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Sample records for disseminated cutaneous leishmaniasis

  1. [Case report: disseminated cutaneous leishmaniasis (LCD)].

    Science.gov (United States)

    Mancheno-Valencia, Alexandra; Cabezas-Arteaga, Julia; Sacoto-Aizaga, Ketty; Arenas-Guzmáno, Roberto

    The World Health Organization (WHO) has classified leishmaniasis as an uncontrolled and emerging disease. In Ecuador, the only anecdotal cases of diffuse cutaneous leishmaniasis were recorded in 1994 and have not been formally published. This form can be differentiated from classical localized cutaneous leishmaniasis by the number of injuries, the clinical type of the main elementary lesions (papular and acneform), and a weak response to standard treatments. The case we report is a 34-year-old woman who presented with disseminated nodular lesions and ulcers of various sizes with erythematous edges and scars. We report the case and review diffuse cutaneous leishmaniasis and the differences that can be found with the other cutaneous variants. The diagnosis requires to be considered by primary care physicians in endemic areas and specialists, taking into account that this presentation can also occur in immunocompetent hosts.

  2. Disseminated Cutaneous Leishmaniasis in HIV positive patient - A ...

    African Journals Online (AJOL)

    Disseminated cutaneous leishmaniasis and HIV dual-infection is seldom reported. Leishmaniasis and HIV co-infection may intensify the immune defect and is the chief reason for atypical presentation and widespread progression of cutaneous leishmaniasis and its defiance to conventional therapy. Here we report a ...

  3. Conjunctival leishmaniasis in a case of disseminated cutaneous leishmaniasis.

    Science.gov (United States)

    Razeghinejad, M Reza; Monabati, Ahmad; Kadivar, Mohammad Rahim; Alborzi, Abdolvahab

    2017-01-01

    A 15-year-old female patient presented with numerous, small, papulonodular skin lesions, and hepatosplenomegaly 9 months after a treated biopsy proved cutaneous leishmaniasis. In ocular examination there were two yellowish, raised gelatinous conjunctival lesions in the left eye. The exisional conjunctival lesion biopsy revealed many Leishman bodies inside tissue histiocytes. The patient had no systemic immunologic problems (normal serum immunoglobulins, nitroblue-tetrazolium test, complement CH50 test and flow cytometry of leukocytes). The indirect immunofluorescent antibody test for Leishmania tropica (titre of 1:1024) and the leishmanin skin test were positive. DNA of L. tropica was detected by a specific polymerase chain reaction on whole blood, bone marrow and skin biopsy specimens. The skin and conjunctival lesions disappeared with miltefosine and no intraocular tissue penetration of organism happened. Conjunctival leishmaniasis should be considered in the differential diagnosis of raised conjunctival lesions in a disseminated cutaneous leishmaniasis patient and needs proper systemic therapy. © The Author(s) 2016.

  4. Cutaneous leishmaniasis

    OpenAIRE

    Ramesh V; Kumar Joginder

    2006-01-01

    ABSTRACTLeishmaniasis is considered to be zoonotic disease, caused by a protozoan parasite of the genus Leishmania, and transmitted by a bite of infected female sandfly. Primary cutaneous leishmaniasis is not common disease in Nepal, however, there were cases reported from Terai region of Nepal. The patients with cutaneous leishmaniasis present with a papule or nodule at the site of inoculation, followed by formation of crusts. Differential diagnoses of cutaneous leishmaniasis include variety...

  5. Cutaneous leishmaniasis

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    Ram Chandra Adhikari

    2017-09-01

    Full Text Available ABSTRACTLeishmaniasis is considered to be zoonotic disease, caused by a protozoan parasite of the genus Leishmania, and transmitted by a bite of infected female sandfly. Primary cutaneous leishmaniasis is not common disease in Nepal, however, there were cases reported from Terai region of Nepal. The patients with cutaneous leishmaniasis present with a papule or nodule at the site of inoculation, followed by formation of crusts. Differential diagnoses of cutaneous leishmaniasis include variety of skin diseases, inflammatory like impetigo, eczema, or granulomatous like sarcoidosis, lupus vulgaris, to skin tumor like basal cell carcinoma & squamous cell carcinoma. There are various procedures and laboratory techniques used to diagnose leishmaniasis. Punch skin biopsy is widely used & popular technique to diagnose cutaneous leishmaniasis. Different drugs like sodium stibogluconate, sodium antimony gluconate, Amphotericin B and Miltefosine: are used for its treatment. No vaccines are available for prevention. 

  6. Cutaneous Leishmaniasis

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    Mehmet Harman

    2015-12-01

    Full Text Available Leishmaniasis is used to describe a spectrum of diseases caused by the parasitic protozoa leishmania spp. and transmitted by infected female sandflies. There are three main forms of the disease; cutaneous, mucocutaneous, and visceral. According to the World Health Organization, almost 12 million people from 98 countries worldwide are currently infected with leishmaniasis, while 350 million people are at risk. It was reported that 2 million new cases are diagnosed every year, with three-fourth are cutaneous leishmaniasis (CL cases. The scientific and medical communities have learnt a lot about CL during the 20th and early 21st centuries. However, the management and control of the disease remains a difficult task. This article was focused on the most common form of the disease, cutaneous leishmaniasis, and especially its epidemiological aspects and treatment.

  7. [Cutaneous leishmaniasis].

    Science.gov (United States)

    von Stebut, E; Sunderkötter, C

    2007-05-01

    Infections with Leishmania are increasing worldwide because of tourism and job-related travel; central Europe is no exception. Infections often first become apparent after return from an endemic region. Depending on the Leishmania species and the host immune status, different forms of cutaneous (CL), mucocutaneous (MCL) (L. brasiliensis complex) or visceral leishmaniasis (L. donovani as well as L. infantum) may develop. CL may heal spontaneously with scarring but can evolve into diffuse CL (with reduced immune response to L. amazonensis, L. guyanensis, L. mexicana or L. aethiopica) or into recurrent CL. Diagnostic criteria include travel to an endemic area as well as ulcerated plaques or nodules on an exposed site which show no tendency towards healing over 3-4 weeks. Differential diagnostic considerations include ecthyma, other infectious ulcers, and malignant neoplasms. The diagnosis is confirmed by finding Leishmania in a smear or tissue biopsy, as well as by culture. Therapy options range from topical treatment of simple CL of the Old World caused by L. major to systemic therapy which is needed for most complex cases of CL as well as MCL. Miltefosine is a less toxic option to replace the antimony compounds.

  8. Further observations on clinical, histopathological, and immunological features of borderline disseminated cutaneous leishmaniasis caused by Leishmania (Leishmania amazonensis

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    Fernando T Silveira

    2005-08-01

    Full Text Available Leishmania (Leishmania amazonensis has for some time been considered as the causative agent of two distinct forms of American cutaneous leishmaniasis (ACL: localized cutaneous leishmaniasis (LCL, and anergic diffuse cutaneous leishmaniasis (ADCL. Recently, a new intermediate form of disease, borderline disseminated cutaneous leishmaniasis (BDCL, was introduced into the clinical spectrum of ACL caused by this parasite, and in this paper we record the clinical, histopathological, and immunological features of eight more BDCL patients from Brazilian Amazonia, who acquired the disease in the Pará state, North Brazil. Seven of them had infections of one to two years' evolution and presented with primary skin lesions and the occurrence of metastases at periods varying from six to 12 months following appearance of the first lesion. Primary skin lesions ranged from 1-3 in number, and all had the aspect of an erythematous, infiltrated plaque, variously located on the head, arms or legs. There was lymphatic dissemination of infection, with lymph node enlargement in seven of the cases, and the delayed hypersensitivity skin-test (DTH was negative in all eight patients prior to their treatment. After that, there was a conversion of DTH to positive in five cases re-examined. The major histopathological feature was a dermal mononuclear infiltration, with a predominance of heavily parasitized and vacuolated macrophages, together with lymphocytes and plasma cells. In one case, with similar histopathology, the patient had acquired his infection seven years previously and he presented with the largest number of disseminated cutaneous lesions. BDCL shows clinical and histopathological features which are different from those of both LCL and ADCL, and there is a good prognosis of cure which is generally not so in the case of frank ADCL.

  9. First case report of atypical disseminated cutaneous leishmaniasis in an opium abuser in Iran

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    Seyed Ahmad Hashemi

    2018-02-01

    Full Text Available ABSTRACT Leishmaniasis is a worldwide tropical infectious disease caused by different species of intracellular protozoa parasites of the genus Leishmania . Herein, we report a 78-year-old man with unusual diffuse cutaneous leishmaniasis (DCL who had a history of opium abuse and chronic obstructive pulmonary disease (COPD. He had multiple papular, crusted and severely ulcerated lesions extended to his arm and chest. Direct smears and skin punch biopsy of the lesions were suggestive of leishmaniasis. Parasite DNA was amplified from ulcers, and identified as Leishmania major by PCR-RFLP, confirmed by sequencing analyses. The aim of the current study was to bring to attention this atypical form of disease in CL endemic countries. Thus, this is the first case of DCL in an opium abuser with COPD due to L. major in Northeastern Iran indicating that atypical and extensive forms of CL (DCL owing to L. major are increasing in Iran.

  10. Canine cutaneous leishmaniasis

    OpenAIRE

    Sasani, F.; Javanbakht, J.; Samani, R.; Shirani, D.

    2014-01-01

    Canine cutaneous leishmaniasis (CCL) is a significant veterinary problem. Infected dogs also serve as parasite reservoirs and contribute to human transmission of cutaneous leishmaniasis. Histologically, the lesions were nodular to diffuse interstitial granulomatous dermatitis with histiocytic pseudorosettes together with numerous amastigotes within macrophages and occasionally within the interstitium. Organisms were often contained within clear and intracellular vacuoles. The other inflammato...

  11. Recurrent cutaneous leishmaniasis

    OpenAIRE

    Gomes,Ciro Martins; Damasco,Fabiana dos Santos; Morais,Orlando Oliveira de; Paula,Carmen Dea Ribeiro de; Sampaio,Raimunda Nonata Ribeiro

    2013-01-01

    We present a case of an 18-year-old male patient who, after two years of inappropriate treatment for cutaneous leishmaniasis, began to show nodules arising at the edges of the former healing scar. He was immune competent and denied any trauma. The diagnosis of recurrent cutaneous leishmaniasis was made following positive culture of aspirate samples. The patient was treated with N-methylglucamine associated with pentoxifylline for 30 days. Similar cases require special attention mainly because...

  12. Canine Cutaneous Leishmaniasis: Dissemination and Tissue Tropism of Genetically Distinct Leishmania (Viannia braziliensis Populations

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    Guilherme Marx de Oliveira

    2013-01-01

    Full Text Available Little is known regarding the internal dissemination of initial cutaneous lesions and tissue tropism of Leishmania (Viannia braziliensis populations in naturally infected dogs. The aim of this study was to investigate genetic polymorphisms of L. (V. braziliensis populations in different anatomic sites of naturally infected dogs by using polymerase chain reaction (PCR and low-stringency single specific primer-PCR (LSSP-PCR techniques. The amplified products were analyzed by LSSP-PCR to investigate the genetic variability of the parasite populations present in different anatomical sites. Twenty-three out of the 52 samples gave PCR-positive results. The existence of L. (V. braziliensis strains that remained restricted to cutaneous lesions and others showing characteristics of dissemination to internal organs and healthy skin was observed. LSSP-PCR and numerical analyses revealed that parasite populations that do not disseminate were genetically similar and belonged to a separate phenetic cluster. In contrast, populations that showed spreading to internal organs displayed a more polymorphic genetic profile. Despite the heterogeneity, L. (V. braziliensis populations with identical genetic profiles were observed in popliteal and cervical lymph nodes of the same animal. Our results indicate that infection in dogs can be manifested by dissemination and tissue tropism of genetically distinct populations of L. (V. braziliensis.

  13. Cutaneous leishmaniasis in Assam

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    Baishya B

    1996-01-01

    Full Text Available A case of cutaneous leishmaniasis is being reported from Assam, a North Eastern state of India. Clinical feature and direct smear examination of the case confirmed the diagnosis. Dramatic resolution of the lesions with sodium antimony gluconate during 10 days of therapy was achieved.

  14. Canine cutaneous leishmaniasis.

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    Sasani, F; Javanbakht, J; Samani, R; Shirani, D

    2016-03-01

    Canine cutaneous leishmaniasis (CCL) is a significant veterinary problem. Infected dogs also serve as parasite reservoirs and contribute to human transmission of cutaneous leishmaniasis. Histologically, the lesions were nodular to diffuse interstitial granulomatous dermatitis with histiocytic pseudorosettes together with numerous amastigotes within macrophages and occasionally within the interstitium. Organisms were often contained within clear and intracellular vacuoles. The other inflammatory cells, which were present in the biopsies of the Leishmania-infected dog, were lymphocytes and plasma cells. The histopathology results emphasized the role of dog, particularly asymptomatic dog, as reservoirs for CCL because of the high cutaneous parasite loads. These results may help to explain the maintenance of high transmission rates and numbers of CCL cases in endemic urban regions.

  15. Epidemiological studies on cutaneous leishmaniasis in Ad ...

    African Journals Online (AJOL)

    Eastern Province of Saudi Arabia, mainly in the. Al-Hassa Oasis. The vector of the disease in. Saudi Arabia is the sand fly and the alternative natural hosts are desert rodents. Leishmania tropica, the causative agent of cutaneous leishmaniasis in the Al-Hassa Oasis, classically causes skin lesions without dissemination. The.

  16. Miltefosine in cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    Rahman, S.B.; Mumtaz, N.; Bari, A.

    2007-01-01

    To determine the efficacy of oral Miltefosine in patients with cutaneous leishmaniasis and its comparison with the most effective standard treatment, pentavalent antimony compound. Thirty patients, 12 years of age or older clinically and histopathologically diagnosed as cutaneous leishmaniasis were selected. Fifteen patients received orally administered Miltefosine 2.5mg/kg/day for 28 days and remaining 15 received injectable pentavalent antimony 20mg/kg/day for 28 days. Pre-treatment complete physical examination was done along with necessary laboratory investigations in all cases. These were repeated again after 2 weeks and at the end of treatment to note any deviation from the normal limits. Groups were almost matched in terms of age, weight, parasitological score. The efficacy was evaluated by ulcer size, before therapy, at 2 weeks and 4 weeks. Patients were followed-up at 3 and 6 months. Efficacy of two groups was statistically compared by calculating p-value by z-test. All patients completed the study without any serious complication. Lesions improved significantly and only scarring and post-inflammatory pigmentation was left. At 3 months, cure rate was 93% in group A and it was 73.33% in group B while at the end of 6 months, it was 86% and 66.6% respectively. This difference between efficacies of two groups was not found to be statistically significant (p-value >0.5). Miltefosine appears to be a safe and effective alternative to currently used therapies. The striking advantage of Miltefosine is its oral administration and it may also be helpful in regions where parasites are resistant to current agents. (author)

  17. Unusual Presentation of Cutaneous Leishmaniasis: Ocular Leishmaniasis

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    Masoud Doroodgar

    2017-01-01

    Full Text Available The leishmaniases are parasitic diseases that are transmitted to humans by infected female sandflies. Cutaneous leishmaniasis (CL is one of 3 main forms of the disease. CL is the most common form of the disease and is endemic in many urban and rural parts of Iran and usually caused by two species of Leishmania: L. major and L. tropica. We report a case of unusual leishmaniasis with 25 lesions on exposed parts of the body and right eyelid involvement (ocular leishmaniasis. The patient was a 75-year-old male farmer referred to health care center in Aran va Bidgol city. The disease was diagnosed by direct smear, culture, and PCR from the lesions. PCR was positive for Leishmania major.

  18. Lupoid Cutaneous Leishmaniasis: Review

    OpenAIRE

    Maryam Amin Moghadam; Vahid Mashayekhi; Ali Taheriyan; Naeme Organji

    2016-01-01

    Introduction: Leishmaniasis is an infectious disease currently threatens 350 million people in 88 countries. Lupoid leishmaniasis occurs as a result of the host response, in which despite an intensified hypersensitivity the cell mediated immunity cannot sterilize lesions. A chronic granulomatous inflammation remains active for a long time. To summarize the articles published about Lupoid leishmaniasis. Materials and Methods: a systematic web base search was conducted in PubMed up to July 2015...

  19. Cutaneous leishmaniasis in North Dakota.

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    Douvoyiannis, Miltiadis; Khromachou, Tamim; Byers, Norman; Hargreaves, James; Murray, Henry W

    2014-09-01

    In the United States, autochthonous cutaneous leishmaniasis caused by infection with Leishmania mexicana has been reported from Texas and Oklahoma. Here, we describe a child with 2 new features: cutaneous infection acquired outside of the south-central United States (in North Dakota) and infection caused by Leishmania donovani species complex. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. Many faces of cutaneous leishmaniasis

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    Bari Arfan Ul

    2008-01-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is known for its clinical diversity and increasing numbers of new and rare variants of the disease are being reported these days. Aim: The aim of this descriptive study was to look for and report the atypical presentations of this common disease occurring in Pakistan. Methods: The study was carried out in three hospitals (MH, Rawalpindi; PAF Hospital, Sargodha; and CMH, Muzaffarabad from 2002 to 2006. Military and civilian patients of all ages, both males and females, belonging to central and north Punjab province and Kashmir were included in the study. Clinical as well as parasitological features of cutaneous leishmaniasis were studied. The unusual lesions were photographed and categorized accordingly using simple descriptive statistics. Results: Out of 718 patients of cutaneous leishmaniasis, 41 (5.7% had unusual presentations. The commonest among unusual morphologies was lupoid leishmaniasis 14 (34.1%, followed by sporotrichoid 5 (12.1%, paronychial 3 (7.3%, lid leishmaniasis 2 (4.9%, psoriasiform 2 (4.9%, mycetoma-like 2 (4.9%, erysipeloid 2 (4.9%, chancriform 2 (4.9%, whitlow 1 (2.4%, scar leishmaniasis 1 (2.4%, DLE-like 1 (2.4%, ′squamous cell carcinoma′-like 1 (2.4%, zosteriform 1 (2.4%, eczematous 1 (2.4%, verrucous 1 (2.4%, palmar/plantar 1 (2.4% and mucocutaneous 1 (2.4%. Conclusion: In Pakistan, an endemic country for CL, the possibility of CL should be kept in mind while diagnosing common dermatological diseases like erysipelas, chronic eczema, herpes zoster, paronychia; and uncommon disorders like lupus vulgaris, squamous cell carcinoma, sporotrichosis, mycetoma and other deep mycoses.

  1. Lupoid Cutaneous Leishmaniasis: Review

    Directory of Open Access Journals (Sweden)

    Maryam Amin Moghadam

    2016-07-01

    Full Text Available Introduction: Leishmaniasis is an infectious disease currently threatens 350 million people in 88 countries. Lupoid leishmaniasis occurs as a result of the host response, in which despite an intensified hypersensitivity the cell mediated immunity cannot sterilize lesions. A chronic granulomatous inflammation remains active for a long time. To summarize the articles published about Lupoid leishmaniasis. Materials and Methods: a systematic web base search was conducted in PubMed up to July 2015. We included articles with available abstract in English language. Manual searching was done within the reference list of articles.  Results: Two reviewers independently reviewed and assessed eligibility criteria, assessed quality, and extracted data. Conclusion: Some patients have periods of relapse and remission at the site of inoculation of parasites and others suffer from chronic injury for years. In the case of effective disease treatment several studies have been conducted, so far, no satisfactory results have been achieved.

  2. New world cutaneous leishmaniasis

    OpenAIRE

    Trufant, Joshua W; Lewin, Jesse M; Hale, Christopher S; Meehan, Shane A; Pomeranz, Miriam Keltz

    2015-01-01

    A 24-year-old Bangladeshi man presented with a 12-week history of a pruritic papule on his left elbow that had enlarged and ulcerated. He was without any constitutional or systemic symptoms. He reported a history of extensive travel in the two years prior to presentation that included Bangladesh, South and Central America, and Mexico. Histopathologic features were consistent with leishmaniasis. Speciation by the Centers for Disease Control showed L. brasiliensis.

  3. Chemotherapy of Cutaneous Leishmaniasis

    Science.gov (United States)

    2012-10-01

    country of Colombia a large numbers of cutaneous leishmania cases (over 40,000) were reported between 2005 and 2009. It was caused by Leishmania...Activity Relationships of Peroxide- Based Artemisinin Antimalarials. In: Biologically Active Natural Products: Pharmaceuticals , Cutler, S.J., Cutler

  4. Chronic zosteriform cutaneous leishmaniasis

    OpenAIRE

    Omidian M; Mapar M

    2006-01-01

    Cutaneous leishmanasis (CL) may present with unusual clinical variants such as acute paronychial, annular, palmoplantar, zosteriform, erysipeloid, and sporotrichoid. The zosteriform variant has rarely been reported. Unusual lesions may be morphologically attributed to an altered host response or owing to an atypical strain of parasites in these lesions. We report a patient with CL in a multidermatomal pattern on the back and buttock of a man in Khozestan province in the south of Iran. To our ...

  5. Chronic zosteriform cutaneous leishmaniasis

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    Omidian M

    2006-01-01

    Full Text Available Cutaneous leishmanasis (CL may present with unusual clinical variants such as acute paronychial, annular, palmoplantar, zosteriform, erysipeloid, and sporotrichoid. The zosteriform variant has rarely been reported. Unusual lesions may be morphologically attributed to an altered host response or owing to an atypical strain of parasites in these lesions. We report a patient with CL in a multidermatomal pattern on the back and buttock of a man in Khozestan province in the south of Iran. To our knowledge, this is the first reported case of multidermatomal zosteriform CL. It was resistant to conventional treatment but responded well to a combination of meglumine antimoniate, allopurinol, and cryotherapy.

  6. Cutaneous Leishmaniasis with Unusual Presentation

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    N Bagherani

    2009-05-01

    Full Text Available "nThis case report states a 25-year-old woman, residing in the city of Dezfool, Khuzestan Province, south of Iran with the diagnosis of cutaneous leishmaniasis in June 2008. Her skin lesion had de­veloped from 8 months earlier as a nodule on her left arm, 1×3 cm in diameter. Because of sever­ity of the lesion, we prescribed meglumine antimoniate intralesionally with giving up her breast feeding. After 6 months follow-up, no recurrence was seen.

  7. Occupationally Acquired American Cutaneous Leishmaniasis

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    Maria Edileuza Felinto de Brito

    2012-01-01

    Full Text Available We report two occupationally acquired cases of American cutaneous leishmaniasis (ACL: one accidental laboratory autoinoculation by contaminated needlestick while handling an ACL lesion sample, and one acquired during field studies on bird biology. Polymerase chain reaction (PCR assays of patient lesions were positive for Leishmania, subgenus Viannia. One isolate was obtained by culture (from patient 2 biopsy samples and characterized as Leishmania (Viannia naiffi through an indirect immunofluorescence assay (IFA with species-specific monoclonal antibodies (mAbs and by multilocus enzyme electrophoresis (MLEE. Patients were successfully treated with N-methyl-glucamine. These two cases highlight the potential risks of laboratory and field work and the need to comply with strict biosafety procedures in daily routines. The swab collection method, coupled with PCR detection, has greatly improved ACL laboratory diagnosis.

  8. Diffuse cutaneous leishmaniasis: Co-infection with human immunodeficiency virus (HIV

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    Chaudhary Raju

    2008-01-01

    Full Text Available Cutaneous leishmaniasis is a disease caused by intracellular protozoal parasites belonging to the genus Leishmania. Immune suppression caused by HIV infection is an important factor for atypical presentation and widespread progression of cutaneous leishmaniasis. Diffuse (disseminated cutaneous leishmaniasis and HIV co-infection is emerging as an extremely serious new disease. A 38-year-old HIV-positive man presented with a 12-month history of a progressive papule and nodular eruptions on face and extremities with infiltrations of nasal and oral mucosa. We report the case due to its atypical, widespread muco-cutaneous presentation masquerading as lepromatous leprosy.

  9. Acute disseminated cutaneous candidiasis.

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    Fong, P H; Chan, H L; Lee, Y S; Wong, H B

    1988-10-01

    Acute disseminated candidiasis is a serious and difficult problem often seen in immunocompromised states. Appearance of a characteristic skin eruption is helpful in the diagnostic. We report below a case report of an eight year old girl with aplastic anemia who had received multiple courses of antibiotics. A profuse monomorphic papular nodular eruption subsequently appeared on the face, palms and soles. Candida tropicalis was identified from the skin biopsy taken from one such lesion.

  10. Cutaneous Manifestations of Human and Murine Leishmaniasis.

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    Scorza, Breanna M; Carvalho, Edgar M; Wilson, Mary E

    2017-06-18

    The leishmaniases are diseases caused by pathogenic protozoan parasites of the genus Leishmania. Infections are initiated when a sand fly vector inoculates Leishmania parasites into the skin of a mammalian host. Leishmania causes a spectrum of inflammatory cutaneous disease manifestations. The type of cutaneous pathology is determined in part by the infecting Leishmania species, but also by a combination of inflammatory and anti-inflammatory host immune response factors resulting in different clinical outcomes. This review discusses the distinct cutaneous syndromes described in humans, and current knowledge of the inflammatory responses associated with divergent cutaneous pathologic responses to different Leishmania species. The contribution of key hematopoietic cells in experimental cutaneous leishmaniasis in mouse models are also reviewed and compared with those observed during human infection. We hypothesize that local skin events influence the ensuing adaptive immune response to Leishmania spp. infections, and that the balance between inflammatory and regulatory factors induced by infection are critical for determining cutaneous pathology and outcome of infection.

  11. Exploring Adaptation Scenarios : Cutaneous Leishmaniasis and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Exploring Adaptation Scenarios : Cutaneous Leishmaniasis and Climate Change in Algeria. In Algeria, climate change is associated with modifications in land use and their interaction with water, with the result that the last 20 years have seen an increase in ... A new publication explores the ethics of these relationships.

  12. Mefloquine in the treatment of cutaneous leishmaniasis

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    Correia Dalmo

    1999-01-01

    Full Text Available Three cases of cutaneous leishmaniasis were treated orally with a mefloquine dose of 4.2mg/kg/day for six days in the Teaching Hospital of the Faculdade de Medicina do Triângulo Mineiro, Uberaba, MG, Brazil. Three weeks later a new series was repeated. No patient was cured.

  13. Coinfection of cutaneous leishmaniasis and hiv infection | Lartey ...

    African Journals Online (AJOL)

    Cutaneous leishmaniasis has recently been discovered in some parts of Ghana. The case of an HIV infected patient presenting with cutaneous leishmaniasis at the Korle-Bu Teaching Hospital is discussed. The diagnosis of leishmaniasis was con-firmed by histology. Also highlighted is the fact that this is the first reported ...

