR, Leishmanin skin test, and clinical records. We obtained CA extracts from promastigotes and amastigotes from macrophage cultures of different zymodemes of endemic Leishmania species circulating in the study area. Crude antigens from the 'local' main zymodeme of L. (V.) braziliensis showed the highest reactivity against anti-Leishmania antibodies compared to the other included species. The CA of amastigotes of this zymodeme was 3.4 fold more reactive than promastigotes one. Moreover, amastigote-membrane CA (MCA) were 3.6 fold more reactive than the soluble antigens. The MCA-ELISA reached a sensitivity and specificity of 98% (CI = 94.7%-100%) and 63.6% (53.9-73.1), respectively. When anti-Trypanosoma cruzi reactive sera were excluded, the specificity reached 98.4% (94.4-100), while the sensitivity was similar, with a positive predictive value (PV) of 98.6% (94.6-100) and negative PV of 96.3% (91.6-100). The performance of the MCA-ELISA results strongly contribute to the final diagnostic decision, since a non-reactive serological result almost discards the suspected ATL, because of its high negative PV. The developed MCA-ELISA showed a high diagnostic performance, which makes it a good candidate for ATL diagnosis, for seroprevalence studies, or for monitoring treatments efficacy.


Assuntos
Anticorpos Antiprotozoários/sangue , Antígenos de Protozoários/imunologia , Membrana Celular/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Leishmania braziliensis/imunologia , Leishmaniose Cutânea/diagnóstico , Afinidade de Anticorpos , Especificidade de Anticorpos , Argentina/epidemiologia , Doadores de Sangue , Doenças Endêmicas , Humanos , Leishmania braziliensis/crescimento & desenvolvimento , Leishmaniose Cutânea/sangue , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/parasitologia , Leishmaniose Mucocutânea/sangue , Leishmaniose Mucocutânea/diagnóstico , Leishmaniose Mucocutânea/parasitologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Estudos Soroepidemiológicos , Trypanosoma cruzi/imunologia
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