  14. Pharmacokinetics of miltefosine in Old World cutaneous leishmaniasis patients

    NARCIS (Netherlands)

    Dorlo, Thomas P. C.; van Thiel, Pieter P. A. M.; Huitema, Alwin D. R.; Keizer, Ron J.; de Vries, Henry J. C.; Beijnen, Jos H.; de Vries, Peter J.

    2008-01-01

    The pharmacokinetics of miltefosine in leishmaniasis patients are, to a great extent, unknown. We examined and characterized the pharmacokinetics of miltefosine in a group of patients with Old World (Leishmania major) cutaneous leishmaniasis. Miltefosine plasma concentrations were determined in

  15. Cutaneous leishmaniasis with lymphadenopathy due to Leishmania donovani

    NARCIS (Netherlands)

    Faber, W. R.; Wonders, J.; Jensema, A. J.; Chocholova, E.; Kager, P. A.

    2009-01-01

    Summary We describe a case of cutaneous leishmaniasis with lymphadenopathy due to Leishmania donovani, which was successfully treated with oral miltefosine. Given the increased prevalence of travelling, patients presenting with lymph-node enlargement should have leishmaniasis included in the

  16. Cutaneous leishmaniasis in Dutch military

    NARCIS (Netherlands)

    van Thiel, P.P.A.M.

    2010-01-01

    Leishmaniasis is een tropische ziekte veroorzaakt door een parasiet die wordt overgebracht door de zandvlieg. Pieter-Paul van Thiel beschrijft de besmetting van militairen tijdens drie missies in Afghanistan, en jungletrainingen in Suriname en Belize. Bij een missie in Noord-Afghanistan in 2005

  17. American cutaneous leishmaniasis in infancy and childhood.

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    Paniz-Mondolfi, Alberto E; Talhari, Carolina; García Bustos, María F; Rosales, Tamara; Villamil-Gomez, Wilmer E; Marquez, Marilianna; Pérez Alvarez, Alexandra M; Tálamo Sánchez, Alejandra I; Rodriguez-Morales, Alfonso J

    2017-12-01

    Infant and young child skin diseases are among the most common features of morbidity throughout the tropics. Because the skin is directly exposed to the environment, it is considerably affected by climatic and local conditions such as vectors and microorganisms, as in the case of leishmaniasis. In America the observed magnitude of cutaneous leishmaniasis in children has led to the study of increased risk of exposure of this group due to the possibility of peri- and intradomiciliary transmission. The present review pretends to make a concrete approach all through the broad and main figures of this parasitic disease, including the clinical, physiopathological, epidemiological, diagnostic, and therapeutic aspects, in order to be used as a practical source of reference for pediatricians leading with tropical cutaneous pathology in the region. © 2017 The International Society of Dermatology.

  18. in experimental treatment of old world cutaneous leishmaniasis ...

    African Journals Online (AJOL)

    In vivo efficacy of oral and intraperitoneal administration of extracts of Warburgia ugandensis (Canellaceae) in experimental treatment of old world cutaneous leishmaniasis caused by Leishmania major .

  19. The immune microenvironment in cutaneous leishmaniasis.

    Science.gov (United States)

    Jabbour, M N; Issa, G; Charafeddine, K; Simaan, Y; Karam, M; Khalifeh, H; Habib, R; Khalifeh, I

    2015-06-01

    Cutaneous leishmaniasis is an infection that has spread to non-endemic regions, stimulating recent interest for the enhanced understanding of this disease. Downregulation of the CD1a receptor on Langerhans cells has been described in various cutaneous infections. In this study, the immune response across different Ridley patterns and parasitic indices is outlined in a case series of cutaneous leishmaniasis. Skin punch biopsies from the interface of normal and lesional cutaneous leishmaniasis were collected from 33 patients with molecularly confirmed Leishmania tropica or L. major infection. Ridley patterns (2-5) were assessed for various clinicopathological features including age, gender, disease duration, parasitic index and constituents of the inflammatory infiltrate. CD1a, CD68, CD3, CD4, CD8, CD20 and CD138 stains were performed on normal skin tissue, cutaneous leishmaniasis biopsies and cytospin/cell block cytology preparations of cultured leishmania promastigotes. CD1a was quantified per mm2 in the epidermis and dermis. The remaining stains were graded according to a 4-tiered grading system [0 (0-4%); 1 (5-24%); 2 (25-49%); 3 (50-74%) and 4 (75-100%). Total CD1a expression significantly decreased (14-fold) from parasitic indices (0-2) to (5-6); (ρ < 0.001). CD1a expression in the epidermis was at least 5-fold lower than normal skin (58 vs. 400 cells/mm2), inversely correlating with the parasitic index. There was an increase in dermal CD1a Langerhans cells (33 vs. 0 cells/mm² in the dermis). CD1a and CD68 staining of amastigotes was strong and diffuse, whereas promastigotes were negative. The major inflammatory infiltrate, in all Ridley patterns, consisted of macrophages and double-negative CD3(+) CD4(-) CD8(-) T lymphocytes. The double-negative CD3 T cells formed a ring around the parasitic laden macrophages. Apart from CD1a, there was no significant difference in inflammatory markers between the various Ridley patterns and parasitic indices. Disease

  20. Anthroponotic Cutaneous Leishmaniasis, Kabul, Afghanistan

    Science.gov (United States)

    Mohsen, Mohammad; Aadil, Khoksar; Sidiqi, Majeed; Erasmus, Panna; Coleman, Paul G.

    2003-01-01

    A prevalence survey in Kabul City showed that 2.7% and 21.9% of persons have active leishmaniasis lesions or scars, respectively. Incidence of disease was estimated to be 2.9% (29 cases/1,000 persons per year; 95% confidence interval 0.018 to 0.031). Disease was associated with age and gender; logistic regression analyses showed significant clustering of cases. PMID:12781016

  1. Cutaneous Manifestations of Human and Murine Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Breanna M. Scorza

    2017-06-01

    Full Text Available The leishmaniases are diseases caused by pathogenic protozoan parasites of the genus Leishmania. Infections are initiated when a sand fly vector inoculates Leishmania parasites into the skin of a mammalian host. Leishmania causes a spectrum of inflammatory cutaneous disease manifestations. The type of cutaneous pathology is determined in part by the infecting Leishmania species, but also by a combination of inflammatory and anti-inflammatory host immune response factors resulting in different clinical outcomes. This review discusses the distinct cutaneous syndromes described in humans, and current knowledge of the inflammatory responses associated with divergent cutaneous pathologic responses to different Leishmania species. The contribution of key hematopoietic cells in experimental cutaneous leishmaniasis in mouse models are also reviewed and compared with those observed during human infection. We hypothesize that local skin events influence the ensuing adaptive immune response to Leishmania spp. infections, and that the balance between inflammatory and regulatory factors induced by infection are critical for determining cutaneous pathology and outcome of infection.

  2. Unusual presentation of cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Lahiry Anup Kumar

    2002-01-01

    Full Text Available Cutaneous leis hmaniasis is endemic in some regions of Saudi Arabia. A case with uncommon hyperkeratotic type of lesion was seen. Being an endemic zone, a slit- skin smear was done and stained with Giemsa′s stain. Smears howed Leishman Donovan bodies within and outside the macrophages. Significant improvement, followed by complete resolution of the lesion was seen with ketoconazole treatment.

  3. Miltefosine for Old World cutaneous leishmaniasis: An experimental ...

    African Journals Online (AJOL)

    Background: Leishmaniasis is one of the neglected diseases included in the World Health Organization's list of the top guns of antimicrobial resistance. Miltefosine (MIL) was the first successful oral agent used against visceral leishmaniasis in India. As regards cutaneous leishmaniasis (CL), multiple experimental and ...

  4. Cutaneous Leishmaniasis – Dermoscopic Findings And Cryotherapy

    Directory of Open Access Journals (Sweden)

    Dobrev Hristo P.

    2015-03-01

    Full Text Available We present a 60-year-old male patient who, three months after a holiday in Southern Greece, found a small ‘pimple’ on his back, which gradually got as big as a small walnut, the central part becoming ulcerated and scabby. Dermatological examination found an erythematous-to-livid nodular lesion on the right shoulder; it was 16 mm in diameter with central ulceration, covered with brownish crust which discharged pus-like secretion upon pressure. Microscope examination of Romanowsky-Giemsa stained lesion material detected amastigote forms of Leishmania tropica. The culture investigation and serological tests for leishmaniasis were negative. Dermoscopy of the lesion found the following features: erythema, hyperkeratosis, central ulceration covered with brownish crust, “yellow tears-like” structures and “white starburst-like” patterns, and various vascular structures (including dotted vessels, comma-shaped vessels, hairpin- and glomerular-like vessels. The patient was diagnosed with cutaneous leishmaniasis and underwent four cryotherapy sessions every other week with excellent therapeutic results - complete resolution of infiltrate with subsequent gentle hypopigmented scarring. In conclusion, dermoscopy is an easily accessible non-invasive method which can be useful for the diagnosis of cutaneous leishmaniasis. Cryotherapy is the treatment of choice for single skin lesions.

  5. Isolation of Leishmania tropica from an Ethiopian cutaneous leishmaniasis patient

    NARCIS (Netherlands)

    Hailu, Asrat; Di Muccio, Trentina; Abebe, Tamrat; Hunegnaw, Mesfin; Kager, Piet A.; Gramiccia, Marina

    2006-01-01

    Cutaneous leishmaniasis (CL) in the Old World is caused mainly by three species of Leishmania: L. major, L. tropica and L. aethiopica, and sporadically by L. infantum and L. donovani. In Ethiopia, zoonotic cutaneous leishmaniasis, caused by L. aethiopica, is a major public health problem affecting

  6. Cutaneous leishmaniasis in Sudan: an update | El Hassan ...

    African Journals Online (AJOL)

    Cutaneous leishmaniasis due to L.major is now endemic in many parts of the northern Sudan. In this up-date we discuss the clinical manifestations of cutaneous leishmaniasis, its diagnosis and treatment. The most common clinical forms are nodular, noduloulcerative and ulcerative lesions. Less common forms are ...

  7. The changing profile of cutaneous leishmaniasis agent in a central ...

    African Journals Online (AJOL)

    Cutaneous leishmaniasis in Iran is usually caused by Leishmania major or L. tropica. However, the direct examination or the cultures of biopsies for diagnosis are not very sensitive. The objective of this study was to identify the responsible species obtained from patients suspected of cutaneous leishmaniasis referred to the ...

  8. Isolated cutaneous leishmaniasis over face – A diagnostic dilemma ...

    African Journals Online (AJOL)

    Isolated cutaneous leishmaniasis over face – A diagnostic dilemma. Santosh K. Swain, Ishwar C. Behera, Mahesh C. Sahu, Maitreyee Panda. Abstract. Cutaneous Leishmaniasis (CL) is a disease caused by an intracellular protozoa belong to the genus Leishmania, transmitted by the bite of a sandfly. It has diverse clinical ...

  9. The changing profile of cutaneous leishmaniasis agent in a central ...

    African Journals Online (AJOL)

    introduced to non-endemic areas, leading to the emergence of new zoonotic cutaneous leishmaniasis (ZCL) foci, provided that ecological conditions such as the presence of potential vectors and reservoir hosts, are in favor of the parasite lifecycle. Therefore, we could hypothesize that zoonotic cutaneous leishmaniasis had ...

  10. Disseminated cutaneous sporotrichosis in patient with alcoholism

    Directory of Open Access Journals (Sweden)

    Ana Maria Benvegnú

    Full Text Available Abstract Sporotrichosis is the most prevalent subcutaneous mycosis and is characterized by a subacute or chronic development of a cutaneous or subcutaneous nodular lesion. It is caused by the dimorphic fungus Sporothrix spp, which may manifest in different clinical forms. The disseminated cutaneous form is uncommon and is more likely to occur in immunocompromised patients. We report a 47-year-old male patient with multiple cutaneous and subcutaneous nodules. The patient was diagnosed with disseminated cutaneous sporotrichosis based on the isolation and identification of Sporothrix spp. The patient was treated with potassium iodide, which resulted in clinical improvement of the lesions.

  11. Leishmaniasis in Turkey: Visceral and cutaneous leishmaniasis caused by Leishmania donovani in Turkey

    NARCIS (Netherlands)

    Özbilgin, Ahmet; Harman, Mehmet; Karakuş, Mehmet; Bart, Aldert; Töz, Seray; Kurt, Özgür; Çavuş, İbrahim; Polat, Erdal; Gündüz, Cumhur; van Gool, Tom; Özbel, Yusuf

    2017-01-01

    In Turkey, the main causative agents are Leishmania tropica (L. tropica) and Leishmania infantum (L. infantum) for cutaneous leishmaniasis (CL) and L. infantum for visceral leishmaniasis (VL). In this study, we investigated leishmaniasis cases caused by L. donovani and established animal models for

  12. Disseminated cutaneous histoplasmosis in newly diagnosed HIV

    OpenAIRE

    Soza, Gabriela M.; Patel, Mahir; Readinger, Allison; Ryan, Caitriona

    2016-01-01

    We present a woman with a widespread severe papulopustular eruption, fever, and fatigue of 5 weeks' duration. HIV infection was diagnosed, with an absolute CD4+ count of 3 cells/µL. The eruption was consistent with disseminated cutaneous histoplasmosis. The clinical manifestations and management of cutaneous histoplasmosis are reviewed.

  13. Prevalence of Cutaneous Leishmaniasis in Ramshir, Iran; an Epidemiological Study

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    Vazirianzadeh B.* PhD,

    2014-08-01

    Full Text Available Aims Cutaneous leishmaniasis is a prevalent parasitological disease with diverse clinical manifestations in Iran. Therefore, the present retrospective study carried out to describe the demographic features of cutaneous leishmaniasis in Ramshir, Iran. Materials & Methods This descriptive study was performed on 136 cutaneous leishmaniasis patients whose data were recorded in the Ramshir health center during 2006-9. Demographic information of patients including age, sex, habitat and sites of lesions, month and years of incidence were recorded. The data were analyzed by SPSS 16 software. Findings Totally 79 patients (58.1% resided in urban areas and the born to 9 years (49.3% was recognized as the most infected age group. Hands (41.2% had the highest rates of cutaneous leishmaniasis lesions followed by face (36.0% and foot (22.8%. The maximum number of cutaneous leishmaniasis lesions was reported in March. Conclusion As cutaneous leishmaniasis in Ramshir seemed to be an endemic rural type, the appropriate preventing measures regarding to the rural cutaneous leishmaniasis should be considered to decrease incidence of the disease in the region.

  14. Sporotrichoid cutaneous leishmaniasis due to Leishmania major of different zymodemes in the Sudan and Saudi Arabia: a comparative study

    DEFF Research Database (Denmark)

    Gaafar, A; Fadl, A; el Kadaro, A Y

    1994-01-01

    Sporotrichoid cutaneous leishmaniasis is due to dissemination of amastigotes via the lymphatics to the subcutaneous tissues. A comparison was made between the potential to disseminate by this route of 2 parasites of different zymodemes in Sudan and Saudi Arabia. In Sudan cutaneous leishmaniasis...... is caused by Leishmania major zymodeme LON-1, and in Saudi Arabia by L. major LON-4. Sporotrichoid leishmaniasis was significantly more common in Sudan, occurring in 23% of patients compared with 10% in Saudi Arabia. Lymph node involvement was slightly more prevalent in the Sudan. Clinical and pathological...... differences between subcutaneous nodules, particularly when they ulcerate, and multiple primary cutaneous lesions are described and treatment of localized and sporotrichoid leishmaniasis is discussed. The pathological features of the primary lesions in the Sudan and Saudi Arabia were similar....

  15. Sporotrichoid cutaneous leishmaniasis due to Leishmania major of different zymodemes in the Sudan and Saudi Arabia: a comparative study

    DEFF Research Database (Denmark)

    Gaafar, A; Fadl, A; el Kadaro, A Y

    1994-01-01

    Sporotrichoid cutaneous leishmaniasis is due to dissemination of amastigotes via the lymphatics to the subcutaneous tissues. A comparison was made between the potential to disseminate by this route of 2 parasites of different zymodemes in Sudan and Saudi Arabia. In Sudan cutaneous leishmaniasis...... differences between subcutaneous nodules, particularly when they ulcerate, and multiple primary cutaneous lesions are described and treatment of localized and sporotrichoid leishmaniasis is discussed. The pathological features of the primary lesions in the Sudan and Saudi Arabia were similar....... is caused by Leishmania major zymodeme LON-1, and in Saudi Arabia by L. major LON-4. Sporotrichoid leishmaniasis was significantly more common in Sudan, occurring in 23% of patients compared with 10% in Saudi Arabia. Lymph node involvement was slightly more prevalent in the Sudan. Clinical and pathological...

  16. Two Cases of Cutaneous Leishmaniasis Seen in Trivandrum

    Directory of Open Access Journals (Sweden)

    M Lohidakshan Unnithen

    1988-01-01

    Full Text Available Two cases of cutaneous leishmaniasis in Trivandrum acquired the infection while residing in Saudi Arabia. One patient responded to trivalent antimony (Fantorin and the other to dapsone.

  17. Proteome profiling of human cutaneous leishmaniasis lesion.

    Science.gov (United States)

    da Silva Santos, Claire; Attarha, Sanaz; Saini, Ravi Kanth; Boaventura, Viviane; Costa, Jackson; Khouri, Ricardo; Barral-Netto, Manoel; Brodskyn, Cláudia Ida; Souchelnytskyi, Serhiy

    2015-02-01

    In this study, we used proteomics and biological network analysis to evaluate the potential biological processes and components present in the identified proteins of biopsies from cutaneous leishmaniasis (CL) patients infected by Leishmania braziliensis in comparison with normal skin. We identified 59 proteins differently expressed in samples from infected and normal skin. Biological network analysis employing identified proteins showed the presence of networks that may be involved in the cell death mediated by cytotoxic T lymphocytes. After immunohistochemical analyses, the expression of caspase-9, caspase-3, and granzyme B was validated in the tissue and positively correlated with the lesion size in CL patients. In conclusion, this work identified differentially expressed proteins in the inflammatory site of CL, revealed enhanced expression of caspase-9, and highlighted mechanisms associated with the progression of tissue damage observed in lesions.

  18. Miltefosine for Old World cutaneous leishmaniasis: An experimental ...

    African Journals Online (AJOL)

    Maha M. Eissa

    2012-06-21

    Jun 21, 2012 ... Abstract Background: Leishmaniasis is one of the neglected diseases included in the World. Health Organization's list of the top guns of antimicrobial resistance. Miltefosine (MIL) was the first successful oral agent used against visceral leishmaniasis in India. As regards cutaneous leish- maniasis (CL) ...

  19. Ongoing epidemic of cutaneous leishmaniasis among Syrian refugees, Lebanon.

    Science.gov (United States)

    Saroufim, Maya; Charafeddine, Khalil; Issa, Grace; Khalifeh, Haifaa; Habib, Robert H; Berry, Atika; Ghosn, Nada; Rady, Alissar; Khalifeh, Ibrahim

    2014-10-01

    In September 2012, a cutaneous leishmaniasis outbreak began among Syrian refugees in Lebanon. For 948 patients in whom leishmaniasis was not confirmed, we obtained samples for microscopic confirmation and molecular speciation. We identified Leishmania tropica in 85% and L. major in 15% of patients. After 3 months of megulamine antimonite therapy, patients initial cure rate was 82%.

  20. Ongoing Epidemic of Cutaneous Leishmaniasis among Syrian Refugees, Lebanon1

    Science.gov (United States)

    Saroufim, Maya; Charafeddine, Khalil; Issa, Grace; Khalifeh, Haifaa; Habib, Robert H.; Berry, Atika; Ghosn, Nada; Rady, Alissar

    2014-01-01

    In September 2012, a cutaneous leishmaniasis outbreak began among Syrian refugees in Lebanon. For 948 patients in whom leishmaniasis was not confirmed, we obtained samples for microscopic confirmation and molecular speciation. We identified Leishmania tropica in 85% and L. major in 15% of patients. After 3 months of megulamine antimonite therapy, patients initial cure rate was 82%. PMID:25279543

  1. Concurrent cutaneous, visceral and ocular leishmaniasis caused by Leishmania (Viannia braziliensis in a kidney transplant patient

    Directory of Open Access Journals (Sweden)

    Gontijo Célia MF

    2002-01-01

    Full Text Available Although cases of leishmaniasis co-infection have been described in acquired immunodeficiency syndrome patients as well as those who have undergone organ transplants, to our knowledge, the present report is the first documented case of simultaneous cutaneous, visceral and ocular leishmaniasis due to Leishmania (Viannia braziliensis in a transplant patient. The patient had been using immunosuppressive drugs since receiving a transplanted kidney. The first clinical signs of leishmaniasis included fever, thoracic pain, hepatosplenomegaly, leucopenia and anemia. The cutaneous disease was revealed by the presence of amastigotes in the skin biopsy. After three months, the patient presented fever with conjunctive hyperemia, intense ocular pain and low visual acuity. Parasites isolated from iliac crest, aqueous humor and vitreous body were examined using a range of molecular techniques. The same strain of L. (V. braziliensis was responsible for the different clinical manifestations. The immunosuppressive drugs probably contributed to the dissemination of Leishmania.

  2. Disseminated cutaneous histoplasmosis with laryngeal involvement ...

    African Journals Online (AJOL)

    Disseminated cutaneous histoplasmosis with laryngeal involvement in a setting of immune reconstitution inflammatory syndrome. ... Grocott-Gomori methenamine silver and Periodic acid–Schiff (PAS) stains revealed a relative paucity of intracellular, narrow-neck budding fungal organisms. Culture findings confirmed the ...

  3. [Cutaneous leishmaniasis due to Leishmania infantum associated with HIV].

    Science.gov (United States)

    Diatta, B-A; Diallo, M; Diadie, S; Faye, B; Ndiaye, M; Hakim, H; Diallo, S; Seck, B; Niang, S-O; Kane, A; Dieng, M-T

    2016-10-01

    In Senegal, reported cases of cutaneous leishmaniasis are often due to Leishmania major. Immunosuppression related to HIV infection contributes to the emergence of leishmaniasis in humans and to cutaneous localization of viscerotropic species. We report the first observed case in Senegal of opportunistic cutaneous leishmaniasis due to Leishmania infantum associated with HIV. A 5-year-old boy presented crusted ulcerative lesions of the scalp and left forearm, together with axillary and cervical lymphadenopathy present for two months. Direct parasitological examination of the scalp and arm lesions, coupled with liquid aspiration of lymph nodes and bone marrow, enabled identification of amastigote forms of Leishmania. Polymerase chain reaction performed on skin, lymph node and bone marrow biopsy samples allowed identification of L. infantum. The child was positive for HIV1. Treatment of HIV infection and leishmaniasis resulted in clinical improvement. Co-infection with cutaneous leishmaniasis due to L. infantum and HIV is a complex combination in terms of the related therapeutic issues. The clinical and laboratory outcomes depend on restoration of immunity and on the efficacy, safety and availability of anti-leishmaniasis drugs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Predicting Geographic Variation in Cutaneous Leishmaniasis, Colombia

    Science.gov (United States)

    Campbell-Lendrum, Diarmid H.; Davies, Clive R.

    2004-01-01

    Approximately 6,000 cases of cutaneous leishmaniasis are reported annually in Colombia, a greater than twofold increase since the 1980s. Such reports certainly underestimate true incidence, and their geographic distribution is likely biased by local health service effectiveness. We investigated how well freely available environmental data explain the distribution of cases among 1,079 municipalities. For each municipality, a unique predictive logistic regression model was derived from the association among remaining municipalities between elevation, land cover (preclassified maps derived from satellite images), or both, and the odds of at least one case being reported. Land cover had greater predictive power than elevation; using both datasets improved accuracy. Fitting separate models to different ecologic zones, reflecting transmission cycle diversity, enhanced the accuracy of predictions. We derived measures that can be directly related to disease control decisions and show how results can vary, depending on the threshold selected for predicting a disease-positive municipality. The results identify areas where disease is most likely to be underreported. PMID:15200848

  5. Interventions for Old World cutaneous leishmaniasis.

    Science.gov (United States)

    Heras-Mosteiro, Julio; Monge-Maillo, Begoña; Pinart, Mariona; Lopez Pereira, Patricia; Reveiz, Ludovic; Garcia-Carrasco, Emely; Campuzano Cuadrado, Pedro; Royuela, Ana; Mendez Roman, Irene; López-Vélez, Rogelio

    2017-12-01

    Cutaneous leishmaniasis, caused by a parasitic infection, is considered one of the most serious skin diseases in many low- and middle-income countries. Old World cutaneous leishmaniasis (OWCL) is caused by species found in Africa, Asia, the Middle East, the Mediterranean, and India. The most commonly prescribed treatments are antimonials, but other drugs have been used with varying success. As OWCL tends to heal spontaneously, it is necessary to justify the use of systemic and topical treatments. This is an update of a Cochrane Review first published in 2008. To assess the effects of therapeutic interventions for the localised form of Old World cutaneous leishmaniasis. We updated our searches of the following databases to November 2016: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trials registers and checked the reference lists of included studies for further references to relevant randomised controlled trials (RCTs). We wrote to national programme managers, general co-ordinators, directors, clinicians, WHO-EMRO regional officers of endemic countries, pharmaceutical companies, tropical medicine centres, and authors of relevant papers for further information about relevant unpublished and ongoing trials. We undertook a separate search for adverse effects of interventions for Old World cutaneous leishmaniasis in September 2015 using MEDLINE. Randomised controlled trials of either single or combination treatments in immunocompetent people with OWCL confirmed by smear, histology, culture, or polymerase chain reaction. The comparators were either no treatment, placebo/vehicle, and/or another active compound. Two review authors independently assessed trials for inclusion and risk of bias and extracted data. We only synthesised data when we were able to identify at least two studies investigating similar treatments and reporting data amenable to pooling. We also recorded data about adverse effects from the

  6. Epidemiological profile of cutaneous leishmaniasis in Morocco, 2004-2013.

    Science.gov (United States)

    Laboudi, M

    2017-02-01

    The main objective of our study is to provide a comprehensive overview of the situation of cutaneous leishmaniasis in Morocco. We therefore conducted a retrospective descriptive study covering the decade 2004-2013. Data were collected from the Moroccan Ministry of Health's annual reports about the national program against leishmaniasis. These data show a regression in the cases due to Leishmania major and the persistence of L. tropica transmission. Mapping cutaneous leishmaniasis cases reported between 2004 and 2013 showed geographical changes ; the number of cases due to L. tropica were concentrated in the regions of Marrakech-Tensift-Elhaouz, Souss Massa-Draa Tadla-Azila, and Taza-Al Hoceima-Taounate. Cutaneous disease due to L. major was most common in the Souss-Massa-Draa region. Continuous monitoring of the epidemiological situation is important to assess the actions taken to reduce its incidence.

  7. Cutaneous and visceral leishmaniasis during anti-TNFα therapy.

    Science.gov (United States)

    Guarneri, Claudio; Bevelacqua, Valentina; Patterson, James W; Tchernev, Georgi

    2017-03-01

    The long-term use of novel antipsoriatic systemic biotechnological drugs may increase susceptibility to opportunistic infections. Several cases of visceral leishmaniasis have been reported in immunosuppressed individuals, including those who have been treated with tumour necrosis factor alpha (TNFα) blocking agents. Simultaneous occurrence of cutaneous and visceral involvement has been more rarely recorded in the medical literature. Herein, we describe a case of mucosal leishmaniasis occurring in a farmer living in an endemic region, who was treated with golimumab because of psoriatic arthritis. This highlights the importance of recognizing cutaneous lesions as a first indicator of possible underlying kala-azar disease.

  8. Clinical and dermoscopic evaluation of cutaneous leishmaniasis.

    Science.gov (United States)

    Ayhan, Erhan; Ucmak, Derya; Baykara, Sule Nergiz; Akkurt, Zeynep Meltem; Arica, Mustafa

    2015-02-01

    Dermoscopy is a method to aid in the visualization of the epidermis and dermis. In recent years, the use of dermoscopy in the diagnosis of non-melanocytic lesions such as those of leishmania cutis has increased. This study was intended to establish whether dermoscopic investigation has any diagnostic value in cutaneous leishmaniasis (CL). Fifty-five patients diagnosed with CL at the Department of Dermatology, Faculty of Medicine, Dicle University, between February and October 2012, were included in the study. Collectively, the patients exhibited a total of 127 lesions. The mean ± standard deviation age of the patients was 25.7 ± 21.3 years (range: 4-86 years). Twenty-three (41.8%) patients were male, and 32 (58.2%) were female. In dermoscopy, teardrop-like structures were observed in 42.5% of the lesions. Vascular structures were detected in 115 (90.6%) lesions; no vascular structures were observed in 12 (9.4%) lesions. Branching, linear, comma-like, and polymorphic vessels were seen more commonly in lesions on the face; pin-point and hairpin-like vessels were seen more commonly in lesions on the upper extremities. When the findings obtained in this study were evaluated along with those reported in the literature, it became apparent that follicular plugs, also called "teardrop-like structures", seen on the face and neck may be a dermoscopic feature specific to CL. As hairpin-like vessels seen in an asymmetric radial arrangement were often observed on parts of the body other than the face, further dermoscopic studies comparing the lesions of CL with other ulcerating lesions are necessary. © 2014 The International Society of Dermatology.

  9. Disseminated cutaneous histoplasmosis in an immunocompetent adult

    Directory of Open Access Journals (Sweden)

    Manoj Harnalikar

    2012-01-01

    Full Text Available Histoplasmosis, a systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum var capsulatum and Histoplasma capsulatum var duboisii is endemic to many parts of the world. The clinical manifestations range from acute or chronic pulmonary infection to a progressive disseminated disease. After initial exposure to the fungus, the infection is self-limited and restricted to the lungs in 99% of healthy individuals. The remaining 1%, however, progress to either disseminated or chronic disease involving the lungs, liver, spleen, lymph nodes, bone marrow or rarely, the skin and mucous membranes. Mucocutaneous histoplasmosis is frequently reported in patients with acquired immune deficiency syndrome (AIDS, but it is rare in immunocompetent hosts. A 60-year-old male presented with asymptomatic swelling of the hard palate and crusted papules and nodules over the extremities, face and trunk. Clinically, the diagnoses of cutaneous cryptococcosis versus histoplasmosis was considered in this patient. A chest X-ray revealed hilar lymphadenopathy. Enzyme-linked immunosorbent assay (ELISA for human immunodeficiency virus (HIV was nonreactive. Skin biopsy revealed multiple tiny intracellular round yeast forms with a halo in the mid-dermis. Culture of the skin biopsy in Sabouraud′s dextrose agar showed colonies of Histoplasma capsulatum. Despite an investigation including no evidence of underlying immunosuppression was found, he was started on IV amphotericin-B (0.5 mg/kg/day. However, the patient succumbed to his disease 2 days after presentation. We report a rare case of disseminated cutaneous histoplasmosis in an immunocompetent individual.

  10. Cutaneous leishmaniasis in Karak, Pakistan: Report of an outbreak ...

    African Journals Online (AJOL)

    A total of 339 patients with clinically suspected cutaneous leishmaniasis (CL) were studied from March to April, 2010 in three villages of Karak, Khyber Pakhtunkhwa, Pakistan where an epidemic of the disease was in question. Using polymerase chain reaction (PCR), 78.17% (265/339) were observed having CL.

  11. Changing pattern of imported cutaneous leishmaniasis in the Netherlands

    NARCIS (Netherlands)

    Zeegelaar, J. E.; Steketee, W. H.; van Thiel, P. P. A. M.; Wetsteyn, J. C. F. M.; Kager, P. A.; Faber, W. R.

    2005-01-01

    Cutaneous leishmaniasis (CL) in western countries seems to be appearing more frequently. Our aim was to determine if there has been a shift in countries where CL is acquired and whether the incidence has changed, and to assess current diagnostic procedures and treatment modalities. In a

  12. Evaluation of treatment with pentamidine for cutaneous leishmaniasis in Suriname

    NARCIS (Netherlands)

    van der Meide, Wendy F.; Sabajo, Leslie O. A.; Jensema, Annigje J.; Peekel, Inge; Faber, William R.; Schallig, Henk D. F. H.; Fat, Rudy F. M. Lai A.

    2009-01-01

    In Suriname, pentamidine isethionate (PI) is the only drug available for the treatment of cutaneous leishmaniasis (CL). Recently, local dermatologists have observed an increase in CL patients not responding adequately to the standard doses. In this study, patient compliance to PI treatment was

  13. Vaccines and vaccination strategies against human cutaneous leishmaniasis.

    Science.gov (United States)

    Okwor, Ifeoma; Uzonna, Jude

    2009-05-01

    One might think that the development of a vaccine against cutaneous leishmaniasis would be relatively straightforward because the type of immune response required for protection is known and natural immunity occurs following recovery from primary infection. However, there is as yet no effective vaccine against the disease in humans. Although vaccination in murine studies has yielded promising results, these vaccines have failed miserably when tested in primates or humans. The reasons behind these failures are unknown and remain a major hurdle for vaccine design and development against cutaneous leishmaniasis. In contrast, recovery from natural, deliberate or experimental infections results in development of long-lasting immunity to re-infection. This so called infection-induced resistance is the strongest anti-Leishmania immunity known. Here, we briefly review the different approaches to vaccination against cutaneous leishmaniasis and argue that vaccines composed of genetically modified (attenuated) parasites, which induce immunity akin to infection-induced resistance, may provide best protection against cutaneous leishmaniasis in humans.

  14. Cutaneous leishmaniasis: recent developments in diagnosis and management

    NARCIS (Netherlands)

    de Vries, Henry J. C.; Reedijk, Sophia H.; Schallig, Henk D. F. H.

    2015-01-01

    This review focuses on recent developments in the diagnosis, treatment, management, and strategies for the prevention and control of cutaneous leishmaniasis (CL) caused by both Old and New World Leishmania species. CL is caused by the vector-borne protozoan parasite Leishmania and is transmitted via

  15. The case of diagnosis of imported cutaneous leishmaniasis in Zaporozhye

    Directory of Open Access Journals (Sweden)

    V. G. Savelyev

    2014-08-01

    Full Text Available Aim. Article presents the current data on the clinical and epidemiological issue of leishmaniasis. Methods and results. Leishmaniasis is endemic disease in 88 countries, mainly in tropical and subtropical climates. Probability of importation of American cutaneous leishmaniasis in our country is practically zero, but, given the rarity of this disease, we present own clinical observation of imported cutaneous leishmaniasis in Zaporozhye. At the beginning of the third millennium has greatly increased the urgency of tropical parasitic diseases, including leishmaniasis. According to WHO, the world's 14 million people are infected each year there is about 2 million new cases and about 350 million live in areas at risk. Leishmaniasis - a group of vector-borne protozoal disease in humans and animals characterized by lesions of the internal organs (visceral leishmaniasis or the skin and mucous membranes (cutaneous leishmaniasis, which is the vector mosquitoes. We present their own clinical observations of American cutaneous leishmaniasis imported. Patient S., 41 years was hospitalized in Zaporozhye Regional Clinical Hospital infectious on 07.17.2013, with suspected cutaneous leishmaniasis. From the history of the disease is known that for the first time in February 2013 the patient have got relative to blade area redness and bump that appeared above the skin, and had a magnitude of 2,3 mm brownish-red. To the doctor the patient has not addressed. After 1,5-2 months bump grew and he began to stand out ichor, which dries and formed a crust on top of the hump. Further small ulcers that did not bring discomfort and pain to the patient appeared. However, every month ulcer increased. In July, after vacation at sea, rose weeping sores and perifocal inflammation appeared. Ulcer size reached 2 cm in diameter. The patient first applied to the dermatologist at the beginning of July 2013. Dermatologist excluded secondary syphilis and tuberculosis skin and sent to an

  16. Resurgence of Cutaneous Leishmaniasis in Israel, 2001–2012

    Science.gov (United States)

    Gandacu, Dan; Anis, Emilia; Karakis, Isabella; Warshavsky, Bruce; Slater, Paul; Grotto, Itamar

    2014-01-01

    Cutaneous leishmaniasis has long been endemic in Israel. After a 15-year period of moderate illness rates, reported incidence increased from 0.4 cases per 100,000 population in 2001 to 4.4 cases per 100,000 population in 2012, and the disease emerged in areas where its presence had previously been minimal. We analyzed all cases reported to the national surveillance system and found that outbreak patterns revealed an expansion of Leishmania major infections over large areas in the southern part of the country and the occurrence of spatially focused L. tropica outbreaks in the northern part of the country. Outbreaks often followed new construction in populated areas. Further study of factors affecting the transmission of cutaneous leishmaniasis is needed in Israel, as well as the development of effective methods to control the disease, an increase in awareness among health care professionals, and intensive public education regarding control measures in areas of known leishmaniasis foci. PMID:25271882

  17. Canine cutaneous leishmaniasis by Leishmania (Viannia braziliensis in an agricultural settlement, endemic area for leishmaniasis

    Directory of Open Access Journals (Sweden)

    A.F. Brilhante

    2016-08-01

    Full Text Available ABSTRACT Cutaneous leishmaniasis has several species of Leishmania as agents, and a wide variety of wild and domestic animals as hosts and different species of phlebotomines as vectors. A case of cutaneous leishmaniasis in a dog coming from an agricultural settlement is described. This is the first report of parasitism in a dog by Le. (Viannia braziliensis in Mato Grosso do Sul State. Attention is called to the importance of including this protozoonosis in the differential diagnosis of dermopathies in dogs as also the need to assess the importance of the domestic dog as a possible reservoir of Le. braziliensis.

  18. Cutaneous Leishmaniasis – A Case Series from Dresden

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    Uwe Wollina

    2018-01-01

    Full Text Available Leishmaniasis is world-wide one of the most common infectious disorders caused by protozoa. Due to the climate change, there is a risk of further spread of the disease to central and northern Europe. Another important issue is the high number of refugees from Syria since Syria is one of the hot spots of Old World leishmaniasis. We report on single-centre experience with leishmaniasis in the capital of Saxony, Dresden, during the years 2001 to 2017. We noted a substantial increase in the last five years. Once a very rare exotic disorder in Germany, cutaneous leishmaniasis has become a reality and physicians should be aware of it. A significant number of cases are from Syrian refugees; other cases had been acquired by tourists in the Mediterranean region!

  19. Immunoglobulin E Antileishmanial Antibody Response in Cutaneous Leishmaniasis

    Science.gov (United States)

    Sousa-Atta, Maria L. B.; Salamé, Gregório S.; D’Oliveira, Argemiro; Almeida, Roque P.; Atta, Ajax M.; Carvalho, Edgar M.

    2002-01-01

    High levels of antileishmanial immunoglobulin E (IgE) antibodies are associated with disease activity in visceral leishmaniasis. Herein, we report our observations about the relationship between antileishmanial IgE antibodies and clinical aspects of cutaneous leishmaniasis. This study was carried out with 45 patients (29 male and 16 female), with ages ranging from 11 to 48 years. All subjects were from an area to which leishmaniasis is endemic, Corte de Pedra (Bahia, Brazil), and the duration of the illness was ≤30 days. The patients were classified as positive or negative for IgE serology in enzyme-linked immunosorbent assay with leishmanial antigens. IgE antibodies were detected in 18 patients (optical density, 0.421 ± 0.30; 95% confidence interval, 0.27 to 0.57), and only 3 (17%) had more than one ulcer. In this group the diameter of Montenegro’s reaction was 18 ± 12.2 mm. In the group with negative IgE serology, 11 of 27 patients (48%) presented two or more cutaneous ulcers, and the mean of the skin test result was 9 ± 6.9 mm. There was a positive correlation between IgE antibody levels and Montenegro’s reaction size and an inverse correlation between IgE antileishmanial antibodies and the number of skin ulcers. The presence of antileishmanial IgE antibodies in cutaneous leishmaniasis may be a result of immunoregulatory events with clinical implications. PMID:11777837

  20. LeishMan recommendations for treatment of cutaneous and mucosal leishmaniasis in travelers, 2014

    NARCIS (Netherlands)

    Blum, Johannes; Buffet, Pierre; Visser, Leo; Harms, Gundel; Bailey, Mark S; Caumes, Eric; Clerinx, Jan; van Thiel, Pieter P A M; Morizot, Gloria; Hatz, Christoph; Dorlo, Thomas P C; Lockwood, Diana N J

    2014-01-01

    BACKGROUND: Treatment of cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML) in travelers is still controversial. Over the last decade, national and international consortia have published recommendations for treating CL in travelers. These guidelines harmonize many issues, but there are some

  1. Epidemiological studies on cutaneous leishmaniasis in Ad ...

    African Journals Online (AJOL)

    Dawadimi region of Saudi Arabia. Methods: Data from the patients included in this retrospective study were collected from the Leishmaniasis Control Center of Ad-Dawadimi District of Saudi Arabia. A total of 370 patients with CL were recorded from ...

  2. Arnica Tincture Cures Cutaneous Leishmaniasis in Golden Hamsters

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    Sara M. Robledo

    2018-01-01

    Full Text Available In search for potential therapeutic alternatives to existing treatments for cutaneous Leishmaniasis, we have investigated the effect of Arnica tincture Ph. Eur. (a 70% hydroethanolic tincture prepared from flowerheads of Arnica montana L. on the lesions caused by infection with Leishmania braziliensis in a model with golden hamsters. The animals were treated topically with a daily single dose of the preparation for 28 days. Subsequently, the healing process was monitored by recording the lesion size in intervals of 15 days up to day 90. As a result, Arnica tincture fully cured three out of five hamsters while one animal showed an improvement and another one suffered from a relapse. This result was slightly better than that obtained with the positive control, meglumine antimonate, which cured two of five hamsters while the other three showed a relapse after 90 days. This result encourages us to further investigate the potential of Arnica tincture in the treatment of cutaneous Leishmaniasis.

  3. Reactive Oxygen Species and Nitric Oxide in Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Maria Fátima Horta

    2012-01-01

    Full Text Available Cutaneous leishmaniasis affects millions of people around the world. Several species of Leishmania infect mouse strains, and murine models closely reproduce the cutaneous lesions caused by the parasite in humans. Mouse models have enabled studies on the pathogenesis and effector mechanisms of host resistance to infection. Here, we review the role of nitric oxide (NO, reactive oxygen species (ROS, and peroxynitrite (ONOO− in the control of parasites by macrophages, which are both the host cells and the effector cells. We also discuss the role of neutrophil-derived oxygen and nitrogen reactive species during infection with Leishmania. We emphasize the role of these cells in the outcome of leishmaniasis early after infection, before the adaptive Th-cell immune response.

  4. The wound repair response controls outcome to cutaneous leishmaniasis

    Science.gov (United States)

    Sakthianandeswaren, Anuratha; Elso, Colleen M.; Simpson, Ken; Curtis, Joan M.; Kumar, Beena; Speed, Terence P.; Handman, Emanuela; Foote, Simon J.

    2005-01-01

    Chronic microbial infections are associated with fibrotic and inflammatory reactions known as granulomas showing similarities to wound-healing and tissue repair processes. We have previously mapped three leishmaniasis susceptibility loci, designated lmr1, -2, and -3, which exert their effect independently of T cell immune responses. Here, we show that the wound repair response is critically important for the rapid cure in murine cutaneous leishmaniasis caused by Leishmania major. Mice congenic for leishmaniasis resistance loci, which cured their lesions more rapidly than their susceptible parents, also expressed differentially genes involved in tissue repair, laid down more ordered collagen fibers, and healed punch biopsy wounds more rapidly. Fibroblast monolayers from these mice repaired in vitro wounds faster, and this process was accelerated by supernatants from infected macrophages. Because these effects are independent of T cell-mediated immunity, we conclude that the rate of wound healing is likely to be an important component of innate immunity involved in resistance to cutaneous leishmaniasis. PMID:16223880

  5. Cutaneous leishmaniasis in Algeria: quadrennial assessment (2008-2011).

    Science.gov (United States)

    Benelmouffok, A B; Sellami, M; Boughoufalah, A

    2017-08-01

    To study the prevalence and epidemiological factors of cutaneous leishmaniasis in Algeria from 2008 through 2011. The endemic site of M'Sila is the most important in Algeria after the historic site of Biskra, but the disease has spread rapidly and created new and important sites of infection, including Batna, Bechar, El Oued and Ghardaïa. The increased number of cases and the spread of this zoonosis require increased surveillance of its evolution and the application of adequate control measures.

  6. Low-cost thermotherapy for cutaneous leishmaniasis in Sindh, Pakistan.

    Science.gov (United States)

    Shah, Sharaf Ali; Memon, Abdul Aziz; Auwj-e-Shamim; Baqi, Shehla; Witzig, Richard

    2014-12-01

    To study the efficacy of a low-cost heating pack device used for thermotherapy in the treatment of cutaneous leishmaniasis. The study was conducted at the Department of Dermatology, Civil Hospital Sukkur, Pakistan, from April 20, 2012, to January 3, 2013. Thermotherapy with Hand-Held Exothermic Crystallisation Therapy for cutaneous leishmaniasis was performed on each lesion of the participating subjects at an average initial temperature of 51.6°C for 3 minutes daily for 7 days. Patients were followed regularly for 6 months after the therapy. SPSS 20 was used for statistical analysis. Even though all 27 patients completed 1 week of thermotherapy, only 23(85.2%) patients could be evaluated for full treatment response since 4(14.8%) were lost to complete follow-up. By the final 180-day evaluation, 19 (83%) patients had been cured. Applications were well tolerated with no side effects. The devise was a convenient, safe, non-toxic and effective treatment for cutaneous leishmaniasis at a fraction of the cost of standard antimonial treatment. Further studies are needed to certify its safety and efficacy as monotherapy for the condition.

  7. Cutaneous leishmaniasis in Senegal: a series of 38 cases at the Aristide Le Dantec University Hospital in Dakar.

    Science.gov (United States)

    Diadie, S; Diatta, B A; Ndiaye, M; Seck, N B; Diallo, S; Niang, S O; Dieng, M T

    2017-12-11

    Our aims were to study the epidemiological, clinical, and parasitological aspects of cutaneous leishmaniasis in the dermatology department of the Aristide Le Dantec hospital. This retrospective study reviewed records of cases treated over a 4-year period (from April 2010 through April 2014) at the HALD Dermatology department. The study included all patients with cutaneous leishmaniasis during the study period. The diagnostic criteria were clinical, parasitological, and histological. The study included 38 patients, corresponding to 9.5 cases per year. Patients' average age was 25 years (4-65 years) and the sex ratio was 1.6. The mean time from symptom outset to consultation was 3.2 months. The disease was located in limbs in 23 cases (63.8%), the face in 6 cases (16.6%), and disseminated in 9 (19.6%). The clinical presentation was ulcerated and crusted in 17 patients (44.7%), sporotrichoid in 13 (28.9%), pseudo-lepromatous in 4 (10.5%), and lupoid in 3 cases (7.9 %). It included warts, mucosa, and tropical sores (Aleppo boils) in all cases. We observed 3 cases associated with HIV; one had a pseudo-lepromatous presentation and resulted from immune restoration syndrome, while two patients had clinical forms of associations: ulcerative and crusted lesions associated with mucosal leishmaniasis in a 55-year-old patient, and cutaneous ulcerative, lupoid, and crusted multifocal (cutaneous, medullary, and lymph nodes) lesions in a 4-year-old infected with Leishmania infantum. Crusted ulcerative cutaneous leishmaniasis is the predominant form of cutaneous leishmaniasis. Infection with HIV can be an important factor in clinical and parasitological atypia.

  8. [Uncommon cutaneous presentation of visceral Leishmaniasis associated with HIV].

    Science.gov (United States)

    Cossart, C; Le Moal, G; Garcia, M; Frouin, E; Hainaut-Wierzbicka, E; Roblot, F

    2016-12-01

    Visceral leishmaniasis is not normally expressed in skin. Herein, we describe the case of an HIV-positive patient who developed two unusual skin manifestations during an episode of visceral leishmaniasis. A 48-year-old female patient consulted initially for infiltrated purpura of all four limbs. Skin biopsy revealed leukocytoclastic vasculitis with Leishman-Donovan bodies. Laboratory tests showed medullary, splenic, gastric and colic involvement, suggesting systemic disease, and enabling visceral leishmaniasis to be diagnosed. Two years later, despite prolonged treatment, the patient presented maculopapular exanthema, and histology revealed persistent Leishman-Donovan bodies. We report herein an association of two rare skin manifestations in an HIV-positive patient with visceral leishmaniasis: infiltrated purpura and maculopapular exanthema. However, the underlying mechanisms remain hypothetical. The initial leukocytoclastic exanthema could be secondary to either polyclonal hypergammaglobulinaemia or to IgA deposits, or possibly to mechanical impairment of blood vessels by the actual parasite. The maculopapular exanthema occurring later raised the possibility of post-Kala-Azar leishmaniasis due to blood-borne dissemination in an anergic subject or perhaps even immune reconstitution inflammatory syndrome. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis

    NARCIS (Netherlands)

    Blum, Johannes; Lockwood, Diana N. J.; Visser, Leo; Harms, Gundel; Bailey, Mark S.; Caumes, Eric; Clerinx, Jan; van Thiel, Pieter P. A. M.; Morizot, Gloria; Hatz, Christoph; Buffet, Pierre

    2012-01-01

    This review addresses the question of whether the risk of developing mucosal leishmaniasis (ML) warrants systemic treatment in all patients with New World cutaneous leishmaniasis (CL) or whether local treatment might be an acceptable alternative. The risk of patients with New World CL developing ML

  10. Disseminated transmissible venereal tumour associated with Leishmaniasis in a dog.

    Science.gov (United States)

    Trevizan, J T; Carreira, J T; Souza, N C; Carvalho, I R; Gomes, P B C; Lima, V M F; Orlandi, C M B; Rozza, D B; Koivisto, M B

    2012-12-01

    This report addresses an atypical transmissible venereal tumour in an 8-year-old bitch that was pluriparous and seropositive for leishmaniasis. There were ascites and a serosanguineous discharge from the vulva, but no lesions on the external genital mucosa. An aspirate of the peritoneal fluid showed mononuclear round cells characteristic of transmissible venereal tumour (TVT). Exploratory laparotomy revealed light red, granulomatous structures in the peritoneum, omentum, spleen, liver and uterine horns. Cytological and histopathological tests confirmed the diagnosis of intra-abdominal TVT. Dissemination of the TVT to several organs inside the abdominal cavity probably resulted from immunosuppression caused by leishmaniasis, which favoured the presence and aggressiveness of TVT. © 2012 Blackwell Verlag GmbH.

  11. A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis

    Science.gov (United States)

    2016-10-01

    AWARD NUMBER: W81XWH-14-2-0195. Log Number: PR130282 TITLE: A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis ...SUBTITLE A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...14. ABSTRACT Leishmaniasis is caused by the protozoan Leishmania and is generally transmitted by the bite of sand flies of the genus Lutzomyia or

  12. Pharmacokinetic of antimony in mice with cutaneous Leishmaniasis

    Energy Technology Data Exchange (ETDEWEB)

    Borborema, Samanta E.T.; Nascimento, Nanci do [Instituto de Pesquisas Energeticas e Nucleares IPEN/CNEN-SP, Sao Paulo, SP (Brazil). Lab. de Biologia Molecular]. E-mails: samanta@usp.br; nnascime@ipen.br; Andrade Junior, Heitor F. de [Instituto de Pesquisas Energeticas e Nucleares IPEN/CNEN-SP, Sao Paulo, SP (Brazil). Lab. de Biologia Molecular; Instituto de Medicina Tropical de Sao Paulo, Sao Paulo, SP (Brazil); E-mail: hfandrad@usp.br; Osso Junior, Joao A. [Instituto de Pesquisas Energeticas e Nucleares IPEN/CNEN-SP, Sao Paulo, SP (Brazil). Centro de Radiofarmacia]. E-mail: jaosso@ipen.br

    2007-07-01

    Cutaneous Leishmaniasis (CL) remains a major world health problem, with about 1.5 million new cases each year. Caused by protozoa Leishmania, in South America, this infection can vary from a chronic skin ulcer, to an erosive mucosal disease and severe facial disfigurement. Pentavalent antimony (Sb{sup +5}) as sodium stibogluconate (Pentostam) or meglumine antimoniate (Glucantime) are main drugs for treating most forms of human leishmaniasis. For six decades, despite the recent developments, the effective therapy to cutaneous leishmaniasis has been based on long parenteral courses of such drugs, even though these are fairly costly, toxic and inconvenient to use, without adequate knowledge on their pharmacokinetics or mechanism of action. Pharmacokinetics studies could be based on bioactive traceable drugs, usually with radioactive isotopes, but antimony radioisotopes are unavailable commercially. Neutron irradiation is a powerful tool in the analysis of mineral content of samples, for antimony, there are at least two main isotopes that could be formed after neutron irradiation in nuclear reactor. The aim of the present study was to construct antimony salts with those radioisotopes to obtain tracers to compare the pharmacokinetic and the tissue distribution of neutron irradiated meglumine antimoniate in healthy and cutaneous leishmaniasis experimentally infected mice. Meglumine antimoniate, (Glucantime, Aventis, S.P, Brazil), was neutron irradiated inside the IEA-R1 nuclear reactor (IPEN/CNEN-SP), producing two radioisotopes {sup 122}Sb and {sup 124}Sb. Its biodistribution was verified in BALB/c mice experimentally infected with Leishmania (Leishmania) Amazonensis, which received a single intraperitoneal dose of the drug. At different times after injection, the tissues and blood were excised and activity measured in a NaI (Tl) scintillation counter. Compared with the healthy mice, experimentally infected mice had significantly lower maximum concentration of antimony

  13. A new scenario in the immunohistochemical diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Fernandez-Flores, Angel

    2017-12-01

    Cutaneous lesions of leishmaniasis are easy to diagnose when clinically obvious or when amastigotes are numerous in the biopsy. However, this is not always the case. In difficult cases, the diagnosis of leishmaniasis requires a reliable tool to identify the microorganisms. The identification of the parasite via microscope has a superior sensitivity to that of culture, and molecular techniques, such as polymerase chain reaction (PCR), highly improve the sensitivity of the diagnosis. Alternatively, immunohistochemistry has emerged as an affordable alternative to PCR. Several laboratories have produced their own antibodies against Leishmania and seem satisfied with the results. Nevertheless, most of these antibodies are not commercialized or standardized. Pathology also welcomed the unexpected positivity of amastigotes with certain clones of anti-CD1a. The latter does not universally stain all species of Leishmania, with a low sensitivity for New World species. In conclusion, although anti-CD1a is a reliable complementary tool in the diagnosis of leishmaniasis, pathologists should familiarize themselves with one of the specific antibodies against Leishmania and globalize its use, standardizing and adapting the technique. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Efficacy of azithromycin in the treatment of cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Prata Aluízio

    2003-01-01

    Full Text Available The present open pilot study was conducted to assess the efficacy of azithromycin for the treatment of patients with cutaneous leishmaniasis in Araçuaí and Varzelândia, MG. Twenty-four patients with less of six months of disease evolution were treated after clinical examination, Montenegro test and a biopsy. The treatment schemes consisted of oral doses of 500 mg per day for 3, 5 and 10 days and of 1000 mg for two days. A clinical control was performed monthly and treatment cycles were repeated when necessary until full reepithelialization of the lesions. On the occasion of the final evaluation, 20 patients had completed the study and 17 of them (85% were cured. The time to obtain a cure was 60 days ifor 6 (30% patients, 90 days for 7 (35%, and 120 for 4 (20%. The three patients with treatment failure received a pentavalent antimonial for 20 days. No adverse reactions to the medication were observed and a 14 month follow-up did not show recurrence in any patient. These results suggest that azithromycin can be a good therapeutic option for the treatment of cutaneous leishmaniasis caused by Leishmania Viannia brasiliensis.

  15. Cytotoxic T cells mediate pathology and metastasis in cutaneous leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Fernanda O Novais

    Full Text Available Disease progression in response to infection can be strongly influenced by both pathogen burden and infection-induced immunopathology. While current therapeutics focus on augmenting protective immune responses, identifying therapeutics that reduce infection-induced immunopathology are clearly warranted. Despite the apparent protective role for murine CD8⁺ T cells following infection with the intracellular parasite Leishmania, CD8⁺ T cells have been paradoxically linked to immunopathological responses in human cutaneous leishmaniasis. Transcriptome analysis of lesions from Leishmania braziliensis patients revealed that genes associated with the cytolytic pathway are highly expressed and CD8⁺ T cells from lesions exhibited a cytolytic phenotype. To determine if CD8⁺ T cells play a causal role in disease, we turned to a murine model. These studies revealed that disease progression and metastasis in L. braziliensis infected mice was independent of parasite burden and was instead directly associated with the presence of CD8⁺ T cells. In mice with severe pathology, we visualized CD8⁺ T cell degranulation and lysis of L. braziliensis infected cells. Finally, in contrast to wild-type CD8⁺ T cells, perforin-deficient cells failed to induce disease. Thus, we show for the first time that cytolytic CD8⁺ T cells mediate immunopathology and drive the development of metastatic lesions in cutaneous leishmaniasis.

  16. IL-22 Protects against Tissue Damage during Cutaneous Leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Ciara Gimblet

    Full Text Available Cutaneous leishmaniasis is a disease characterized by ulcerating skin lesions, the resolution of which requires an effective, but regulated, immune response that limits parasite growth without causing permanent tissue damage. While mechanisms that control the parasites have been well studied, the factors regulating immunopathologic responses are less well understood. IL-22, a member of the IL-10 family of cytokines, can contribute to wound healing, but in other instances promotes pathology. Here we investigated the role of IL-22 during leishmania infection, and found that IL-22 limits leishmania-induced pathology when a certain threshold of damage is induced by a high dose of parasites. Il22-/- mice developed more severe disease than wild-type mice, with significantly more pathology at the site of infection, and in some cases permanent loss of tissue. The increased inflammation was not due to an increased parasite burden, but rather was associated with the loss of a wound healing phenotype in keratinocytes. Taken together, these studies demonstrate that during cutaneous leishmaniasis, IL-22 can play a previously unappreciated role in controlling leishmania-induced immunopathology.

  17. Unusual forms of cutaneous leishmaniasis due to Leishmania major.

    Science.gov (United States)

    Solomon, M; Greenberger, S; Baum, S; Pavlotsky, F; Barzilai, A; Schwartz, E

    2016-07-01

    Cutaneous leishmaniasis (CL) due to Leishmania major (L. major) is common in the Middle East; however, this skin infection may be under-diagnosed when it presents atypically. To highlight the occurrence of uncommon presentations of CL that may elude diagnosis. A retrospective study was performed among patients who presented at The Sheba Medical Center between 2005 and 2014 with atypical clinical presentations of CL due to L. major. Twelve patients with unusual clinical presentations of L. major CL were identified. All infections were acquired in L. major - endemic areas of Israel. The average age was 37 years. The average number of lesions was 2. Nine patients presented with a form that mimicked other forms of CL, such as lupoid, giant ulcer, sporotrichoid and recidivans, and three had a variant resembling other infectious skin diseases, such as erysipeloid and verruciform. All patients required systemic therapy. Cutaneous leishmaniasis due to L. major can masquerade as many other infectious and inflammatory diseases. In addition, it can mimic clinical forms of New World CL. We suggest that in endemic countries or in travellers returning from countries where L. major is endemic, polymerase chain reaction (PCR) for Leishmania-specific DNA should be performed routinely in cases of unusual presentations of dermatitis with a single or a few lesions, even if a diagnosis of CL was not considered by the referring clinician. © 2015 European Academy of Dermatology and Venereology.

  18. Recurrent cutaneous leishmaniasis Leishmaniose recidiva cútis

    Directory of Open Access Journals (Sweden)

    Ciro Martins Gomes

    2013-06-01

    Full Text Available We present a case of an 18-year-old male patient who, after two years of inappropriate treatment for cutaneous leishmaniasis, began to show nodules arising at the edges of the former healing scar. He was immune competent and denied any trauma. The diagnosis of recurrent cutaneous leishmaniasis was made following positive culture of aspirate samples. The patient was treated with N-methylglucamine associated with pentoxifylline for 30 days. Similar cases require special attention mainly because of the challenges imposed by treatment.Paciente do sexo masculino, 18 anos. Dois anos após tratamento insuficiente para leishmaniose tegumentar americana, apresentou, na mesma localização, lesão formada por cicatriz atrófica central e nódulos verrucosos na periferia. Era imunocompetente, hígido e negava qualquer trauma local. O diagnóstico de leishmaniose recidiva cutis foi feito através de cultura do aspirado da lesão. Realizou tratamento com N-metilglucamina (20mgSbV/kg/dia associado à pentoxifilina (1200mg/dia durante 30 dias alcançando cura clínica. Os casos semelhantes requerem atenção diferenciada pela dificuldade ao tratamento.

  19. Novel low-cost thermotherapy for cutaneous leishmaniasis in Peru.

    Directory of Open Access Journals (Sweden)

    Braulio M Valencia

    Full Text Available Thermotherapy is an accepted alternative therapy for new-world cutaneous leishmaniasis, but current heat-delivery modalities are too costly to be made widely available to endemic populations. We adapted a low-cost heat pack named the HECT-CL device that delivers safe, reliable, and renewable conduction heat. 25 patients with cutaneous leishmaniasis completed treatment with the device at an initial temperature of 52°C ± 2°C for 3 minutes to each lesion, repeated daily for 7 days, and were followed up for 6 months by direct observation. The overall definitive clinical cure rate was 60%. Concurrently, 13 patients meeting minimally significant exclusion criteria received identical compassionate use treatment with a cumulative definitive cure rate of 68.4%, 75% for those who had experienced CL relapse after prior antimonial treatment. Therapy was well tolerated. Reversible second-degree burns occurred in two patients and no bacterial super-infections were observed. HECT-CL is a promising treatment and deserves further study to verify its safety and efficacy as adjuvant and mono- therapy.

  20. Molecular prevalence and estimated risk of cutaneous leishmaniasis in Libya

    Directory of Open Access Journals (Sweden)

    Ayman A. El-Badry

    2017-12-01

    Full Text Available Background/Purpose: Cutanoeus leishmaniasis (CL is an endemic disease in the Mediterranean area including Libya. The aim of the present study is to detect the prevalent Leishmania species obtained from smeared cutaneous lesions in addition to studying the diverse sociodemographic risk factors of the reported cases from different provinces of Libya. Methods: A total of 250 archived microscopic slides from clinically suspected cases of CL attending the leishmaniasis clinic in the Dermatology Department, Tripoli Central Hospital, Tripoli, Libya, were microscopically examined. Leishmania-DNA was amplified using combined polymerase chain reaction (PCR targeting kinetoplast-DNA (kDNA and ribosomal internal transcribed spacer 1 (ITS1-DNA with restriction fragment length polymorphism analysis for direct Leishmania species identification. Results: Using kDNA and ITS1-PCR, 22.5% and 20% of cases were positive, respectively. Only 14.4% of cases were positive using microscopy. Nominating ITS1-PCR as the reference standard, kDNA-PCR assay was highly sensitive while microscopy was 100% specific but of limited sensitivity (72% with a substantial agreement and an overall accuracy of 94.4%. Leishmania major and Leishmania tropica were the predominant species reported from the north-western provinces including Tripoli, Zintan, and Gharyan with their related subprovinces; Asabaa, Mizdan, Alkawasem, and Alorban. CL prevailed more among men and residents of rural areas. House wives and students were the most affected professions. Children were the least affected, while the middle-aged were the most affected age group. Conclusion: L. major and L. tropica are the predominant species in the north-western regions of Libya. ITS1-PCR-restriction fragment length polymorphism assay offered a sensitive, specific, and faster diagnostic method especially with negative parasitologic examination. Keywords: Archived microscopic slides, Cutaneous leishmaniasis, ITS1-PCR, kDNA-PCR

  1. Leishmaniasis

    DEFF Research Database (Denmark)

    Kemp, M; Theander, T G

    2000-01-01

    Leishmania parasites are obligate intracellular protozoa, that produce clinical pictures, ranging from localised, self-healing ulcers to systemic, lethal diseases. The diseases caused by the parasites can be divided into cutaneous, mucocutaneous, and visceral leishmaniasis. Recovery from the infe......Leishmania parasites are obligate intracellular protozoa, that produce clinical pictures, ranging from localised, self-healing ulcers to systemic, lethal diseases. The diseases caused by the parasites can be divided into cutaneous, mucocutaneous, and visceral leishmaniasis. Recovery from...... the infection often leaves lifelong immunity. Leishmaniasis may occur in individuals who have been to the Mediterranean countries, the countries on the Horn of Africa, the Arabian Peninsula, parts of Asia, and South and Central America. Co-infection of Leishmania parasites and HIV is a special problem....... Leishmaniasis can be treated with pentavalent compounds of antimony, but other drugs, including amphotericin B, are also affective. Udgivelsesdato: 2000-Nov-13...

  2. Cutaneous leishmaniasis in three Dutch military cohorts following jungle training in Belize.

    Science.gov (United States)

    van Thiel, P P A M; Zeegelaar, J E; van Gool, T; Faber, W R; Kager, P A

    2011-05-01

    Skin lesions occur frequently in travelers to tropical countries. Military personnel acquire skin lesions regularly during jungle training as did Dutch troops who trained in the jungle of Belize in 1998, 2004 and 2009, in an area endemic for cutaneous leishmaniasis. Demographic and clinical data were collected retrospectively. Diagnostic investigations for cutaneous leishmaniasis included Giemsa stain, culture, PCR and NASBA and histopathology of biopsies. Treatment of leishmaniasis was with sodium stibogluconate, given intravenously or intralesionally, the latter with cryotherapy. In 1998 and 2004 cutaneous leishmaniasis due to Leishmania braziliensis and Leishmania mexicana infection was diagnosed in 25 persons out of 99 (attack rate 25.2%) and 14 persons out of 80 (attack rate 17.5%) respectively. In 2009 cutaneous leishmaniasis was not acquired. Skin problems were common during and after jungle training. Cutaneous leishmaniasis was important in the first two cohorts but not observed in the third cohort. Factors that could have played a role in the absence of cutaneous leishmaniasis in the third cohort include variability in transmission and availability of better preventive measures and adherence to these. Sodium stibogluconate treatment, intralesional or intravenous, was effective. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Leishmaniasis

    DEFF Research Database (Denmark)

    Kemp, M; Theander, T G

    2000-01-01

    Leishmania parasites are obligate intracellular protozoa, that produce clinical pictures, ranging from localised, self-healing ulcers to systemic, lethal diseases. The diseases caused by the parasites can be divided into cutaneous, mucocutaneous, and visceral leishmaniasis. Recovery from...... the infection often leaves lifelong immunity. Leishmaniasis may occur in individuals who have been to the Mediterranean countries, the countries on the Horn of Africa, the Arabian Peninsula, parts of Asia, and South and Central America. Co-infection of Leishmania parasites and HIV is a special problem....... Leishmaniasis can be treated with pentavalent compounds of antimony, but other drugs, including amphotericin B, are also affective. Udgivelsesdato: 2000-Nov-13...

  4. First Cases of Cutaneous Leishmaniasis Caused by Leishmania (Viannia) naiffi Infection in Surinam

    NARCIS (Netherlands)

    van Thiel, Pieter-Paul A. M.; van Gool, Tom; Kager, Piet A.; Bart, Aldert

    2010-01-01

    Cutaneous leishmaniasis in Surinam is generally caused by infection by Leishmania guyanensis. We report three cases of infection with Leishmania (Viannia) naiffi, a Leishmania species not described from Surinam before. Treatment with pentamidine proved to be effective

  5. Case Report: First Case of Cutaneous Leishmaniasis Caused by Leishmania (Viannia) braziliensis in Suriname

    NARCIS (Netherlands)

    Hu, Ricardo V. P. F.; Kent, Alida D.; Adams, Emily R.; van der Veer, Charlotte; Sabajo, Leslie O. A.; Mans, Dennis R. A.; de Vries, Henry J. C.; Schallig, Henk D. F. H.; Fat, Rudy F. M. Lai A.

    2012-01-01

    The main causative agent of cutaneous leishmaniasis (CL) in Suriname is Leishmania (Viannia) guyanensis. This case report presents a patient infected with Leishmania (Viannia) braziliensis, a species never reported before in Suriname. This finding has clinical implications, because L. braziliensis

  6. Cutaneous leishmaniasis after travel to Cyprus and successful treatment with miltefosine.

    Science.gov (United States)

    Poeppl, Wolfgang; Walochnik, Julia; Pustelnik, Tom; Auer, Herbert; Mooseder, Gerhard

    2011-04-01

    A patient presenting with an atypical manifestation of cutaneous leishmaniasis after travel to Cyprus was successfully treated with miltefosine. The K26 typing revealed a hitherto undescribed strain of the Leishmania donovani/infantum complex as the causing agent.

  7. Diabetes melutus associated with pentamidine isethionate in diffuse cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Jackson Mauricio Lopes Costa

    1995-12-01

    Full Text Available The authors report a case of a male patient from Bacabal, MA with diffuse cutaneous leishmaniasis (DCL, for at least nine years, with 168 lesions on his body. These were tumour-like nodules with some ulceratmi. He usedpentavalent antimonial (glucantime® and an association of gamma interferon plus glucantime with improvement of the lesions but relapsed later. Recently, pentamidine isethionate (pentacarinat® was given a dosage of 4mg/kg/weight/day on alternate days for 20 applications. After 3 months a similar course of 10 application was given 2 times. Later he developed diabetic signs with weight loss of 10kg, polydypsia, polyuria and xerostomia. The lower limbs lesions showed signs of activity. Blood glucose levels normalised and remain like this at moment. Attention is drawn to the fact that pentamidine isethionate should be used as a therapy option with care, obeyng rigorous laboratory controls including a glucose tolerance test.

  8. Tratamento da Leishmaniose Tegumentar Americana Treatment of american cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Edson Borges de Lima

    2007-04-01

    Full Text Available A leishmaniose tegumentar americana é doença infecciosa da pele e mucosa, cujo agente etiológico é um protozoário do gênero Leishmania. Seu tratamento é desafio porque as drogas disponíveis apresentam elevada toxicidade, e nenhuma delas é bastante eficaz. A recidiva, a falha terapêutica em pacientes imunodeprimidos e a resistência ao tratamento são fatores que motivam a busca de uma droga ideal.American cutaneous leishmaniasis is an infectious disease of the skin and mucosa caused by a protozoon of the genus Leishmania. Its treatment is a challenge since the drugs available are highly toxic and none is completely effective. Recurrence, therapeutic failure in immunosuppressed patients and treatment resistance are some factors that encourage searching an ideal drug.

  9. The unwelcome trio: HIV plus cutaneous and visceral leishmaniasis.

    Science.gov (United States)

    Guarneri, C; Tchernev, G; Bevelacqua, V; Lotti, T; Nunnari, G

    2016-01-01

    Leishmania/Human Immunodeficiency Virus (HIV) coinfection has emerged as an extremely serious and increasingly frequent health problem in the last decades. Considering the insidious and not typical clinical picture in presence of immunosuppressive conditions, the increasing number of people travelling in endemic zones, the ability to survive, within both human and vector bodies, of the parasite, clinicians and dermatologists as the first line should be aware of these kind of "pathologic alliances," to avoid delayed diagnosis and treatment. In this setting, the occurrence of cutaneous lesions can, paradoxically, aid the physician in recognition and approaching the correct staging and management of the two (or three) diseases. Treatment of these unwelcome synergies is a challenge: apart from the recommended anti-retroviral protocols, different anti-leishmanial drugs have been widely used, according with the standard guidelines for visceral leishmaniasis (VL), with no successful treatment regimen still been established. © 2015 Wiley Periodicals, Inc.

  10. A cluster of cutaneous leishmaniasis associated with human smuggling.

    Science.gov (United States)

    Cannella, Anthony P; Nguyen, Bichchau M; Piggott, Caroline D; Lee, Robert A; Vinetz, Joseph M; Mehta, Sanjay R

    2011-06-01

    Cutaneous leishmaniasis (CL) is rarely seen in the United States, and the social and geographic context of the infection can be a key to its diagnosis and management. Four Somali and one Ethiopian, in U.S. Border Patrol custody, came to the United States by the same human trafficking route: Djibouti to Dubai to Moscow to Havana to Quito; and then by ground by Columbia/Panama to the United States-Mexico border where they were detained. Although traveling at different times, all five patients simultaneously presented to our institution with chronic ulcerative skin lesions at different sites and stages of evolution. Culture of biopsy specimens grew Leishmania panamensis. Soon thereafter, three individuals from East Africa traveling the identical route presented with L. panamensis CL to physicians in Tacoma, WA. We document here the association of a human trafficking route and new world CL. Clinicians and public health officials should be aware of this emerging infectious disease risk.

  11. Topical treatment of experimental cutaneous leishmaniasis in golden hamster (Mesocricetus auratus) with formulations containing pentamidine

    OpenAIRE

    COMANDOLLI-WYREPKOWSKI, Claudia Dantas; GRAFOVA, Iryna; NAIFF, Maricleide de Farias; AVELLA, Maurizio; GENTILE, Gennaro; GRAFOV, Andriy; FRANCO, Antonia Maria Ramos

    2017-01-01

    ABSTRACT Current treatment of cutaneous leishmaniasis (CL) relies mainly on pentavalent antimonials salts and second-line drugs include pentamidine and amphotericin B, but these therapies have side effects and require parenteral administration. The aim of this work was to evaluate the topical formulations containing pentamidine isethionate (PI) in the experimental treatment of cutaneous leishmaniasis (CL). Golden hamsters (Mesocricetus auratus) were infected in the nose with Leishmania (Leish...

  12. Topical liposomal azithromycin in the treatment of acute cutaneous leishmaniasis.

    Science.gov (United States)

    Rajabi, Omid; Layegh, Pouran; Hashemzadeh, Sara; Khoddami, Mohsen

    2016-09-01

    Cutaneous leishmaniasis (CL) treatment is based on pentavalant antimony (sbv) drugs which are accompanied by many side effects and are facing ever-increasing resistance. Topical treatment of CL is an attractive alternative avoiding toxicities of parenteral therapy while being administered through a simple painless route. The liposomal formulations of different drugs have recently been increasingly used in the treatment of several types of leishmaniasis. The efficacy of a topical liposomal azithromycin formulation was compared with intralesional meglumine antimoniate (glucantime) in the treatment of CL. Sixty-six patients with 97 lesions who met our inclusion criteria were randomly divided into two groups. One group was administered with the topical liposomal form of azithromycin twice daily. The other group was treated by weekly intralesional injections of glucantime with a volume of 0.5-2 cm3 into each lesion till complete blanching of the lesion occurred. Clinical evaluations were performed weekly during the treatment course (8 weeks) by a single dermatologist for both groups. Per-protocol analysis showed no statistically significant difference between the two groups (p = 0.84, 95% confidence interval (CI) = 0.764 (0.714-0.821). Serious drug side effects were not observed in either group. Topical liposomal azithromycin has the same efficacy as intralesional glucantime in the treatment of CL. © 2016 Wiley Periodicals, Inc.

  13. Leprosy Associated with Atypical Cutaneous Leishmaniasis in Nicaragua and Honduras.

    Science.gov (United States)

    Soto, Lucrecia Acosta; Caballero, Nelson; Fuentes, Lesny Ruth; Muñoz, Pedro Torres; Gómez Echevarría, Jose Ramón; López, Montserrat Pérez; Bornay Llinares, Fernando Jorge; Stanford, John L; Stanford, Cynthia A; Donoghue, Helen D

    2017-10-01

    In Central America, few cases of leprosy have been reported, but the disease may be unrecognized. Diagnosis is based on clinical criteria and histology. Preliminary field work in Nicaragua and Honduras found patients, including many children, with skin lesions clinically suggestive of atypical cutaneous leishmaniasis or indeterminate leprosy. Histology could not distinguish these diseases although acid-fast organisms were visible in a few biopsies. Lesions healed after standard antimicrobial therapy for leprosy. In the present study, patients, family members, and other community members were skin-tested and provided nasal swabs and blood samples. Biopsies were taken from a subgroup of patients with clinical signs of infection. Two laboratories analyzed samples, using local in-house techniques. Mycobacterium leprae , Leishmania spp. and Leishmania infantum were detected using polymerase chain reactions. Mycobacterium leprae DNA was detected in blood samples and nasal swabs, including some cases where leprosy was not clinically suspected. Leishmania spp. were also detected in blood and nasal swabs. Most biopsies contained Leishmania DNA and coinfection of Leishmania spp. with M. leprae occurred in 33% of cases. Mycobacterium leprae DNA was also detected and sequenced from Nicaraguan and Honduran environmental samples. In conclusion, leprosy and leishmaniasis are present in both regions, and leprosy appears to be widespread. The nature of any relationship between these two pathogens and the epidemiology of these infections need to be elucidated.

  14. Histological grading patterns in patients of cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    Saleem, K.; Ayaz, B.; Shaikh, A.

    2007-01-01

    To determine the histological grading patterns in a cohort of hospitalized patients of cutaneous leishmaniasis. One hundred patients of Cutaneous Leishmaniasis (CL), admitted in dermatology wards at PNS Shifa Hospital, Karachi, were examined. Only admitted patients of all ages and both sexes were included in the study. Patients of CL, who had received or were receiving systemic treatment were excluded. The lesions having marked secondary bacterial infection were also excluded. Initial diagnosis was clinical. History of being to an endemic area supported the diagnosis. The lesions were divided in two groups. Early, with duration less than 03 months and late, with duration between 3 and 12 months. The clinical lesions were noted as nodules, plaques, ulcers, crusted ulcers, lupoid lesions and plaques with scarring. Three types of skin smears (slit skin smear, saline aspirate smear and dab smear) were taken and examined with Giemsa stain. Cultures were performed on Nicolle-Novy-MacNeal (NNN) culture medium from Defense Scientific and Technology Organization (DESTO) Lab., Pakistan. Incisional skin biopsies were done. The biopsy specimens were examined by hemotoxylin and eosin stain (H and E stain). The number of Leishmania Tropica (LT) bodies was graded according to modified Ridley's parasitic index 1983. Clinical features were correlated with the histological patterns. Five histological patterns were identified in current study: 1) diffuse dermal infiltration without necrosis, 2) patchy dermal infiltration, 3) diffuse dermal infiltration with necrosis, 4) early reactive granuloma formation and 5) established epithelioid granuloma formation. LT bodies were identified in 75% of cases. Epidermal features were non-specific. The early lesions presented with diffuse infiltrate and late lesions showed granuloma formation. Five distinct types of histological patterns of CL have been recognized in this study. The early lesions presented with diffuse infiltrate and late lesions

  15. Leishmaniasis cutánea difusa en un paciente con sida Diffuse cutaneous leishmaniasis in a patient with AIDS

    Directory of Open Access Journals (Sweden)

    Carlos Pérez

    2006-12-01

    .Objective: A patient with a leishmaniasis-Aids co-infection was presented and discussed.
    Methods and results: A 29-year -old soldiier, coming from the Province of San José del Guaviare, Colombia, complained of a weight loss of 18 kgs in the previous ten months as well as a two-month-old cutaneous leision. Elisa and Western blot tests were positive for HIV infection. LT CD4 were 92/mm3. He had a generalized erythematous, psoriasiform dermal lesion,which, upon biopsy, revealed an abundance of phagocytosed microorganisms that stained black with Gomory's technique. Disseminated histoplasmosis was diagnosed. The patient received anti-retroviral therapy and itraconazole, without regression of the lesions. Amphotericin B was beneficial but the lesions recurred several months later, more numerous, nodular and with occurrence in the oral mucosa. Nine months after the initial diagnosis additional skin biopsies and review of the previous biopsies established that the patient had diffuse cutaneous leishmaniasis. The leishmania parasite did not grow in culture. Miltefosine produced marked improvement, but the lesions recurred and were cured finally with 52 Glucantime® injections administered for two months. Presently, the patient remains in good condition 21 months after diagnosis of leishmaniasis.
    Conclusions: Diffuse cutaneous leishmaniasis may be a common clinical manifestation when leishmaniasis and AIDS co-occur. Its treatment is difficult and must include an antiparasitic drug as well as prophylactic,and anti-retroviral therapy. Leishmania amastigotes typically are not Gomory-positive and can be differentiated from Histoplasma by morphology, immunohistochemistry, culture, antibody-specific response and PCR. The leishmaniasis-AIDS co-infection enhances invasive capacity for both causal microorganisms. Increasing case numbers can be expected in Colombia, due to the high frequency of both diseases.

  16. Clinical and epidemiological characteristics of cutaneous leishmaniasis in Sri Lanka.

    Science.gov (United States)

    Iddawela, Devika; Vithana, Sanura Malinda Pallegoda; Atapattu, Dhilma; Wijekoon, Lanka

    2018-03-06

    Leishmaniasis, a vector borne tropical/subtropical disease caused by the protozoan Leishmania is transmitted to humans by sandfly vectors Phlebotomus and Lutzomyia. The principal form found in Sri Lanka is cutaneous leishmaniasis (CL) and is caused by Leishmania donovani. A rising trend in disease prevalence has been observed recently in Sri Lanka and the island is in fact the newest endemic focus in South Asia. Determining the prevalence of smear positivity among clinically suspected CL patients, identifying risk factors and specific clinical presentations of CL in order to implement preventive and early treatment strategies were the objectives of this study. A sample of 509 clinically suspected cases of CL referred to the Department of Parasitology from all across Sri Lanka between 2005 and 2015 was selected consecutively. Diagnosis was confirmed by microscopic visualization of the Leishmania amastigote from the slit skin smear. A structured questionnaire was used to identify exposure related risk factors and a clinical examination was performed to identify lesion characteristics. Out of 509 clinical cases, 41.5% (n = 211) were smear positive. The study population ranged from ages 1 to 80 years (mean age = 34.76) and the most affected age group was 40-49. Of the smear positives, 58.85% were males. Majority (47.86%) were from the North Western region (Kurunegala) of the country and were exposed to scrub jungles. Sand fly exposure (p = 0.04) and positive contact history (p = 0.005) were significant risk factors for smear positivity. Erythema (p = 0.02), lack of pruritus (p = 0.02) and scaly appearance (p = 0.003) were significant lesion characteristics in smear positivity. Lesions were commonly found in the exposed areas and the commonest morphological type was papulo-nodular. An increasing trend in the spread of cutaneous leishmaniasis from endemic to non-endemic areas has become evident. Positive contact history and sandfly exposure

  17. [Clinical and histological study of lupoid cutaneous leishmaniasis (16 cases)].

    Science.gov (United States)

    Masmoudi, Abderrahmen; Boudaya, Sonia; Ayadi, Narjes; Bouassida, Samir; Khabir, Abdelmajid; Meziou, Taha Jalel; Akrout, Feryel; Sallemi, Tahia; Turki, Hamida; Zahaf, Abdelmajid

    2007-12-01

    Zoonotic cutaneous leishmaniasis (CL) is characterised by a major clinical polymorphism, especially the lupoid type. The aim of our study was to precise the anatomic and clinical particularities of this clinical form of CL. The present work was a prospective 1-year study. In all patients, the epidemiologic and clinical characteristics were identified, together with those regarding disease progression. Standard cutaneous biopsies were carried out for all study patients. The lupoid form was observed in 15% of the patients. It was clinically characterised by a lupoid aspect with papular and squamous placard surrounded by a satellite papule, a short duration of disease progression (28 months in average) and a preferential localisation at the level of the face and the elbow, statistically proven. At the histological level, epidermic hyperplasia was found in 93.8% of the cases; an inflammatory polymorphic dermic infiltrate consisting of lymphocytes and plasmocytes was found in all patients; granulomas were noted in 50% of the cases, and isolated epitheloid cells were observed in the derm of 3 patients. Amastigotes were rarely observed. In our series, the lupoid form was characterised with a short and non chronic evolution and two preferential sites for the affection: the face and the elbow. At the histological level, the lupoid type of CL appeared characterized by a high frequency of granuloma, usually organized, and rare amastigotes. However, the histology of authentic lupoid forms can be non granolomatosic.

  18. Toxicological analysis and effectiveness of oral Kalanchoe pinnata on a human case of cutaneous leishmaniasis.

    Science.gov (United States)

    Torres-Santos, E C; Da Silva, S A G; Costa, S S; Santos, A P P T; Almeida, A P; Rossi-Bergmann, B

    2003-08-01

    Leishmaniasis is an extremely difficult disease to treat. Previously, it was shown that oral Kalanchoe pinnata (Kp) leaf extract is strongly effective against murine leishmaniasis. Here, it is shown that the serum levels of alanine-aminotransferase (ALT), aspartate-aminotransferase (AST), urea and alkaline phosphatase were unchanged in mice orally treated with supraoptimal Kp doses for 30 days, indicating the absence of chronic toxicity to the liver, heart or kidney. Additionally, evidence is presented that human leishmaniasis may also be controlled with oral Kp. A 36-year-old man with an active cutaneous leishmaniasis was orally treated with 30 g wet weight of Kp leaves/day for 14 days. During the Kp treatment, the lesion stopped growing and slightly decreased. No adverse reactions or toxicity was observed. This study reports for the first time that Kalanchoe pinnata contains substances potentially active and safe for the oral treatment of human cutaneous leishmaniasis. Copyright 2003 John Wiley & Sons, Ltd.

  19. First report of diffuse cutaneous leishmaniasis and Leishmania amazonensis infection in Rio de Janeiro State, Brazil.

    Science.gov (United States)

    Azeredo-Coutinho, R B G; Conceição-Silva, F; Schubach, A; Cupolillo, E; Quintella, L P; Madeira, M F; Pacheco, R S; Valete-Rosalino, C M; Mendonça, S C F

    2007-07-01

    Diffuse cutaneous leishmaniasis (DCL) is characterised by multiple and progressive cutaneous lesions, resistance to chemotherapy and Leishmania-specific T-cell anergy. We report the first autochthonous DCL case and the first human infection with Leishmania amazonensis in Rio de Janeiro State, Brazil, where only L. braziliensis is considered to be the causative agent of cutaneous leishmaniasis. Leishmania amazonensis was identified by multilocus enzyme electrophoresis and PCR-RFLP. Our case was diagnosed as DCL according to clinical, parasitological, histopathological and immunological criteria. These observations indicate that L. amazonensis is increasing its geographical distribution in Brazil, accounting for unusual clinical presentations in new transmission areas.

  20. Molecular prevalence and estimated risk of cutaneous leishmaniasis in Libya.

    Science.gov (United States)

    El-Badry, Ayman A; El-Dwibe, Hamida; Basyoni, Maha M A; Al-Antably, Abeer S A; Al-Bashier, Wafaa A

    2017-12-01

    Cutanoeus leishmaniasis (CL) is an endemic disease in the Mediterranean area including Libya. The aim of the present study is to detect the prevalent Leishmania species obtained from smeared cutaneous lesions in addition to studying the diverse sociodemographic risk factors of the reported cases from different provinces of Libya. A total of 250 archived microscopic slides from clinically suspected cases of CL attending the leishmaniasis clinic in the Dermatology Department, Tripoli Central Hospital, Tripoli, Libya, were microscopically examined. Leishmania-DNA was amplified using combined polymerase chain reaction (PCR) targeting kinetoplast-DNA (kDNA) and ribosomal internal transcribed spacer 1 (ITS1)-DNA with restriction fragment length polymorphism analysis for direct Leishmania species identification. Using kDNA and ITS1-PCR, 22.5% and 20% of cases were positive, respectively. Only 14.4% of cases were positive using microscopy. Nominating ITS1-PCR as the reference standard, kDNA-PCR assay was highly sensitive while microscopy was 100% specific but of limited sensitivity (72%) with a substantial agreement and an overall accuracy of 94.4%. Leishmania major and Leishmania tropica were the predominant species reported from the north-western provinces including Tripoli, Zintan, and Gharyan with their related subprovinces; Asabaa, Mizdan, Alkawasem, and Alorban. CL prevailed more among men and residents of rural areas. House wives and students were the most affected professions. Children were the least affected, while the middle-aged were the most affected age group. L. major and L. tropica are the predominant species in the north-western regions of Libya. ITS1-PCR-restriction fragment length polymorphism assay offered a sensitive, specific, and faster diagnostic method especially with negative parasitologic examination. Copyright © 2016. Published by Elsevier B.V.

  1. Lupoid cutaneous leishmaniasis: A report of 16 cases

    Directory of Open Access Journals (Sweden)

    Ul Bari Arfan

    2010-01-01

    Full Text Available Background: Lupoid cutaneous leishmaniasis (CL is known as the chronic form of CL. However, keeping its clinical presentation in view, there is a need to revisit this form of disease. Aims: To redefine/describe lupoid CL in view of clinical features. Methods: It was a case series seen in Muzaffarabad (Pakistan from Jan 2006 to May 2008. All patients clinically suggestive and consistent with laboratory diagnosis of CL were registered. Patients of all age groups and either sex having cutaneous lesions resembling lupus vulgaris or lupus erythematosus on the face or elsewhere were included in the study. Those having chronic fluctuating/relapsing course or scarring within the lesions were also included. Various demographic features of the patients and clinical patterns were recorded. Descriptive statistics were used for analysis. Results: Of 254 registered patients of CL, 16 (6.3% were diagnosed as lupoid CL. None of the patients had scarred lesions. Age ranged from 38 to 75 (55 + 15.11 years and duration of lesions varied from 4 to 32 (14.25 + 07.59 weeks. All patients had lesions over the face. Thirteen (81.25% had a large solitary plaque extending over the nose and a large part of the cheeks and three (18.75% had multiple lesions. Lesions were central/nasal in two (12.5%, unilateral/asymmetrical in four (25% and bilateral/symmetrical in 10 (62.5%. Morphological patterns included erythematous/infiltrated (7, psoriasiform (6, ulcerated/crusted (2 and Discoid lupus erythematosus (DLE[G1] like (1. Conclusion: Lupoid CL is not strictly a chronic form of disease, which presents on the face from the very onset and shows no scarring or recurrence.

  2. Forecasting temporal dynamics of cutaneous leishmaniasis in Northeast Brazil.

    Directory of Open Access Journals (Sweden)

    Joseph A Lewnard

    2014-10-01

    Full Text Available Cutaneous leishmaniasis (CL is a vector-borne disease of increasing importance in northeastern Brazil. It is known that sandflies, which spread the causative parasites, have weather-dependent population dynamics. Routinely-gathered weather data may be useful for anticipating disease risk and planning interventions.We fit time series models using meteorological covariates to predict CL cases in a rural region of Bahía, Brazil from 1994 to 2004. We used the models to forecast CL cases for the period 2005 to 2008. Models accounting for meteorological predictors reduced mean squared error in one, two, and three month-ahead forecasts by up to 16% relative to forecasts from a null model accounting only for temporal autocorrelation.These outcomes suggest CL risk in northeastern Brazil might be partially dependent on weather. Responses to forecasted CL epidemics may include bolstering clinical capacity and disease surveillance in at-risk areas. Ecological mechanisms by which weather influences CL risk merit future research attention as public health intervention targets.

  3. A sensitive new microculture method for diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Allahverdiyev, Adil M; Uzun, Soner; Bagirova, Malahat; Durdu, Murat; Memisoglu, Hamdi R

    2004-03-01

    A sensitive microcapillary culture method (MCM) was developed for rapid diagnosis of cutaneous leishmaniasis (CL). The MCM is superior to the traditional culture method (TCM) as determined by the smaller inoculum size, the higher sensitivity for detection of promastigotes, and the more rapid time for emergence of promastigotes. With lesion amastigote loads from grade III to 0, the positive rates and the periods for promastigote emergence were 3-4-fold higher and faster with the MCM than with the TCM, e.g., 83-97% positive in 4-7 days versus 20-40% positive in 15-30 days (P = 0.0001). The higher Pco(2) and lower Po(2) and pH presumably encourage a rapid amastigote-to-promastigote differentiation and/or the survival or growth of the latter. This MCM has the advantage of simplicity, and may be suitable for diagnostic use and for parasite retrieval in many other endemic sites where parasites are known to be difficult to grow.

  4. An improved microculture method for diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Pagheh, Abdolsattar; Fakhar, Mahdi; Mesgarian, Fatemeh; Gholami, Shirzad; Ahmadpour, Ehsan

    2014-12-01

    This study evaluated the performance of three diagnostic methods for cutaneous leishmaniasis (CL). Patients who came to the Health Center Laboratory of Gonbad-e-Qabus in Golestan Province, Iran, were enrolled in the study. Skin scraping smear, improved microculture (IMC) and polymerase chain reaction (PCR) were performed. A total of 303 subjects were recruited, among whom 273 subjects fulfilled the criteria for CL. Sensitivity and specificity were 88.8 % (95 % CI = 84.2-92.2 %) and 100.0 % for smears, 98.4 % (95 % CI = 96.1-99.1 %) and 100.0 % for IMC, both of them 100.0 % for PCR. Although, PCR was relatively more sensitive than the IMC, the high correlation (agreement = 96 %, Kappa = 0.82) between IMC and PCR along with the advantages of simplicity, rapidity, adequate sensitivity and as a needle free method, offers the IMC as a valuable alternative diagnostic method for PCR in diagnosis of CL.

  5. Forecasting Temporal Dynamics of Cutaneous Leishmaniasis in Northeast Brazil

    Science.gov (United States)

    Lewnard, Joseph A.; Jirmanus, Lara; Júnior, Nivison Nery; Machado, Paulo R.; Glesby, Marshall J.; Ko, Albert I.; Carvalho, Edgar M.; Schriefer, Albert; Weinberger, Daniel M.

    2014-01-01

    Introduction Cutaneous leishmaniasis (CL) is a vector-borne disease of increasing importance in northeastern Brazil. It is known that sandflies, which spread the causative parasites, have weather-dependent population dynamics. Routinely-gathered weather data may be useful for anticipating disease risk and planning interventions. Methodology/Principal Findings We fit time series models using meteorological covariates to predict CL cases in a rural region of Bahía, Brazil from 1994 to 2004. We used the models to forecast CL cases for the period 2005 to 2008. Models accounting for meteorological predictors reduced mean squared error in one, two, and three month-ahead forecasts by up to 16% relative to forecasts from a null model accounting only for temporal autocorrelation. Significance These outcomes suggest CL risk in northeastern Brazil might be partially dependent on weather. Responses to forecasted CL epidemics may include bolstering clinical capacity and disease surveillance in at-risk areas. Ecological mechanisms by which weather influences CL risk merit future research attention as public health intervention targets. PMID:25356734

  6. Intralesional isotype profiles in human localized cutaneous leishmaniasis lesions

    Science.gov (United States)

    Aragort De Rossell, Raiza; Calcagno, Marina; Rossell, Osmán; Maizo De Segnini, Zulay; Rodríguez, Ana María

    2001-01-01

    This immunocytochemical study evaluates the presence of IgG1–4, IgA and IgE immunoglobulins in active lesions of 25 localized cutaneous leishmaniasis patients from three bioclimatic areas (Awa, Afa and Bsha) in Mérida State, Venezuela. All immunoglobulin isotypes except IgE were detected, with variable intensity, in one or more of the epidermal or dermal components of skin lesions. IgG1 and IgG2 were detected significantly more frequently than IgG3, IgG4 and IgA. The ranking of the isotypes according to frequency of detection was the same in all areas: IgG1 = IgG2 > IgG3 = IgG4 = IgA, but considered as whole, all isotypes were detected significantly more frequently in patients from the Awa area than in those from the Bsha area. The predominant expression of isotypes IgG1 and IgG2 suggests a preferential Th1 like immune response. Anti-Leishmania immunoserum stained only parasites and their debris, suggesting that most of the immunostaining was nonspecific. PMID:11454104

  7. Misdiagnosis of cutaneous leishmaniasis and recurrence after surgical excision.

    Science.gov (United States)

    Bailey, Mark S; Langman, G

    2014-12-01

    Cutaneous Leishmaniasis (CL) occurs in British troops deployed to Belize, Afghanistan, Iraq and elsewhere. From 1998 to 2009, 156 (45%) of 343 confirmed cases seen in the UK were in military personnel. CL is a rare disease and requires specialist clinical management because numerous pitfalls exist during diagnosis and treatment. A 19-year-old soldier developed CL on his neck 6 weeks after taking part in jungle warfare training in Belize. However, this was not suspected and the diagnosis was not made from either a skin biopsy or following surgical excision. The travel history and the patient's own photograph prompted retrospective investigations that confirmed this was CL due to Leishmania mexicana. Three months after surgery, the disease recurred locally and was treated appropriately with a good outcome. British military personnel with suspected CL should be referred to the UK Role 4 Military Infectious Diseases & Tropical Medicine Service. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Reactive Nitrogen and Oxygen Intermediates in Patients with Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Erel Ozcan

    1999-01-01

    Full Text Available The metabolisms of reactive nitrogen and oxygen intermediates (RNI and ROI in patients with cutaneous leishmaniasis (CL were investigated and compared with those of healthy subjects. To determine RNI metabolism, nitrite plus nitrate concentrations were measured spectrophotometrically. Nitrite concentration in plasma was determined directly by the Griess method. Nitrate levels in plasma were measured after reduction into nitrite by using copper-cadmium-zinc. ROI metabolism was evaluated by measuring erythrocyte superoxide dismutase, catalase and glutathione peroxidase activities. Plasma nitrite plus nitrate levels and erythrocyte superoxide dismutase activity were higher in the patient group than healthy subjects (p<0.01. In contrast, erythrocyte catalase and glutathione peroxidase activities were lower (p<0.05, p<0.01, respectively. ROI metabolism was altered in relation to hydrogen peroxide elevation in patients with CL. These alterations in ROI enable nitric oxide (NO to amplify its leishmanicidal effect. The determination of ROI and RNI in patients with CL may be a useful tool to evaluate effector mechanisms of NO and clinical manifestations.

  9. Zoonotic Cutaneous Leishmaniasis Prevalence Among Farmers in Central Tunisia, 2014.

    Science.gov (United States)

    Bellali, Hedia; Chemak, Fraj; Nouiri, Issam; Ben Mansour, Dorra; Ghrab, Jamila; Chahed, Mohamed Kouni

    2017-01-01

    Zoonotic cutaneous leishmaniasis (ZCL) is endemic in central Tunisia and is more prevalent in rural agricultural areas. The aim of this work was to determine ZCL prevalence among farmers and to test their availability to take ownership of the problem and participate actively to fight and address the disease. A sample of farmers from Sidi Bouzid, central Tunisia, was selected randomly. Farmers were interviewed using a standardized questionnaire about ZCL lesion occurrence, its date of onset among family members, and the farmers' availability to contribute to fighting this disease. ZCL occurred in at least one of the family members of 38.5% interviewed farmers. The disease was endemic with recurrent epidemics every 4 or 5 years. ZCL among farmers was associated with irrigation management. With regard to ZCL preventive measures, the majority of farmers agreed and expressed willingness to collaborate (93.1%), to follow health care facilities instructions (73.1%), and to join the nongovernmental organization (NGO) (56.9%). However, they did not agree to reduce irrigation activities mainly at night, to live far from their irrigated fields, or to sleep out of their houses at night. ZCL is more prevalent in farmers engaged in irrigation activities. Farmers are not agreeable to reducing their activity to avoid exposure to the sand fly bites. Thus, population involvement and commitment is required to implement effective control measures to fight and address ZCL.

  10. Leishmaniasis in Turkey: Visceral and cutaneous leishmaniasis caused by Leishmania donovani in Turkey.

    Science.gov (United States)

    Özbilgin, Ahmet; Harman, Mehmet; Karakuş, Mehmet; Bart, Aldert; Töz, Seray; Kurt, Özgür; Çavuş, İbrahim; Polat, Erdal; Gündüz, Cumhur; Van Gool, Tom; Özbel, Yusuf

    2017-09-01

    In Turkey, the main causative agents are Leishmania tropica (L. tropica) and Leishmania infantum (L. infantum) for cutaneous leishmaniasis (CL) and L. infantum for visceral leishmaniasis (VL). In this study, we investigated leishmaniasis cases caused by L. donovani and established animal models for understanding its tropism in in vivo conditions. Clinical samples (lesion aspirations and bone marrow) obtained from CL/VL patients were investigated using parasitological (smear/NNN) and DNA-based techniques. For species identification, a real time ITS1-PCR was performed using isolates and results were confirmed by hsp70 PCR-N/sequencing and cpb gene PCR/sequencing in order to reveal Leishmania donovani and Leishmania infantum discrimination. Clinical materials from CL and VL patients were also inoculated into two experimental groups (Group CL and Group VL) of Balb/C mice intraperitoneally for creating clinical picture of Turkish L. donovani strains. After 45days, the samples from visible sores of the skin were taken, and spleens and livers were removed. Measurements of the internal organs were done and touch preparations were prepared for checking the presence of amastigotes. The strains were isolated from all patients and amastigotes were seen in all smears of the patients, and then isolates were immediately stored in liquid nitrogen. In real time ITS1-PCR, the melting temperatures of all samples were out of range of L. infantum, L. tropica and L. major. Sequencing of hsp70 PCR-N showed that all isolates highly identical to previously submitted L. donovani sequences in GenBank, and cpb gene sequencing showed five isolates had longer cpbF allele, whereas one isolate contained a mixed sequence of both cpbF and cpbE. All mice in both experimental groups became infected. Compared to controls, the length and width of both liver and spleen were significantly elevated (pTurkey. Animal models using clinical samples were successfully established and important clinical

  11. Visceral leishmaniasis with cutaneous symptoms in a patient treated with infliximab followed by fatal consequences.

    Science.gov (United States)

    Juzlova, Katerina; Votrubova, Jana; Kacerovska, Denisa; Lukas, Milan; Bortlik, Martin; Rohacova, Hana; Nohynkova, Eva; Vojackova, Nadezda; Fialova, Jorga; Hercogova, Jana

    2014-01-01

    Leishmaniasis is an infectious disease caused by parasitic flagellates of the genus Leishmania. The authors present a case of 44-year-old man with Crohn's disease treated successfully with infliximab. This case report shows rare visceral leishmaniasis with cutaneous symptoms in an immunocompromised patient. Skin manifestations may occur before or after the visceral infection and they are often diverse. © 2013 Wiley Periodicals, Inc.

  12. [Ankle and foot ulcerations in a diabetic patient revealing cutaneous leishmaniasis].

    Science.gov (United States)

    Niclot, J; Stansal, A; Lazareth, I; Galloula, A; Duchatelle, V; Laurent-Bellue, A; Priollet, P

    2014-12-01

    Cutaneous leishmaniasis is a parasitic disease that typically manifests as a typical crusted ulcer called the oriental sore. Its localization on the lower limbs can be mistaken for a leg ulcer. An 81-year-old male, native of Algeria, with type 2 diabetes, arterial hypertension and arteriopathy developed a chronic ulceration of the right ankle and foot compatible with the diagnosis of infectious diabetic foot. Non-improvement with antibiotics, local treatment and rest, and the absence of any hemodynamic arteriopathy led to skin biopsies. Polymerase chain reaction performed on biopsy samples for parasitological investigations yielded the diagnosis of cutaneous leishmaniasis due to Leishmania major. Complete healing was obtained with topical care alone, the patient having declined an etiological treatment. Cutaneous leishmaniasis is one of the rare infectious etiologies of chronic leg ulcers. Several therapeutic options, including abstention, can be proposed. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. Detection of Cutaneous Leishmaniasis by PCR in Fasa district in 2012

    Directory of Open Access Journals (Sweden)

    Mehdi Sharafi

    2013-09-01

    Material & Methods: Slit biopsies were collected from 138 suspected cases of cutaneous leishmaniasis who were presented, consecutively, in Fasa district from April 2011 to February 2012. After the microscopy, the entire smear was then scraped off the slide surface for DNA extraction and PCR assay. Results: All 138 investigated smears were reported positive by microscopy and nested PCR assay. In PCR, One of the smears had the 750-bp band, indicative of L. tropica and the rest had the 560-bp band indicative of L. major. Conclusion: In conclusion, the cutaneous leishmaniasis found in Fasa district is predominantly Rural Cutaneous Leishmaniasis. The PCR-based assay used in the present study appears to be a suitable and powerful tool for the characterization of Leishmanial species.

  14. Diagnostic methods to cutaneous leishmaniasis detection in domestic dogs and cats.

    Science.gov (United States)

    Trevisan, Daliah Alves Coelho; Lonardoni, Maria Valdrinez Campana; Demarchi, Izabel Galhardo

    2015-01-01

    Cutaneous leishmaniasis is caused by different species of Leishmania. In domestic animals such as dogs and cats, the diagnostic consists of clinical, epidemiological and serological tests, which changes among countries all around the world. Because of this diversity in the methods selected, we propose this systematic literature review to identify the methods of laboratory diagnosis used to detect cutaneous leishmaniasis in domestic dogs and cats in the Americas. Articles published in the last 5 years were searched in PubMed, ISI Web of Science, LILACS and Scielo, and we selected 10 papers about cutaneous leishmaniasis in dogs and cats in the Americas. In Brazil, often the indirect immunofluorescence and enzyme immunoassay (ELISA) have been applied. Other countries like United States and Mexico have been using antigenic fractions for antibodies detections by Western blot. ELISA and Western blot showed a higher sensitivity and efficacy in the detection of leishmaniasis. Analysis of sensibility and specificity of the methods was rarely used. Although confirmatory to leishmaniasis, direct methods for parasites detection and polymerase chain reaction showed low positivity in disease detection. We suggested that more than one method should be used for the detection of feline and canine leishmaniasis. Serological methods such as Western blot and enzyme immunoassay have a high efficacy in the diagnosis of this disease.

  15. Visceral leishmaniasis with cutaneous lesions in a patient infected with human immunodeficiency virus.

    Science.gov (United States)

    Ara, M; Maillo, C; Peón, G; Clavel, A; Cuesta, J; Grasa, M P; Carapeto, F J

    1998-07-01

    We report a case of visceral leishmaniasis (VL) with cutaneous lesions in a patient infected with human immunodeficiency virus (HIV). The cutaneous lesions consisted of erythematous papules on the legs. Biopsy of one lesion showed abundant Leishmania amastigotes within epithelial cells of an eccrine sweat gland in the dermis. Leishmania organisms were also found in a blood smear. Rapid and complete clearance of the cutaneous lesions was achieved after antimony therapy. Cutaneous lesions in VL are being reported increasingly frequently in patients with HIV infection and their significance remains in discussion.

  16. Systemic Meglumine Antimoniate in Cutaneous Leishmaniasis of Children: Clinical and Laboratory Complications.

    Science.gov (United States)

    Layegh, Pouran; Khademi, Zeinab; Afzal Aghaee, Monavar; Moghiman, Toktam

    2015-12-01

    Children account for 7%-20% of cutaneous leishmaniasis cases in Iran, but there are few safety data to guide pediatric antiparasitic therapy. We evaluated the clinical and laboratory tolerance of the systemic pentavalent antimonial compound meglumine antimoniate, in 70 Iranian children with cutaneous leishmaniasis. Adverse effects were similar to those seen in adults. © The Author 2014. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. A Novel Field Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis

    Science.gov (United States)

    2015-10-01

    equivalent of ᝺ parasites in spiked clinical specimens. We will compare the analytical sensitivity and specificity of RPA-LF with qPCR using a broad panel of...AWARD NUMBER: W81XWH-14-2-0196 TITLE: A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis PRINCIPAL INVESTIGATOR... Diagnostic Test for Cutaneous Leishmaniasis 5b. GRANT NUMBER W81XWH-14-2-0196 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER LT Robert

  18. Identification of Leishmania tropica from micro-foci of cutaneous leishmaniasis in the Kenyan Rift Valley.

    Science.gov (United States)

    Odiwuor, Samwel; Muia, Alfred; Magiri, Charles; Maes, Ilse; Kirigi, George; Dujardin, Jean-Claude; Wasunna, Monique; Mbuchi, Margaret; Auwera, Gert Van der

    2012-07-01

    We performed diagnosis and species identification of parasites in lesion samples from suspected cutaneous leishmaniasis patients in four villages, three of which are in a known Leishmania tropica endemic region in Kenya. Samples were analyzed both by microscopy and PCR for Leishmania, and typed by an assay using four ribosomal DNA-based species-identification PCRs. The lesions were demonstrated to be caused by L. tropica, which confirms the re-emergence of cutaneous leishmaniasis from this species after a period of reduced incidence in the endemic zone. Our report highlights the importance of an intervention and sustained Leishmania control program.

  19. [The Assesment of Cutaneous Leishmaniasis Patients Admiting to Gaziantep University of Medicine Faculty Leishmaniasis Diagnosis and Treatment Center].

    Science.gov (United States)

    Korkmaz, Selma; Özgöztaşı, Orhan; Kayıran, Nuriye

    2015-03-01

    Cutaneous Leishmaniasis (CL) is a curable clinical condition characterized by atrophic scars caused by the Leishmania species of protozoan parasites. In the period following the beginning of the Syrian Civil War, there has been a dramatic increase in number of CL cases in Gaziantep. The aim of this study was to evaluate the epidemiological characteristics of CL patients admitted to Gaziantep University of Medicine Faculty Leishmaniasis diagnosis and treatment center in Gaziantep. Within the context of this study, a total of 635 CL patients admitted between 01 April 2013 and 01 April 2014 to the Leishmaniasis diagnosis and treatment center of the Gaziantep were evaluated retrospectively. Patient data regarding age, sex, the location of lesions, the number of lesions, the duration of the lesions, and the months in which the lesions appeared were recorded and statistically analyzed. Of these patients, 67 (10.6%) were Turkish citizens, while 568 (89.4%) were Syrian citizens. In addition, 299 (47.1%) of the patients were female, while 336 (52.9%) were male. The large majority of the cases were between 5-9 (n=140, 22%) and 10-19 (n=168, 26.5%) years of age; 66% of all cases were below 20 years of age. An evaluation of the distribution of cases according to the months revealed that the lowest number of cases occurred in the months of July (n=14, 2.2%) and August (n=13, 2.0%), while the highest number of cases occurred in the months of January (n=122, 19.2%) and February (n=106, 16.7%). Cutaneous Leishmaniasis is a condition that affects individuals of all ages and genders. It is thus necessary to conduct regular health screenings for Cutaneous Leishmaniasis, and to inform and educate vulnerable communities and the society in general regarding this condition.

  20. IL-1β production by intermediate monocytes is associated with immunopathology in cutaneous leishmaniasis.

    Science.gov (United States)

    Santos, Daniela; Campos, Taís M; Saldanha, Maíra; Oliveira, Sergio C; Nascimento, Mauricio; Zamboni, Dario S; Machado, Paulo R; Arruda, Sérgio; Scott, Phillip; Carvalho, Edgar M; Carvalho, Lucas P

    2017-12-12

    Cutaneous leishmaniasis due to Leishmania braziliensis infection is an inflammatory disease which skin ulcer development is associated with mononuclear cells infiltrate and high levels of inflammatory cytokines production. Recently, NOD-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome activation and IL-1β production has been associated with increased pathology in murine cutaneous leishmaniasis. We hypothesized that cutaneous leishmaniasis patients have increased expression of NLRP3 leading to high levels of IL-1β production. In this work we show high production of IL-1β in biopsies and Leishmania antigen-stimulated peripheral blood mononuclear cells (PBMC) from patients infected with L. braziliensis, and reduced IL-1β levels after cure. IL-1β production positively correlated with the area of necrosis in lesions and duration of the lesions. The main source of IL-1β was intermediate monocytes (CD14++CD16+). Furthermore, our murine experiments show that IL-1β production in response to L. braziliensis was dependent on NLRP3, Caspase-1 and caspase-recruiting domain (ASC). Additionally, we observed an increased expression of NLRP3 gene in macrophages and NLRP3 protein in intermediate monocytes from cutaneous leishmaniasis patients. These results identify an important role for human intermediate monocytes for the production of IL-1β which contributes to the immunopathology observed in cutaneous leishmanisis patients. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Molecular detection and identification of Leishmania infection in naturally infected sand flies in a focus of cutaneous leishmaniasis in northern Morocco

    OpenAIRE

    Es-Sette, Nargys; Ajaoud, Malika; Laamrani-Idrissi, Abderrahman; Mellouki, Fouad; Lemrani, Meryem

    2014-01-01

    Background Cutaneous leishmaniasis is an infectious disease caused by various species of the flagellate protozoan Leishmania. During the past 20 years, cutaneous leishmaniasis has emerged as a major public health threat in Morocco. The main objective of this study was to study the occurrence of Leishmania infection in vectors and to identify sand fly blood meal sources in an endemic locality of cutaneous leishmaniasis within Sefrou province, where the vectors of leishmaniasis were still unkno...

  2. Protection against Cutaneous Leishmaniasis in Outbred Vervet Monkeys, Using a Recombinant Histone H1 Antigen

    OpenAIRE

    Masina, Slavica; M. Gicheru, Michael; Demotz, Stéphane O.; Fasel, Nicolas J.

    2017-01-01

    Infection with Leishmania major parasites results in the development of cutaneous ulcerative lesions on the skin. We investigated the protective potential of a single, recombinant histone H1 antigen against cutaneous leishmaniasis in an outbred population of vervet monkeys, using Montanide adjuvant. Protection was assessed by challenging the animals with a mixture of vector sand fly salivary-gland lysate and a low dose of in vitro-derived parasites, thus more closely mimicking natural infecti...

  3. Leishmanization revisited: immunization with a naturally attenuated cutaneous Leishmania donovani isolate from Sri Lanka protects against visceral leishmaniasis.

    Science.gov (United States)

    McCall, Laura-Isobel; Zhang, Wen-Wei; Ranasinghe, Shanlindra; Matlashewski, Greg

    2013-02-27

    Leishmaniasis is a neglected tropical disease caused by Leishmania protozoa and associated with three main clinical presentations: cutaneous, mucocutaneous and visceral leishmaniasis. Visceral leishmaniasis is the second most lethal parasitic disease after malaria and there is so far no human vaccine. Leishmania donovani is a causative agent of visceral leishmaniasis in South East Asia and Eastern Africa. However, in Sri Lanka, L. donovani causes mainly cutaneous leishmaniasis, while visceral leishmaniasis is rare. We investigate here the possibility that the cutaneous form of L. donovani can provide immunological protection against the visceral form of the disease, as a potential explanation for why visceral leishmaniasis is rare in Sri Lanka. Subcutaneous immunization with a cutaneous clinical isolate from Sri Lanka was significantly protective against visceral leishmaniasis in BALB/c mice. Protection was associated with a mixed Th1/Th2 response. These results provide a possible rationale for the scarcity of visceral leishmaniasis in Sri Lanka and could guide leishmaniasis vaccine development efforts. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Spatial modeling of cutaneous leishmaniasis in Iran from 1983 to 2013.

    Science.gov (United States)

    Holakouie-Naieni, Kourosh; Mostafavi, Ehsan; Boloorani, Ali Darvishi; Mohebali, Mehdi; Pakzad, Reza

    2017-02-01

    Cutaneous Leshmaniasis (CL), a parasitic skin infection caused by Leishmania species, is endemic in some regions of Iran. In this study, the effect of location on the incidence and distribution of CL in Iran was studied. We collected datas including the number of Cutaneous Leishmaniasis cases and populations at-risk of disease in Iran's different provinces reported by the Iranian ministry of health and the National Bureau of Statistics, respectively. Spatial modeling was performed using Arc GIS software. Descriptive maps, hotspot analysis, and high/low clustering analysis were used to demonstrate distribution of the cutaneous leishmaniasis, to determine regions at risk of disease's incidence, and to reach the most appropriate method for clustering of disease. The total number of cases of cutaneous leishmaniasis reported through the study period was 589,913. The annual incidence of CL was estimated to be 30.9 per 100,000 in Iranian population. We also demonstrated that Cutaneous leishmaniasis most prominently occurs in regions with dry and desert climates as well as in central parts of Iran. It affected the southwest of Iran between 1983 and 1997, and subsequently developed towards the center and the eastern between 1998 and 2013. Disease hotspots were focused in the provinces of Yazd, Khozestan and Kohgiloyeh-Boyer-Ahmad (p<0.05). No pattern of spatial clustering was observed. Cutaneous leishmaniasis is a major health problem which could be a serious threat for inhabitants who live in high-risk provinces of Iran; much more resources need to be allocated in these areas, to warrant the prevention as well as effectively management of this disease. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Reprint of "Spatial modeling of Cutaneous Leishmaniasis in Iran from 1983 to 2013".

    Science.gov (United States)

    Holakouie-Naieni, Kourosh; Mostafavi, Ehsan; Boloorani, Ali Darvishi; Mohebali, Mehdi; Pakzad, Reza

    2017-01-01

    Cutaneous Leshmaniasis (CL), a parasitic skin infection caused by Leishmania species, is endemic in some regions of Iran. In this study, the effect of location on the incidence and distribution of CL in Iran was studied. We collected datas including the number of Cutaneous Leishmaniasis cases and populations at-risk of disease in Iran's different provinces reported by the Iranian ministry of health and the National Bureau of Statistics, respectively. Spatial modeling was performed using Arc GIS software. Descriptive maps, hotspot analysis, and high/low clustering analysis were used to demonstrate distribution of the cutaneous leishmaniasis, to determine regions at risk of disease's incidence, and to reach the most appropriate method for clustering of disease. The total number of cases of cutaneous leishmaniasis reported through the study period was 589,913. The annual incidence of CL was estimated to be 30.9 per 100,000 in Iranian population. We also demonstrated that Cutaneous leishmaniasis most prominently occurs in regions with dry and desert climates as well as in central parts of Iran. It affected the southwest of Iran between 1983 and 1997, and subsequently developed towards the center and the eastern between 1998 and 2013. Disease hotspots were focused in the provinces of Yazd, Khozestan and Kohgiloyeh-Boyer-Ahmad (p<0.05). No pattern of spatial clustering was observed. Cutaneous leishmaniasis is a major health problem which could be a serious threat for inhabitants who live in high-risk provinces of Iran; much more resources need to be allocated in these areas, to warrant the prevention as well as effectively management of this disease. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Therapeutic Effect of Onosma Stinosiphon Extract on Cutaneous Leishmaniasis in Infected BALB/c Mice

    Directory of Open Access Journals (Sweden)

    A Fattahi Bafghi

    2015-07-01

    Conclusion: topical use of Onosma stinosiphon extract in the treatment of cutaneous Leishmaniasis wounds causes to be the growth slower diameter size and use of topical honey prevention of cause necrosis and creation of secondary bacterial infections are, but it Do not none whole parasite removal from the body.

  7. The pathology of cutaneous leishmaniasis due to Leishmania major in Sudan

    DEFF Research Database (Denmark)

    Gaafar, A; el Kadaro, A Y; Theander, T G

    1995-01-01

    The pathology of cutaneous leishmaniasis in Sudan, where the disease is caused by Leishmania major, was studied by light and electron microscopy. Lesions were classified into four distinct groups based on the ratio of different cell types, especially lymphocytes, macrophages, and plasma cells...

  8. Cutaneous leishmaniasis in three Dutch military cohorts following jungle training in Belize

    NARCIS (Netherlands)

    van Thiel, P. P. A. M.; Zeegelaar, J. E.; van Gool, T.; Faber, W. R.; Kager, P. A.

    2011-01-01

    Skin lesions occur frequently in travelers to tropical countries. Military personnel acquire skin lesions regularly during jungle training as did Dutch troops who trained in the jungle of Belize in 1998, 2004 and 2009, in an area endemic for cutaneous leishmaniasis. Demographic and clinical data

  9. American cutaneous leishmaniasis: epidemiological profile of patients treated in Londrina from 1998 to 2009*

    Science.gov (United States)

    Junior, Rubens Pontello; Gon, Airton dos Santos; Ogama, Alessandra

    2013-01-01

    BACKGROUND American cutaneous leishmaniasis is a dermatozoonosis of compulsory notification with relevant morbidity. The disease is considered endemic in northern Paraná. OBJECTIVES To evaluate the clinical, laboratory and epidemiological aspects of patients with American cutaneous leishmaniasis treated at Clinics Hospital, State University of Londrina, Brazil (Paraná). METHODS This was an observational, cross-sectional, retrospective and descriptive study. The medical records of patients with American cutaneous leishmaniasis treated at the University Hospital of Londrina - Paraná, from 1998 to 2009 were evaluated. RESULTS A total of 470 patients, with prevalence of 8.72 cases / 100,000 inhabitants, participated in the study. Most patients were male, aged 21-40 years, with a single ulcerated lesion as the most common clinical presentation, located mainly in an exposed area of the body. With regard to immunological tests, the Montenegro intradermal reaction was positive in 84.4% of cases. Treatment with pentavalent antimony was well tolerated, and patient follow-up for a year occurred in 59% of cases. CONCLUSION American cutaneous leishmaniasis is still an endemic disease in the region, with a high potential for morbidity, but with a cure rate of around 95% after treatment. The use of immunological techniques facilitates the diagnosis of clinically suspicious cases. PMID:24173180

  10. Is the dog a possible reservoir for cutaneous leishmaniasis in suriname?

    NARCIS (Netherlands)

    Kent, Alida; Ramkalup, Prakash; Mans, Dennis; Schallig, Henk

    2013-01-01

    Cutaneous leishmaniasis (CL) is an emerging disease in Suriname, with at least 200 cases per year. Little is known about the biology of CL in the country. The most important parasite species is Leishmania Viannia guyanensis, but possible vectors and reservoirs are hardly incriminated. In the present

  11. Dynamics of parasite clearance in cutaneous leishmaniasis patients treated with miltefosine

    NARCIS (Netherlands)

    Dorlo, Thomas P. C.; van Thiel, Pieter P. A. M.; Schoone, Gerard J.; Stienstra, Ymkje; van Vugt, Michèle; Beijnen, Jos H.; de Vries, Peter J.

    2011-01-01

    Parasite loads were quantified in repeated skin biopsies from lesions of 2 patients with Old-World cutaneous leishmaniasis (CL) caused by Leishmania major and L. infantum during and after treatment with miltefosine. Miltefosine induced a rapid therapeutic effect on both infections with an initial

  12. Domestic and peridomestic transmission of American cutaneous leishmaniasis: changing epidemiological patterns present new control opportunities

    Directory of Open Access Journals (Sweden)

    Diarmid Campbell-Lendrum

    2001-02-01

    Full Text Available Predictions that deforestation would reduce American cutaneous leishmaniasis incidence have proved incorrect. Presentations at a recent international workshop, instead, demonstrated frequent domestication of transmission throughout Latin America. While posing new threats, this process also increases the effectiveness of vector control in and around houses. New approaches for sand fly control and effective targeting of resources are reviewed.

  13. Sensitive diagnosis of cutaneous leishmaniasis by lesion swab sampling coupled to qPCR

    NARCIS (Netherlands)

    Adams, Emily R.; Gomez, Maria Adelaida; Scheske, Laura; Rios, Ruby; Marquez, Ricardo; Cossio, Alexandra; Albertini, Audrey; Schallig, Henk; Saravia, Nancy Gore

    2014-01-01

    Variation in clinical accuracy of molecular diagnostic methods for cutaneous leishmaniasis (CL) is commonly observed depending on the sample source, the method of DNA recovery and the molecular test. Few attempts have been made to compare these variables. Two swab and aspirate samples from lesions

  14. Antigen-presenting cells in human cutaneous leishmaniasis due to Leishmania major

    DEFF Research Database (Denmark)

    ElHassan, A M; Gaafar, A; Theander, T G

    1995-01-01

    In this study biopsies from skin lesions and draining lymph nodes of patients suffering from cutaneous leishmaniasis caused by Leishmania major were examined by immunohistochemistry, and by light and electron microscopy to identify the types of antigen-presenting cells (APC) and their location. APC...

  15. Phenotyping of circulating CD8(+) T cell subsets in human cutaneous leishmaniasis

    Czech Academy of Sciences Publication Activity Database

    Khamesipour, A.; Rostami, M.N.; Tasbihi, M.; Mohammadi, A.M.; Shahrestani, T.; Sarrafnejad, A.; Sohrabi, Yahya; Eskandari, S.E.; Valian, H.K.

    2012-01-01

    Roč. 14, č. 9 (2012), s. 702-711 ISSN 1286-4579 Institutional research plan: CEZ:AV0Z50520514 Institutional support: RVO:68378050 Keywords : CD8(+) T cells * memory T cells * cutaneous leishmaniasis * IFN-gamma Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 2.920, year: 2012

  16. Intralesional autotherapy of cutaneous leishmaniasis with buffy coat cells: cytological findings

    DEFF Research Database (Denmark)

    Dabiri, S; Meymandi, S S; Hayes, M M

    2000-01-01

    The skin lesions of five patient volunteers with dry-type cutaneous leishmaniasis were treated by intralesional injection of auto-leukocytes prepared from buffy coat of the patient's own blood. Giemsa stained, air-dried cytological smear preparations were prepared from scrapings taken from the ma...

  17. Spontaneous cure of American cutaneous leishmaniasis due to Leishmania naiffi in two Dutch infantry soldiers

    NARCIS (Netherlands)

    van der Snoek, E. M.; Lammers, A. M.; Kortbeek, L. M.; Roelfsema, J. H.; Bart, A.; Jaspers, C. A. J. J.

    2009-01-01

    We report two Dutch infantry soldiers who acquired American cutaneous leishmaniasis (ACL) during military jungle training in Surinam. The lesions had existed for 3 and 5 months, respectively, before the soldiers presented for treatment. The lesions occurred on the head and right thigh, and were

  18. Entomological and epidemiological study of a new focus of cutaneous leishmaniasis in Morocco.

    Science.gov (United States)

    Ramaoui, K; Guernaoui, S; Boumezzough, A

    2008-09-01

    Cutaneous leishmaniasis (CL) due to Leishmania tropica Wright has become an increasingly important problem in Al-Haouz province, Morocco. The objective of this paper was to undertake a retrospective analysis of CL between 2000 and 2006 and to study the sandfly fauna for the first time in this focus. The consultation of bulletins, registers and monthly and annual reports published by local and national medical services permitted a global synthesis of CL in Al-Haouz between 2000 and 2006. Sandflies were collected using sticky-paper traps in five selected stations in two communes, Ourika and Sti Fadma, the most affected by CL in Al-Haouz. Overall, 2,648 sandflies, belonging to five species of Phlebotomus and three of Sergentomyia, were collected. Phlebotomus sergenti Parrot (14.5%) was found in all studied stations where it was associated with domestic and peridomestic habitats. Based on this first report on ecology of sandflies and epidemiology of CL, Al-Haouz seems to be a typical focus of L. tropica and P. sergenti like the other Moroccan foci. Two communes, Sti Fadma and Ourika, constituted an important CL micro-focus in this region. Considering their economical importance (trade and tourism), they contribute probably to the dissemination of Leishmania parasite in bordering regions.

  19. Diabetes melutus associated with pentamidine isethionate in diffuse cutaneous leishmaniasis

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    Jackson Mauricio Lopes Costa

    1995-12-01

    Full Text Available The authors report a case of a male patient from Bacabal, MA with diffuse cutaneous leishmaniasis (DCL, for at least nine years, with 168 lesions on his body. These were tumour-like nodules with some ulceratmi. He usedpentavalent antimonial (glucantime® and an association of gamma interferon plus glucantime with improvement of the lesions but relapsed later. Recently, pentamidine isethionate (pentacarinat® was given a dosage of 4mg/kg/weight/day on alternate days for 20 applications. After 3 months a similar course of 10 application was given 2 times. Later he developed diabetic signs with weight loss of 10kg, polydypsia, polyuria and xerostomia. The lower limbs lesions showed signs of activity. Blood glucose levels normalised and remain like this at moment. Attention is drawn to the fact that pentamidine isethionate should be used as a therapy option with care, obeyng rigorous laboratory controls including a glucose tolerance test.Os autores relatam o caso de um paciente procedente de Bacabal, MA, portador de leishmaniose cutânea difusa (LCD há 9 anos, apresentando um total de 168 lesões distribuídas pelo corpo, de caráter nódulo tumoral e algumas ulceradas, tendo sido submetido a tratamentos anteriores á base de antimonial pentavalente (gluc antime® e associação interferom gamma+glucantime® com melhora e posterior recidiva das lesões. Recentemente quando da utilização do medicamento isotianato de pentamidina (pentacarinat® na dose de 4mg/kg/peso/dia, aplicados 1M em dias alternados em 3 séries de 20, 10, 10 aplicações com intervalos entre as séries de 3 meses. Na evolução do tratamento desenvolveu um quadro de perda de peso 10kg, polidpsia, poliúria, xerostomia, lesões de membros inferiores com sinais de atividade. Glicemia em jejum 420mg/dl, presença de glicose e corpos cetônicos na urina. Instituída insulinoterapia houve melhora do quadro e retorno dos níveis glicêmicos permanecendo estãvel até o presente

  20. Clinical study of cutaneous leishmaniasis in the Kashmir Valley

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    Gh Mohiuddin Wani

    2015-01-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is an infectious disease of tropical and semitropical areas of the world. The cold and harsh winter conditions of the Kashmir Valley do not favor the survival and growth of the Leishmania parasite or its vector, the sand fly, and the disease was until now practically unheard of in the Kashmir Valley. Aims: There has been a recent rise in the number of cases of CL in the Kashmir Valley. Against this background, the present study was taken up to describe the epidemiology, clinical features, and management outcomes of CL in the Kashmir Valley, where it represents a new phenomenon. Materials and Methods: Patients with direct smear-confirmed CL were evaluated. For each patient, we noted age, gender, geographical origin, stays in endemic areas, clinical aspects, number, site and size of lesions, treatment, and outcome. All the infected patients were treated with sodium stibogluconate. The dose, route of administration, adverse effects, and the clinical response in each patient was noted down. Results: Eighteen patients, 11 males (61.12% and 7 females (38.88% were studied. The age of the patients ranged from 3 to 60 years (mean age 29.8. The majority of our patients (16, 88.9% belonged to two hilly areas, Uri and Karnah. Duration of the disease ranged from a minimum of 1 month to a maximum of 18 months (mean duration 4.6 months. Lesions in most of our patients (16, 88.9% were located on the face including the lip and nose. The size of lesions varied from 4 to about 50 mm (average 2-3 cm. Most of our patients (13, 73.3% had only a single lesion and a few (5, 26.7% had two or three lesions. The clinical type of lesion in most of our patients (16, 88.9% was noduloulcerative, only two (11.1% had nodular (nonulcerative lesions. Sixteen patients; all with facial lesions were treated with intravenous sodium stibogluconate. A complete response was seen in 14 (87%, without any major adverse effect. Two adult patients with

  1. Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya.

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    Ahmad Amro

    2017-09-01

    Full Text Available Cutaneous leishmaniasis (CL is a major public health problem in Libya. In this paper, we describe the eco-epidemiological parameters of CL during the armed conflict period from January 2011 till December 2012. Current spatiotemporal distributions of CL cases were explored and projected to the future using a correlative modelling approach. In addition the present results were compared with our previous data obtained for the time period 1995-2008.We investigated 312 CL patients who presented to the Dermatology Department at the Tripoli Central Hospital and came from 81 endemic areas distributed in 10 districts. The patients presented with typical localized lesions which appeared commonly on the face, arms and legs. Molecular identification of parasites by a PCR-RFLP approach targeting the ITS1 region of the rDNA was successful for 81 patients with two causative species identified: L. major and L. tropica comprised 59 (72.8% and 22 (27.2% cases, respectively. Around 77.3% of L. tropica CL and 57.7% of L. major CL caused single lesions. Five CL patients among our data set were seropositive for HIV. L. tropica was found mainly in three districts, Murqub (27.3%, Jabal al Gharbi (27.3% and Misrata (13.7% while L. major was found in two districts, in Jabal al Gharbi (61% and Jafara (20.3%. Seasonal occurrence of CL cases showed that most cases (74.2% admitted to the hospital between November and March, L. major cases from November till January (69.4%, and L. tropica cases mainly in January and February (41%. Two risk factors were identified for the two species; the presence of previously infected household members, and the presence of rodents and sandflies in patient's neighborhoods. Spatiotemporal projections using correlative distribution models based on current case data and climatic conditions showed that coastal regions have a higher level of risk due to more favourable conditions for the transmitting vectors.Future projection of CL until 2060

  2. Occurrence of two autochthonous cases of American cutaneous leishmaniasis in the neighborhood of Caju, city of Rio de Janeiro, Brazil.

    Science.gov (United States)

    Bernardes Filho, Fred; Bonatto, Danielle Cristine; Martins, Gustavo; Maier, Leonardo de Medeiros; Nery, José Augusto da Costa; Azulay-Abulafia, Luna

    2014-01-01

    American cutaneous leishmaniasis is in full geographic expansion in Brazil and it is considered among the infectious and parasitic diseases of utmost importance worldwide, not only by its frequency, but mainly by therapeutic difficulties, deformities and sequelae that may result. In the state of Rio de Janeiro, the first autochthonous case of American cutaneous leishmaniasis was registered by Rabello in 1913. The authors report two cases of the disease in the region around the Cemetery São Francisco Xavier, in the Caju neighborhood, Rio de Janeiro city, and emphasize the need for actions that aim to early diagnosis and treatment of American cutaneous leishmaniasis cases.

  3. Occurrence of two autochthonous cases of American cutaneous leishmaniasis in the neighborhood of Caju, city of Rio de Janeiro, Brazil*

    Science.gov (United States)

    Bernardes Filho, Fred; Bonatto, Danielle Cristine; Martins, Gustavo; Maier, Leonardo de Medeiros; Nery, José Augusto da Costa; Azulay-Abulafia, Luna

    2014-01-01

    American cutaneous leishmaniasis is in full geographic expansion in Brazil and it is considered among the infectious and parasitic diseases of utmost importance worldwide, not only by its frequency, but mainly by therapeutic difficulties, deformities and sequelae that may result. In the state of Rio de Janeiro, the first autochthonous case of American cutaneous leishmaniasis was registered by Rabello in 1913. The authors report two cases of the disease in the region around the Cemetery São Francisco Xavier, in the Caju neighborhood, Rio de Janeiro city, and emphasize the need for actions that aim to early diagnosis and treatment of American cutaneous leishmaniasis cases. PMID:25184938

  4. Epidemiological role of a rodent in Morocco: Case of cutaneous leishmaniasis

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    Mohamed Echchakery

    2015-08-01

    Full Text Available Commensal rodents as well as wild ones may present a potential risk to public health. They are reservoirs or vectors of many pathogens. This review provides an update on their epidemiological role in the spread of leishmaniasis in Morocco. In Morocco, the order Rodentia is represented by 7 families and 32 species of which Rattus norvegicus, Psammomys obesus, Mastomys erythrolecus, Meriones shawi, Meriones crassus and Meriones libycus are considered reservoirs of leishmaniasis in Asia, Midle East and Africa. With the aim to define the extent of zoonotic leishmaniasis risk in Morocco, we represent and discuss the geographical distribution of these potential reservoirs in relation to that of Phlebotomus papatasi, proven vector of cutaneous leishmaniasis by Leishmania major in Morocco.

  5. Ecological Niche Modeling for the Prediction of the Geographic Distribution of Cutaneous Leishmaniasis in Tunisia.

    Science.gov (United States)

    Chalghaf, Bilel; Chlif, Sadok; Mayala, Benjamin; Ghawar, Wissem; Bettaieb, Jihène; Harrabi, Myriam; Benie, Goze Bertin; Michael, Edwin; Salah, Afif Ben

    2016-04-01

    Cutaneous leishmaniasis is a very complex disease involving multiple factors that limit its emergence and spatial distribution. Prediction of cutaneous leishmaniasis epidemics in Tunisia remains difficult because most of the epidemiological tools used so far are descriptive in nature and mainly focus on a time dimension. The purpose of this work is to predict the potential geographic distribution of Phlebotomus papatasi and zoonotic cutaneous leishmaniasis caused by Leishmania major in Tunisia using Grinnellian ecological niche modeling. We attempted to assess the importance of environmental factors influencing the potential distribution of P. papatasi and cutaneous leishmaniasis caused by L. major. Vectors were trapped in central Tunisia during the transmission season using CDC light traps (John W. Hock Co., Gainesville, FL). A global positioning system was used to record the geographical coordinates of vector occurrence points and households tested positive for cutaneous leishmaniasis caused by L. major. Nine environmental layers were used as predictor variables to model the P. papatasi geographical distribution and five variables were used to model the L. major potential distribution. Ecological niche modeling was used to relate known species' occurrence points to values of environmental factors for these same points to predict the presence of the species in unsampled regions based on the value of the predictor variables. Rainfall and temperature contributed the most as predictors for sand flies and human case distributions. Ecological niche modeling anticipated the current distribution of P. papatasi with the highest suitability for species occurrence in the central and southeastern part of Tunisian. Furthermore, our study demonstrated that governorates of Gafsa, Sidi Bouzid, and Kairouan are at highest epidemic risk. © The American Society of Tropical Medicine and Hygiene.

  6. A new focus of cutaneous leishmaniasis in Jammu division of Jammu and Kashmir State, India

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    Neenu Kaul

    2016-01-01

    Full Text Available Background: Cutaneous leishmaniasis in India is mainly confined to the deserts of Rajasthan; some cases have been reported from the dry north-western half of the Indo-Gangetic plain, including Punjab, Himachal Pradesh, Delhi and Varanasi. Aims: To highlight a new focus of cutaneous leishmaniasis in the Jammu division of Jammu and Kashmir State, previously a non-endemic area. This report presents the clinico-epidemiological and investigative results of 120 new cases of cutaneous leishmaniasis detected between November 2012 and October 2013. Methods: The clinical diagnosis of cutaneous leishmaniasis was made using criteria proposed by Bari and Rahman. It was further confirmed by the demonstration of Leishman-Donovan bodies in Leishman stained slit skin smears and skin biopsy specimens, and/or by a satisfactory response to intra-lesional sodium stibogluconate given weekly for 4 weeks. Serial clinical photographs were taken before giving injections and at the end of the 6 th week. Results: There were 67 females and 53 males with an age range of 8 months to 80 years. The most frequently affected site was the face. Lesions were most commonly of the nodulo-ulcerative type. The number of lesions ranged from 1 to 4. Farmers (28.1%, homemakers (27.2% and students (27.2% were significantly over-represented among the occupations (P < 0.001. Skin smears and biopsies were positive for Leishman-Donovan bodies in 50.8% and 44.2% cases, respectively. Conclusions: There is a new focus of cutaneous leishmaniasis in Jammu division which deserves urgent attention from the public health angle. Further epidemiological studies are warranted to establish the identity of the vector and the strain of Leishmania involved.

  7. Identification of Leishmania Species Causing Cutaneous Leishmaniasis Using Random Amplified Polymorphic DNA (RAPD-PCR in Kharve, Iran

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    Fatemeh Saadabadi

    2013-05-01

    Full Text Available Background: Leishmaniasis, especially cutaneous leishmaniasis, is considered an important health problem in many parts of Iran including Kharve, Khorasan Razavi province. Cutaneous leishmaniasis is caused by various species of Leishmania, each having a different secondary host. Thus, identifying the parasites’ specie is of paramount importance for containment strategy planning. The morphological differentiation of Leishmania species is not possible, rendering the molecular methods as the sole means to this purpose. Therefore, to identify the causative agent of cutaneous leishmaniasis in Kharve, Random Amplified Polymorphic DNA-PCR (RAPD-PCR was used. Methods: The disease was first confirmed by direct smears. Samples were gathered from 22 patients with established cutaneous leishmaniasis. The samples were immediately cultured in NNN medium, followed by sub-culture in RPMI-1640. Afterwards, DNA was extracted and amplified using RAPD-PCR. Electrophoresis patterns from each isolate were compared with reference strains of Leishmania major (L. major and Leishmania tropica (L. tropica. Results: The results of this study indicated that the parasite causing cutaneous leishmaniasis in Kharve is L. tropica. Conclusion: It seems that L. tropica is the only causative agent of cutaneous leishmaniasis in Kharve, and RAPD-PCR is a suitable tool for Leishmania characterization in epidemiological studies.

  8. Reevaluating leishmanin skin test as a marker for immunity against cutaneous leishmaniasis.

    Science.gov (United States)

    Momeni Boroujeni, Amir; Aminjavaheri, Malih; Moshtaghian, Bahador; Momeni, Arash; Momeni, Ali Z

    2013-07-01

    The leishmanin skin test (LST) has been used for clinical diagnosis of leishmaniasis and epidemiological studies of the disease. Thus far, evidence has suggested that LST conversion indicates a degree of protection against leishmaniasis. In this study, we have put this assumption to test. A total of 273 participants with positive LST living in a hyperendemic area for leishmaniasis were followed for three years for any occurrence of cutaneous leishmaniasis. Twenty-two of the 273 participants contracted leishmaniasis during the 3-year follow-up. These new cases included participants who had a previous history of active disease, those who had a history of leishmanization, or those who were suspected of having a history of subclinical infection. In this study, the incidence of leishmaniasis in individuals with positive LST was close to the general incidence of the disease in the same hyperendemic area. These results suggest that although LST conversion may be a marker for partial immunity towards leishmaniasis, it may not, however, indicate complete protection against the disease, and consequently there is a need for revision of current vaccine development approaches which are based on rendering vaccinated individuals LST positive. © 2013 The International Society of Dermatology.

  9. Protection against cutaneous leishmaniasis in outbred vervet monkeys using a recombinant histone H1 antigen.

    Science.gov (United States)

    Masina, Slavica; M Gicheru, Michael; Demotz, Stéphane O; Fasel, Nicolas J

    2003-10-15

    Infection with Leishmania major parasites results in the development of cutaneous ulcerative lesions on the skin. We investigated the protective potential of a single, recombinant histone H1 antigen against cutaneous leishmaniasis in an outbred population of vervet monkeys, using Montanide adjuvant. Protection was assessed by challenging the animals with a mixture of vector sand fly salivary-gland lysate and a low dose of in vitro-derived parasites, thus more closely mimicking natural infection induced by L. major. The course of infection in immunized monkeys was compared with that of animals that had healed from a primary infection and were immune. The monkeys immunized with recombinant histone H1 showed a reduced development of lesion size, compared with controls. Our study therefore illustrates the potential use of histone H1 as a vaccine candidate against cutaneous leishmaniasis in humans.

  10. [Chronic facial ulceration in France and potential involvement of Leishmania infantum cutaneous leishmaniasis].

    Science.gov (United States)

    Lenvers, P; Marty, P; Peyron, F

    2013-11-01

    In France, cutaneous leishmaniasis is frequently seen in patients returning from North Africa or South America. Autochthonous leishmaniasis due to Leishmania infantum causes rather visceral forms. Nevertheless, cutaneous leishmaniasis caused by this parasite is occasionally seen in immunocompetent patients who have never been outside France. An 8-year-old girl living in the Haute-Savoie region and who had never travelled overseas presented with chronic ulceration of the right cheekbone that failed to regress under topical therapy. Laboratory tests demonstrated the presence of L. infantum. Following cryotherapy and intralesional injections of meglumine antimonite, the lesion resolved within a month. The patient's medical history revealed repeated journeys to the Pyrénées-Orientales region of southern France. For chronic ulceration on an uncovered area that does not resolve with topical therapy, cutaneous leishmaniasis should be considered in the differential diagnosis even if the patient has never left France. Trips to the South of France (an endemic region) should be sought in the history. In addition to direct examination of the product from curettage of the lesion and histopathology, non-invasive methods such as Western blotting with PCR run on filter paper impressions allow accurate diagnosis. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. Epidemiological Pattern of Cutaneous Leishmaniasis in the Province of Fars, Iran (Since 2010-2014

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    Ali Fattahi Bafghi

    2016-10-01

    Full Text Available Abstract Introduction: Cutaneous Leishmaniasis is considered as an important health problem in Iran. This disease begins as small papules and then they gradually grow and turn into wounds. Since the epidemiological study of this problem is effective in preventing and controlling it, the current research was conducted on epidemiological pattern of Cutaneous Leishmaniasis in the province of Fars, Iran (2010-2014 Materials and Methods: This cross-sectional study was conducted on the registered information (20601 patients and documents of the patients having problem in Fars province remedial and health care centers over the last 5 years. First, the registered demographic and epidemiological data of patients were extracted and then analyzed through by using SPSS software. Results: A total of 20601 patients including 10607 males (51% and 9994 females (49% participated this study. Patients were in the age range of 20-29 years old and minority of them was 5-9 years old. Most lesions were on the hand and leg of the patients. It was also found that there was a significant relationship between age groups and types of Leishmaniasis (P<0.05 as well as gender and type of Cutaneous Leishmaniasis (P<0.05. Conclusion: According to this is investigation, there was an ascending trend in disease frequency which was based on the descending process. This indicates promotion of educational- hygiene status as well as observance of personal hygiene principals.

  12. Emergence of cutaneous leishmaniasis in Polonnaruwa, Sri Lanka 2008-2011.

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    Sandanayaka, Rohana; Kahawita, Indra; Gamage, Ajith; Siribaddana, Sisira; Agampodi, Suneth

    2014-02-01

    To report cutaneous leishmaniasis (CL) in Polonnaruwa, Sri Lanka. The study population included all patients with CL reported from Polonnaruwa district from January 2008 through April 2012. Data were collected in the dermatology unit of Polonnaruwa General Hospital and the regional epidemiology unit of Polonnaruwa. Four hundred and forty six patients with leishmaniasis were detected; clinical details were available for 362. Mean annual incidence of leishmaniasis between 2008 and 2012 in Polonnaruwa district was 26.2 per 100,000. The case incidence steadily increased during the study period. Case distribution by month peaked between August and November. Cases were geographically clustered in three administrative divisions with a mean annual incidence ranging from 94.7 to 54.1 per 100,000 population. Significantly more (n = 294, 65.9%) males than females were affected (χ(2) for goodness of fit = 48.4, P < 0.001). The commonest type of lesion was nodules (n = 157, 43.4%) followed by crust (n = 116, 32.0%). The majority of patients had lesions on upper limbs (n = 144, 39.8%) or the face (n = 117, 32.3%). Cutaneous leishmaniasis is increasing in Polonnaruwa, with clear spatial and temporal clustering. Sri Lanka needs more vigilant leishmaniasis surveillance. © 2013 John Wiley & Sons Ltd.

  13. Oral azithromycin versus its combination with miltefosine for the treatment of experimental Old World cutaneous leishmaniasis.

    Science.gov (United States)

    Amer, Eglal I; Eissa, Maha M; Mossallam, Shereen F

    2016-06-01

    Leishmaniasis is one of the neglected infectious diseases included in the World Health Organization's list of the top guns of antimicrobial resistance. Miltefosine is the first and the only available oral effective therapy for leishmaniasis. For fear of its potential resistance, identification of alternative, effective and safe drugs is urgently needed. Therefore, in view of azithromycin promising activity against a number of Leishmania species, this work was carried out to evaluate the efficacy of oral azithromycin alone versus its combination with miltefosine against experimental Old World Cutaneous leishmaniasis thus, can provide another alternative oral therapy or for the first time an oral combination therapy for leishmaniasis. The experiment were carried out on Swiss strain albino mice which were treated either with miltefosine for 20 days, Azithromycin for 20 days or both drugs in combination therapy for shorter duration of 10 days. Efficacy of azithromycin mono and combination therapy with miltefosine was evaluated clinically, parasitologically and by examination of the cutaneous lesions by Transmission Electron Microscopy. The current work demonstrated superior activity of oral azithromycin over oral miltefosine in the treatment of experimentally infected mice with Leishmania major (MHOM/IL/81/FEBNI). Unfortunately, oral combination therapy of azithromycin and miltefosine for short duration though, induced dramatic clinical improvement yet, relapse rapidly developed after cessation of therapy. Oral azithromycin could be a promising oral antileishmanial agent. Further research is recommended to investigate its leishmanicidal activity against other Leishmania species thus; another alternative oral therapy for leishmaniasis can be rapidly available.

  14. Efficacy of fractional CO2 laser in treatment of atrophic scar of cutaneous leishmaniasis.

    Science.gov (United States)

    Banihashemi, Mahnaz; Nahidi, Yalda; Maleki, Masoud; Esmaily, Habibollah; Moghimi, Hamid Reza

    2016-05-01

    Cutaneous leishmaniasis is an endemic disease in Iran. Unfortunately, it can lead to unsightly atrophic scars with limited treatment options. Fractional CO2 laser is accepted for treatment of atrophic acne scars and recently has been used to treat cutaneous leishmaniasis, so we planned to use fractional CO2 laser on leishmaniasis scar. We conducted this study on 60 leishmaniasis scars on the face of 40 patients. The lesions were treated by a fractional CO2 laser with beam size of 120 μm, with energy of 50-90 mJ, and 50-100 spots/cm(2) density with two passes in three monthly sessions. Evaluation was done in the first and second months after the first treatment and 3 and 6 months after the last treatment. Digital photography was performed at each visit. Assessment of improvement rate by patient and physician was rated separately as follows: no improvement (0%), mild (high efficacy of fractional CO2 laser for leishmaniasis scar. No significant adverse effects were noted.

  15. Case Report: Cutaneous Leishmaniasis in Cuban Immigrants to Texas who Traveled through the Darién Jungle, Panama

    Science.gov (United States)

    Barry, Meagan A.; Koshelev, Misha V.; Sun, Grace S.; Grekin, Sarah J.; Stager, Charles E.; Diwan, A. Hafeez; Wasko, Carina A.; Murray, Kristy O.; Woc-Colburn, Laila

    2014-01-01

    Cutaneous leishmaniasis is rarely seen in the United States. Four Cuban immigrants traveled along the same route at different times from Cuba to Ecuador, then northward, including through the Darién Jungle in Panama. These patients had chronic ulcerative non-healing skin lesions and were given a diagnosis of leishmaniasis. PMID:24865687

  16. Cutaneous leishmaniasis in Cuban immigrants to Texas who traveled through the Darién Jungle, Panama.

    Science.gov (United States)

    Barry, Meagan A; Koshelev, Misha V; Sun, Grace S; Grekin, Sarah J; Stager, Charles E; Diwan, A Hafeez; Wasko, Carina A; Murray, Kristy O; Woc-Colburn, Laila

    2014-08-01

    Cutaneous leishmaniasis is rarely seen in the United States. Four Cuban immigrants traveled along the same route at different times from Cuba to Ecuador, then northward, including through the Darién Jungle in Panama. These patients had chronic ulcerative non-healing skin lesions and were given a diagnosis of leishmaniasis. © The American Society of Tropical Medicine and Hygiene.

  17. Sporothrix schenckii Sensu Lato identification in fragments of skin lesion cultured in NNN medium for differential diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Antonio, Liliane de Fátima; Pimentel, Maria Inês Fernandes; Lyra, Marcelo Rosandiski; Madeira, Maria de Fátima; Miranda, Luciana de Freitas Campos; Paes, Rodrigo Almeida; Brito-Santos, Fábio; Carvalho, Maria Helena Galdino Figueredo; Schubach, Armando de Oliveira

    2017-02-01

    Eighty-nine patients with clinical suspicion of leishmaniasis were referred for differential diagnosis. Sporothrix schenckii sensu lato was isolated in Novy-MacNeal-Nicolle + Schneider media in 98% of 64 patients with final diagnosis of sporotrichosis. This medium may be suitable for diagnosis of sporotrichosis in areas where cutaneous leishmaniasis is also endemic. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. The protective capacities of histone H1 against experimental murine cutaneous leishmaniasis.

    Science.gov (United States)

    Solioz, N; Blum-Tirouvanziam, U; Jacquet, R; Rafati, S; Corradin, G; Mauël, J; Fasel, N

    1999-12-10

    In a murine model of experimental cutaneous leishmaniasis, we investigated the protection elicited by injection of histone H1 isolated from parasites by perchloric extraction, of a H1 recombinant protein produced in E. coli, and of H1 long and short synthetic peptides, against infection by L. major. Partial protection was achieved in most of the animals as shown by reduction in lesion size, upon immunization with histone H1 or its peptides, provided that the region 1-60 was present in the molecule. These observations argue in favor of a thorough examination of the possibility of including histone H1 described here in a cocktail vaccine against human leishmaniasis.

  19. CD8+ T cells in cutaneous leishmaniasis: The good, the bad and the ugly

    Science.gov (United States)

    Novais, Fernanda O.; Scott, Phillip

    2015-01-01

    CD8+ T lymphocytes are components of the adaptive immune response and play an important role in protection against many viral and bacterial infections. However, their role in parasitic infections is less well understood. In leishmaniasis, a disease caused by intracellular protozoan parasites of the genus Leishmania, CD8+ T cells have been shown to be protective. However, increasing evidence indicates that CD8+ T cells may also exacerbate disease. In this review, we will describe the situations where CD8+ T cells are either good or bad for the outcome of the infection, and attempt to reconcile the dual role played by CD8+ T cells in cutaneous leishmaniasis. PMID:25800274

  20. Evaluation of the histopathological classifications of American cutaneous and mucocutaneous leishmaniasis

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    A. L. Bittencourt

    1991-03-01

    Full Text Available In order to evaluate the reliability of histopathological classifications of cutaneous and mucocutaneous leishmaniasis the authors compared the histopathological patterns of two biopsies taken simultaneously from the same patient, and classified the material according to Ridley et al. (1980, to Magalhães et al. (1986a, and to a more simplified classification with only three patterns. District histopathological aspects, were observed in different lesions or even in the same lesion. The authors concluded that histopathological patterns do not represent a stage of tegumentary leishmaniasis, thus they can not be correlated with prognosis and therapeutical response as suggested in the literature.

  1. Cutaneous leishmaniasis in Karak, Pakistan: Report of an outbreak ...

    African Journals Online (AJOL)

    Jane

    2011-08-29

    Aug 29, 2011 ... of Yucutan leishmaniasis in old world and new world CL. (Philip et al., 1975). CL pathogens are carried by sand flies (Phlebotomus) vector and in Pakistan, some 29 species of Phlebotomus are present (Lewis, 1967). Phlebotomus papatasi was found in Kashmore, Bannu, Dera Ismail Khan, Idak, Tank.

  2. Differential Expression of the Eicosanoid Pathway in Patients With Localized or Mucosal Cutaneous Leishmaniasis.

    Science.gov (United States)

    França-Costa, Jaqueline; Andrade, Bruno B; Khouri, Ricardo; Van Weyenbergh, Johan; Malta-Santos, Hayna; da Silva Santos, Claire; Brodyskn, Cláudia I; Costa, Jackson M; Barral, Aldina; Bozza, Patrícia T; Boaventura, Viviane; Borges, Valeria M

    2016-04-01

    Unfettered inflammation is thought to play critical role in the development of different clinical forms of tegumentary leishmaniasis. Eicosanoids are potent mediators of inflammation and tightly associated with modulation of immune responses. In this cross-sectional exploratory study, we addressed whether targets from the eicosanoid biosynthetic pathway, assessed by multiplexed expression assays in lesion biopsy and plasma specimens, could highlight a distinct biosignature in patients with mucocutaneous leishmaniasis (MCL) or localized cutaneous leishmaniasis (LCL). Differences in immunopathogenesis between MCL and LCL may result from an imbalance between prostaglandins and leukotrienes, which may serve as targets for future host-directed therapies. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  3. Molecular diagnosis of Leishmania mexicana in a cutaneous leishmaniasis case in Sinaloa, Mexico.

    Science.gov (United States)

    Ochoa-Diaz, Yssete O; Lopez-Moreno, Carmina Y; Rendon-Maldonado, Jose G; Lopez-Moreno, Hector S

    2012-01-01

    Leishmaniasis has been considered endemic in Sinaloa, Mexico, since 1994. Despite that Leishmania mexicana is the main etiological agent of cutaneous leishmaniasis (CL) in other regions of Mexico, the species causing CL in patients from Sinaloa state has not been previously established, although Leishmania braziliensis has been found in the neighboring southern state, Nayarit. L. braziliensis is also associated with mucocutaneous leishmaniasis, which is a more complicated clinical variant. Due to the implications on individual and public health, the objective of this report was to identify the Leishmania species present in Sinaloa, Mexico. Using the first internal transcribed spacer (ITS-1) polymerase chain reaction-restriction fragment length polymorphism, we identified L. mexicana in a CL patient from Sinaloa and confirmed the extended distribution of this parasite in Mexico.

  4. An epidemic outbreak of canine cutaneous leishmaniasis in Colombia caused by Leishmania braziliensis and Leishmania panamensis.

    Science.gov (United States)

    Vélez, Iván D; Carrillo, Lina M; López, Liliana; Rodríguez, Erwin; Robledo, Sara M

    2012-05-01

    The largest recorded outbreak of cutaneous leishmaniasis in Colombia's history occurred during 2005-2009 in soldiers of the Colombian Army, with ~40,000 cases. This outbreak was caused by the influx of military personnel into the jungle with the mission of combat illicit crops and the guerrilla. The soldiers remain for long periods within the rainforest and are exposed to the bite of infected sand flies. During the military activities, soldiers work with dogs specially trained to detect landmines, and therefore, dogs are also exposed to the infected sand flies and show high incidence of cutaneous leishmaniasis (CL). This work describes an epidemic outbreak of canine CL caused by Leishmania braziliensis and Leishmania panamensis in Colombia, South America. The clinical features of the disease and the response to treatment with pentavalent antimonials observed in 72 guard dogs from the Colombian Army are described. A program for prevention and control of canine CL is also discussed.

  5. Chemotherapeutic potential of 17-AAG against cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis.

    Science.gov (United States)

    Santos, Diego M; Petersen, Antonio L O A; Celes, Fabiana S; Borges, Valeria M; Veras, Patricia S T; de Oliveira, Camila I

    2014-10-01

    Leishmaniasis remains a worldwide public health problem. The limited therapeutic options, drug toxicity and reports of resistance, reinforce the need for the development of new treatment options. Previously, we showed that 17-(allylamino)-17-demethoxygeldanamycin (17-AAG), a Heat Shock Protein 90 (HSP90)-specific inhibitor, reduces L. (L.) amazonensis infection in vitro. Herein, we expand the current knowledge on the leishmanicidal activity of 17-AAG against cutaneous leishmaniasis, employing an experimental model of infection with L. (V.) braziliensis. Exposure of axenic L. (V.) braziliensis promastigotes to 17-AAG resulted in direct dose-dependent parasite killing. These results were extended to L. (V.) braziliensis-infected macrophages, an effect that was dissociated from the production of nitric oxide (NO), superoxide (O(-2)) or inflammatory mediators such as TNF-α, IL-6 and MCP-1. The leishmanicidal effect was then demonstrated in vivo, employing BALB/c mice infected with L. braziliensis. In this model, 17-AAG treatment resulted in smaller skin lesions and parasite counts were also significantly reduced. Lastly, 17-AAG showed a similar effect to amphotericin B regarding the ability to reduce parasite viability. 17-AAG effectively inhibited the growth of L. braziliensis, both in vitro and in vivo. Given the chronicity of L. (V.) braziliensis infection and its association with mucocutaneous leishmaniasis, 17-AAG can be envisaged as a new chemotherapeutic alternative for cutaneous Leishmaniasis.

  6. Spatial Distribution of Sand Fly Vectors and Eco-Epidemiology of Cutaneous Leishmaniasis Transmission in Colombia

    OpenAIRE

    Ferro, Cristina; López, Marla; Fuya, Patricia; Lugo, Ligia; Cordovez, Juan Manuel; González, Camila

    2015-01-01

    Background Leishmania is transmitted by Phlebotominae insects that maintain the enzootic cycle by circulating between sylvatic and domestic mammals; humans enter the cycles as accidental hosts due to the vector’s search for blood source. In Colombia, leishmaniasis is an endemic disease and 95% of all cases are cutaneous (CL), these cases have been reported in several regions of the country where the intervention of sylvatic areas by the introduction of agriculture seem to have an impact on th...

  7. Cutaneous leishmaniasis: treatment with low-dose oral fluconazole with an excellent cosmetic result.

    Science.gov (United States)

    Aerts, Olivier; Duchateau, Nathalie; Willemse, Peter; Lambert, Julien

    2015-01-01

    We report the successful treatment of cutaneous leishmaniasis in a 6-year-old girl who presented with a solitary lesion on the cheek. A low dose of 3 mg/kg/day of fluconazole was used, with remarkable improvement at 6 weeks and complete regression at 12 weeks, excellent cosmetic results, and no relapse during a follow-up of 1 year. © 2014 Wiley Periodicals, Inc.

  8. The immune response in patients with cutaneous leishmaniasis and the influence of zinc supplementation.

    Science.gov (United States)

    Guzman-Rivero, Miguel; Verduguez-Orellana, Aleida; Montaño, Karen; Cloetens, Lieselotte; Rojas, Ernesto; Åkesson, Björn; Sejas, Edgar

    2015-02-01

    Cutaneous leishmaniasis triggers a varied immune response depending on parasite and host factors, which in turn can be influenced by nutrients. The resistance to the infection is associated with the Th1 type of cytokine production. The Th1 type can be reduced as a consequence of zinc deficiency, which may increase the risk for chronicity of the infection. Using in vitro and ex vivo models, we studied the influence of zinc supplementation on the immune response in patients with cutaneous leishmaniasis treated with antimony and the data were also compared to those of matched controls. Twenty-nine patients with cutaneous leishmaniasis (n=14 in zinc-supplemented group [45mg/day] and n=15 in placebo group) were treated by intramuscular injections of antimony for 20 days and took supplements for 60 days. Immunoglobulins in plasma and cell proliferation, IFN-γ production and CD markers of isolated peripheral blood mononuclear cells (PBMC) were measured. It was found that the cellular immune response of the patients maintained its activity as assessed by the ability of the PBMC to proliferate and produce IFN-γ in response to concanavalin A. Moreover, there was no difference in these variables between the zinc-supplemented and placebo groups after 60 days. The addition of zinc sulphate in vitro to PBMC reduced the IFN-γ production in the placebo group only. It is concluded that the cellular immune response of the cutaneous leishmaniasis patients remained active during treatment by antimony when compared to that of controls. It was not possible to document an additional effect of zinc supplementation for 60 days on the immune response. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. Cutaneous Leishmaniasis in dogs: is high seroprevalence indicative of a reservoir role?

    OpenAIRE

    CALZADA, JOS? E.; SALDA?A, AZAEL; GONZ?LEZ, KADIR; RIGG, CHYSTRIE; PINEDA, VANESSA; SANTAMAR?A, ANA MAR?A; RODR?GUEZ, INDRA; GOTTDENKER, NICOLE L.; LAURENTI, MARCIA D.; CHAVES, LUIS F.

    2015-01-01

    SUMMARY American cutaneous leishmaniasis (ACL) is a complex disease with a rich diversity of animal host species. This diversity imposes a challenge, since understanding ACL transmission requires the adequate identification of reservoir hosts, those species able to be a source of additional infections. In this study we present results from an ACL cross-sectional serological survey of 51 dogs (Canis familiaris), where we used diagnostic tests that measure dog's exposure to Leishmania spp. para...

  10. Leishmaniasis in Turkey: first clinical isolation of Leishmania major from 18 autochthonous cases of cutaneous leishmaniasis in four geographical regions.

    Science.gov (United States)

    Özbilgin, Ahmet; Çulha, Gülnaz; Uzun, Soner; Harman, Mehmet; Topal, Suhan Günaştı; Okudan, Fulya; Zeyrek, Fadile; Gündüz, Cumhur; Östan, İpek; Karakuş, Mehmet; Töz, Seray; Kurt, Özgür; Akyar, Işın; Erat, Ayşegül; Güngör, Dilek; Kayabaşı, Çağla; Çavuş, İbrahim; Bastien, Patrick; Pratlong, Francine; Kocagöz, Tanıl; Özbel, Yusuf

    2016-06-01

    To report isolation of Leishmania major strains obtained from 18 Turkish autochthonous cutaneous leishmaniasis (CL) patients infected with L. major between 2011 and 2014. Initial diagnosis relied on microscopy and culture in enriched medium, prepared by adding specific amounts of liver extract, protein and lipid sources to NNN medium. Promastigotes were then transferred to RPMI medium including 10% of foetal calf serum for mass culture. Species-specific real-time PCR targeting ITS1 region of Leishmania spp. was performed using both lesion aspiration samples and cultured promastigotes. Two of 18 isolates were identified by isoenzyme analysis in the Leishmaniasis Reference Center in Montpellier, France. Each isolate was inoculated into the footpads of six mice to observe the pathogenicity of L. major. Developing lesions were observed, and the thickening of footpads was measured weekly. Melting curve analyses of 18 isolates showed a peak concordant with L. major, and two of them were confirmed by isoenzyme analyses as L. major zymodeme MON103. In the mouse model, acute lesions seen on day 21 were accepted as an indication of heavy infection. Severe impairments were observed on all mouse footpads over 3 weeks, which even progressed to extremity amputation. Cutaneous leishmaniasis-causing L. major was recently identified in Adana province in southern Turkey, with PCR. Our study shows that such CL cases are not limited to Adana but currently present from western to Southeastern Anatolia, and along the Mediterranean coast. The role of small mammals, the main reservoirs of L. major in Anatolia, needs to be elucidated, as do the underlying factors that cause severe clinical manifestations in L. major infections in Turkey, contrary to the infections in neighbouring countries. © 2016 John Wiley & Sons Ltd.

  11. Obtaining membranes for alternative treatment hydrogels of cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    Oliveira, Maria Jose Alves de

    2013-01-01

    Polymeric Hydrogels formed by crosslinked polymeric chains were obtained by ionizing radiation process according to Rosiak technique. In the last 40 years the use of hydrogels has been investigated for various applications as curatives. In this work hydrogel membranes were synthesized with poly (N-2-pyrrolidone) (PVP), poly (vinyl alcohol) (PVA), chitosan and laponita clay for use as a vehicle for controlled glucantime release on the surface of skin tissues injured by leishmaniasis. Leishmaniasis is a disease caused by a protozoan parasite of the genus Leishmania transmitted by the bite of phlebotomies sandfly. The traditional treatment of patients infected by these parasites is done with pentavalent antimony in injectable form. However, these antimonates are highly toxic and cause side effects in these patients. In addition, patients with heart and kidney disease can not use this treatment. In treatment with drug delivery hydrogel membrane applied on the surface of leishmaniasis injured tissues the drug is released directly to the wound in a controlled manner, reducing the side effects. Membranes prepared in this study were characterized by X-ray diffraction (XRD), thermogravimetric analysis (TG), swelling, gel fraction, infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and atomic force microscopy (AFM). The characterizations of cytotoxicity and drug release were made 'in vitro' and 'in vivo' with functional test according to ethical protocol of the Division of Infectious and Parasitic Diseases at the Hospital of Clinics, Sao Paulo University-School of Medicine, University. The 'in vivo' test of these membranes proved to be effective in controlled release of drugs directly into leishmaniasis damaged tissues. Results of 'in vivo' tests using PVP/PVAl / clay 1,5% and glucantime membrane showed remarkable contribution to wound reduction and cure in clinical therapy. (author)

  12. Use of hematological parameters in evaluation of treatment efficacy in cutaneous leishmaniasis

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    Bilal Sula

    2015-12-01

    Full Text Available Objective: In the present study we investigated the role of hematological parameters, including neutrophil/lymphocyte ratio and platelet/lymphocyte ratio, mean platelet volume and platelet distribution width in the evaluation of treatment efficacy in adult patients diagnosed with cutaneous leishmaniasis. Methods: The study group included 45 adult patients diagnosed with cutaneous leishmaniasis and treated as inpatients in the dermatology clinic between 2011 and 2014. A group of 45 healthy adults served as a control group. Results: Pre- and post-treatment white blood cell count, neutrophils, and lymphocytes were significantly reduced among the patient group relative to the control group. Platelet distribution width, red cell distribution width, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were significantly elevated among the patients compared to the healthy subjects. Pre-treatment white blood cell, lymphocyte and platelet counts were significantly elevated compared to post-treatment counts among the patient cohort. Treatment was associated with reduced eosinophil count, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio relative to pre-treatment status. Conclusion: Routine hematological testing results such as platelet/lymphocyte ratio, white blood cell count, neutrophil count, red cell distribution width, platelet distribution width, and mean platelet volume may be clinically significant markers of the inflammatory state useful in the evaluation of early treatment efficacy among patients with cutaneous leishmaniasis. J Microbiol Infect Dis 2015;5(4: 167-172

  13. Molecular Characterization of Leishmania Species Isolated from Cutaneous Leishmaniasis in Yemen

    Science.gov (United States)

    Mahdy, Mohammed A. K.; Al-Mekhlafi, Hesham M.; Al-Mekhlafi, Abdulsalam M.; Lim, Yvonne A. L.; Bin Shuaib, Naemah O. M.; Azazy, Ahmed A.; Mahmud, Rohela

    2010-01-01

    Background Cutaneous leishmaniasis (CL) is a neglected tropical disease endemic in the tropics and subtropics with a global yearly incidence of 1.5 million. Although CL is the most common form of leishmaniasis, which is responsible for 60% of DALYs lost due to tropical-cluster diseases prevalent in Yemen, available information is very limited. Methodology/Principal Findings This study was conducted to determine the molecular characterization of Leishmania species isolated from human cutaneous lesions in Yemen. Dermal scrapes were collected and examined for Leishmania amastigotes using the Giemsa staining technique. Amplification of the ribosomal internal transcribed spacer 1(ITS-1) gene was carried out using nested PCR and subsequent sequencing. The sequences from Leishmania isolates were subjected to phylogenetic analysis using the neighbor-joining and maximum parsimony methods. The trees identified Leishmania tropica from 16 isolates which were represented by two sequence types. Conclusions/Significance The predominance of the anthroponotic species (i.e. L. tropica) indicates the probability of anthroponotic transmission of cutaneous leishmaniasis in Yemen. These findings will help public health authorities to build an effective control strategy taking into consideration person–to-person transmission as the main dynamic of transmission of CL. PMID:20862227

  14. Alterations of serum antioxidant trace elements (Se, Zn and Cu status in patients with cutaneous leishmaniasis

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    Leila Farzin

    2014-02-01

    Full Text Available Objective: To assess the serum antioxidant trace elements selenium (Se, zinc (Zn and copper (Cu in cutaneous leishmaniasis patients. Methods: In this study, serum Se, Zn and Cu was determined by using atomic absorption spectrometry in patients with cutaneous leishmaniasis (n=95. The values were statistically compared between patients and control group (n=100 using One-way analysis of variance (ANOVA. Results: Our results showed that there was a significant difference in the values of Se and Zn between two groups (P0.05. Se and Zn levels were found to be (4.33依1.06 and (70.23依19.12 µg/dL in cutaneous leishmaniasis cases, and these values were found statistically lower compared to the controls (11.10依2.37 and (119.61依26.18 µg/dL, respectively. Conclusions: The observations that host products are released from stimulated leukocytes and could induce metabolic changes similar to an acute-phase response revealed an endocrine role for the immune system. Characteristic changes in trace-mineral metabolism are an integral part of the acute-phase response. The changes are usually reflected in decreased serum Se and Zn concentrations.

  15. Epidemiology of cutaneous leishmaniasis in Sidi Kacem Province, Northwestern Morocco (2006–2014

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    Aziz El Aasri

    2016-10-01

    Full Text Available Objective: To describe the epidemiological profile of cutaneous leishmaniasis (CL in Sidi Kacem Province, North-Western Morocco between 2006 and 2014. Methods: The Leishmania parasite (amastigotes was identified by direct microscopic identification after staining. May-Grünwald Giemsa was the method used to diagnose CL in Sidi Kacem Province between 2006 and 2014. The collected data were exploited by using Microsoft Office Excel 2010 and the geographical distribution was prepared by the Geographical Information System ArcGIS Version 10.2. Results: From 2006 to 2014, 415 cases of CL were reported in Sidi Kacem area. The incidence of this skin disease that had affected all age groups was 49.1 cases per year and the sex ratio (M/F was 0.85. Children aged 15 to 19 represented the most affected class with more than 28.2% of the study population. Also, CL affected virtually the rural and urban areas but with an uneven incidence. It is more important in rural areas where they were registered 56.85% of cases against 43.15% in urban areas. Conclusions: The retrospective analysis has showed that cutaneous leishmaniasis is still major public health problem in Sidi Kacem Province. Indeed, this disease which presented an evolution according hyperendemic fashion can become endemic to the future in this province which borders the endemic area of Ouazzane. We highlight the cutaneous leishmaniasis incidence through the Sidi Kasem area during the last 8 years (2006-2014.

  16. Thermoterapy effective and safer than miltefosine in the treatment of cutaneous leishmaniasis in Colombia

    Directory of Open Access Journals (Sweden)

    Liliana López

    2013-06-01

    Full Text Available In Colombia, pentavalent antimonials and miltefosine are the drugs of choice for the treatment of cutaneous leishmaniasis; however, their toxicity, treatment duration, (treatment adherence problems, cost, and decreased parasite sensitivity make the search for alternative treatments of American cutaneous leishmaniasis necessary. Based on the results found in a controlled, open, randomized, phase III clinical trial, the efficacy and safety of miltefosine was compared to that of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia. Adult patients from the Colombian army participated in the study; they received either 50 mg of miltefosine three times per day for 28 days by the oral route (n = 145 or a thermotherapy (Thermomed® application of 50 °C for 30 seconds over the lesion and surrounding area (n = 149. Both groups were comparable with respect to their sociodemographic, clinical, and parasitological characteristics. The efficacy of miltefosine by protocol and by intention to treat was 70% (85/122 patients and 69% (85/145 patients, respectively. The adverse effects were primarily gastrointestinal for miltefosine and pain at the lesion site after treatment for thermotherapy. No statistically significant difference was found in the efficacy analysis (intention to treat and protocol between the two treatments. ClinicalTrials.gov: NCT00471705.

  17. Two cases of cutaneous leishmaniasis in Dutch military personnel treated with oral miltefosine.

    Science.gov (United States)

    van der Snoek, Eric Martin; Couwenberg, S M; Stijnis, C; Kortbeek, L M; Schadd, E M

    2017-02-01

    In the Netherlands, cutaneous leishmaniasis is most commonly seen in military personnel deployed on a mission or training abroad. The treatment of two Dutch soldiers who acquired cutaneous leishmaniasis with oral miltefosine was evaluated. Adverse effects were monitored and the improvement of skin lesions was assessed. A military nurse with a painless Chiclero's ulcer due to Leishmania (Viannia) braziliensis acquired in Belize and a military physical training instructor with itchy swelling and small ulcer of the back of his left elbow due to L. donovani/infantum complex acquired in Ibiza were treated with oral miltefosine 50 mg three times a day for 28 days. Both patients responded well to oral miltefosine. Adverse effects were mild. Increase of creatinine levels was seen while liver transaminase levels were unremarkable. Miltefosine proved to be a convenient, effective and well-tolerated treatment option in the treatment of cutaneous leishmaniasis in Dutch military personnel. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Chemokines and chemokine receptors expression in the lesions of patients with American cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Nilka Luisa Diaz

    2013-06-01

    Full Text Available American cutaneous leishmaniasis (ACL presents distinct active clinical forms with different grades of severity, known as localised (LCL, intermediate (ICL and diffuse (DCL cutaneous leishmaniasis. LCL and DCL are associated with a polarised T-helper (Th1 and Th2 immune response, respectively, whereas ICL, or chronic cutaneous leishmaniasis, is associated with an exacerbated immune response and a mixed cytokine expression profile. Chemokines and chemokine receptors are involved in cellular migration and are critical in the inflammatory response. Therefore, we evaluated the expression of the chemokines CXCL10, CCL4, CCL8, CCL11 and CXCL8 and the chemokine receptors CCR3, CXCR3, CCR5 and CCR7 in the lesions of patients with different clinical forms of ACL using immunohistochemistry. LCL patients exhibited a high density of CXCL10+, CCL4+ and CCL8+ cells, indicating an important role for these chemokines in the local Th1 immune response and the migration of CXCR3+ cells. LCL patients showed a higher density of CCR7+ cells than ICL or DCL patients, suggesting major dendritic cell (DC migration to lymph nodes. Furthermore, DCL was associated with low expression levels of Th1-associated chemokines and CCL11+ epidermal DCs, which contribute to the recruitment of CCR3+ cells. Our findings also suggest an important role for epidermal cells in the induction of skin immune responses through the production of chemokines, such as CXCL10, by keratinocytes.

  19. Sandfly Surveillance within an Emerging Epidemic Focus ofCutaneous Leishmaniasis in Southeastern Iran

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    MR Yaghoobi-Ershadi

    2010-06-01

    Full Text Available "n "nBackground: Cutaneous leishmaniasis due to Leishmania major has become a hot topic in Iran. The objective of this study was to determine some ecological aspects of sand flies in the study area. "n "nMethods: Sand flies were collected biweekly from indoors and outdoors fixed places in the selected villages, using 30 sticky paper traps from the beginning to the end of the active season of 2006 in Kerman Province, south of Iran. The flies were mounted and identified. Some blood fed and gravid female sand flies of rodent burrows and indoors were dissected and examined microscopically for natural promastigote infection of Leishmania parasite during August to September. "n "nResults: In total, 2439 specimens comprising 8 species (3 Phlebotomus and 5 Sergentomyia were identified. The most common sand fly was P. papatasi and represented 87.1% of sand flies from indoors and 57.2% from outdoors. The activity of the species extended from April to end October. There are two peaks in the density curve of this species, one in June and the second in August. Natural promastigote infection was found in P. papatasi (12.7%. "n "nConclusion: Phlebotomus papatasi is considered as a probable vector among gerbils and to humans with a high percentage of promastigote infection in this new focus of cutaneous leishmaniasis. The Bahraman area which until recently was unknown as an endemic area seems now to represent a focus of zoonotic cutaneous leishmaniasis transmission in Iran.

  20. Isolation and identification of cutaneous leishmaniasis species by PCR-RFLP in Ilam province, the west of Iran.

    Science.gov (United States)

    Kermanjani, Ali; Akhlaghi, Lame; Oormazdi, Hormozd; Hadighi, Ramtin

    2017-03-01

    Cutaneous leishmaniasis (CL) is one of the most common parasitic diseases and public health problems in Iran. CL is endemic in most parts of Ilam province, in the west of Iran. The distance from the center of country, the great number of divers rural areas, and lack of specialists and laboratory facilities have been the major causes of Leishmania species remaining unknown in this region. Polymerase chain reaction followed by restriction fragment length polymorphism was performed to identify the Leishmania species in 61 patients with cutaneous lesions. Eventually L. major was confirmed as the cause of cutaneous leishmaniasis in Ilam province, the west of Iran.

  1. INFLUENCE OF MICROBIOTA IN EXPERIMENTAL CUTANEOUS LEISHMANIASIS IN SWISS MICE

    OpenAIRE

    OLIVEIRA, Marcia Rosa de; TAFURI, Wagner Luis; NICOLI, Jacques Robert; VIEIRA, Enio Cardillo; MELO, Maria Norma; VIEIRA, Leda Quercia

    1999-01-01

    Infection of Swiss/NIH mice with Leishmania major was compared with infection in isogenic resistant C57BL/6 and susceptible BALB/c mice. Swiss/NIH mice showed self-controlled lesions in the injected foot pad. The production of high levels of interferon-g (IFN-g) and low levels of interleukin-4 (IL-4) by cells from these animals suggests that they mount a Th1-type immune response. The importance of the indigenous microbiota on the development of murine leishmaniasis was investigated by infecti...

  2. Cutaneous leishmaniasis in tripoli (A study of 36 cases

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    M L Khatri

    1984-01-01

    Full Text Available The present report is an analysis of thirty six cases of cutaneous leis in Tripoli over a periol of two yeai special emphasis in clinical featur epide . miology. Factors likely to be resf for the increased incidence of the disease are discussed.

  3. Cutaneous Corynebacterium Infection Presenting with Disseminated Skin Nodules and Ulceration

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    Antonios G.A. Kolios

    2017-05-01

    Full Text Available In the context of the European migrant crisis, more and more cases of cutaneous diphtheria are seen. A typical presentation includes painful cutaneous ulcerations with grayish-whitish pseudomembranes. Here we present 2 male Eritrean patients suffering from cutaneous nontoxigenic Corynebacterium diphtheriae (patient 1 and Corynebacterium striatum (patient 2 infection.

  4. Cutaneous Corynebacterium Infection Presenting with Disseminated Skin Nodules and Ulceration.

    Science.gov (United States)

    Kolios, Antonios G A; Cozzio, Antonio; Zinkernagel, Annelies S; French, Lars E; Kündig, Thomas M

    2017-01-01

    In the context of the European migrant crisis, more and more cases of cutaneous diphtheria are seen. A typical presentation includes painful cutaneous ulcerations with grayish-whitish pseudomembranes. Here we present 2 male Eritrean patients suffering from cutaneous nontoxigenic Corynebacterium diphtheriae (patient 1) and Corynebacterium striatum (patient 2) infection.

  5. Effect of topical honey application along with intralesional injection of glucantime in the treatment of cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Moradi Shahram

    2007-04-01

    Full Text Available Abstract Background Leishmaniasis is an endemic disease in Iran. Although many treatments have been suggested for this disease, there hasn't been an effective and safe treatment yet. Regarding the healing effect of honey in the chronic ulcers and its reported therapeutic effect in cutaneous leishmaniasis, we performed a study to better evaluate the efficacy of honey in cutaneous leishmaniasis and its final scar. Methods In a prospective clinical trial, 100 patients with confirmed cutaneous leishmaniasis were selected and randomized into 2 groups. Group A were treated with topical honey twice daily along with intralesional injection of glucantime once weekly until complete healing of the ulcer or for maximum of 6 weeks. Group B were treated with intralesional injection of glucantime alone until complete healing of the ulcer or for a maximum of 6 weeks, too. The patients were followed for 4 months. The collected data were analyzed statistically using statistical tests including Chi-square, Mann Whitney and Kaplan – Mayer tests. Results In this study, 45 patients that had cutaneous leishmaniasis were treated with intralesional glucantime alone and 45 patients were treated with topical honey and glucantime . Ten patients left out the study. In the glucantime alone treated group, 32 patients (71.1% had complete cure whereas in the group treated with both glucantime & topical honey, 23 patients (51.1% achieved complete cure. This difference was significant statistically (p = 0.04. Conclusion Further studies to better clarify the efficacy of honey in cutaneous leishmaniasis is needed. We suggest that in another study, the efficacy of honey with standardized level of antibacterial activity is evaluated against cutaneous leishmaniasis.

  6. Histopathologic features of cutaneous leishmaniasis and use of CD1a staining for amastigotes in Old World and New World leishmaniasis.

    Science.gov (United States)

    Sundharkrishnan, Lohini; North, Jeffrey P

    2017-12-01

    Positive CD1a staining of Leishmania has been reported in Old World leishmaniasis, but the sensitivity of such staining for other Leishmania species is unknown. A retrospective review was done on skin biopsies of proven cutaneous leishmaniasis based on histology, immunohistochemistry, culture and/or polymerase chain reaction (PCR). We assessed the pattern of inflammation present and assessed for CD1a (MTB1 clone) positivity in amastigotes. Patients without a clearly documented travel history to delineate Old vs New World leishmaniasis and cases without tissue for CD1a staining were excluded. Various patterns of granulomatous inflammation were observed including sarcoidal (31%), diffuse (25%), suppurative and granulomatous (25%), palisaded (13%) and lichenoid (6%). CD1a staining was positive in amastigotes in 9 of 16 cases (56%). Five of 7 (71%) cases of Old World disease were CD1a positive, while 4 of 9 cases (44%) of New World cases were positive. Multiple patterns of granulomatous inflammation occur in cutaneous leishmaniasis. Our results confirm CD1a (MTB1 clone) can be a diagnostic adjunct to highlight amastigotes in biopsies of cutaneous leishmaniasis, with variable positivity in both Old World and New World forms of the disease. As 44% of cases were CD1a negative in our cohort, there are significant limitations to this screening approach. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Cutaneous Leishmaniasis in Pediatric Patients in a Single Tertiary Hospital in Ankara.

    Science.gov (United States)

    Kaman, Ayşe; Tanır, Gönül; Gayretli Aydın, Zeynep Gökçe; Metin, Özge; Aydın Teke, Türkan; Öz, Fatma Nur; Mungan, Mesut

    2017-12-01

    Leishmaniasis is an infectious disease that is caused by a protozoan parasite of the Leishmania genus and that occurs worldwide. Leishmaniasis is endemic in southeastern Turkey and the neighboring Middle Eastern countries. The purpose of this study was to describe the clinical characteristics of patients admitted to our hospital with a diagnosis of cutaneous leishmaniasis (CL). A total of 16 CL patients [11 (69%) boys and five (31%) girls] were admitted between January 2014 and December 2015. The data of the patients were retrospectively recorded from their medical records. Their mean age was 74.3±32.3 months (range: 1-10.5 years). Double lesions were most commonly seen in eight (50%) patients. The face and neck was the most commonly involved site (87.5% of the patients). Skin smears for a parasitological examination were positive in nine (56%) patients. Two patients (12.5%) with limb lesions were treated with intralesional meglumine antimoniate. Fourteen patients were treated with systemic agents. We felt that the increase in human movement that include travels and forced migration due to the war might make it possible for CL to appear in non-endemic provinces such as Ankara. In particular, in patients with painless cutaneous lesion(s) who came from endemic areas such as Syria, CL should be kept in mind by the clinicians that residing in even non-endemic areas .

  8. Oral metabolism and efficacy of Kalanchoe pinnata flavonoids in a murine model of cutaneous leishmaniasis.

    Science.gov (United States)

    Muzitano, Michelle F; Falcão, Camila A B; Cruz, Elaine A; Bergonzi, Maria C; Bilia, Anna R; Vincieri, Franco F; Rossi-Bergmann, Bartira; Costa, Sônia S

    2009-03-01

    Leishmaniasis is a parasitic disease that threatens 350 million people worldwide. In a search for new antileishmanial drugs, the in vitro activity of flavonoids from Kalanchoe pinnata (Crassulaceae) was previously demonstrated in infected cells. In order to demonstrate the safety and oral activity of K. pinnata, flavonoids were evaluated in vivo in a murine model of cutaneous leishmaniasis. Daily oral doses of quercetin 3-O-alpha-L-arabinopyranosyl (1-->2)-alpha-L-rhamnopyranoside, quercetin 3-O-alpha-L-rhamnopyranoside, and free quercetin (16 mg/kg body weight) all were able to control the lesion growth caused by Leishmania amazonensis and to significantly reduce parasite load. These flavonoids were as effective as the crude K. pinnata aqueous extract given at 320 mg/kg body weight. HPLC-DAD-MS analysis of the plasma of extract-treated mice suggested that quercetin and quercetin glucuronides are the main metabolites of K. pinnata quercetin glycosides. Our results indicate that K. pinnata quercetin glycosides are important active components of the aqueous extract and that they possess potent oral efficacy against cutaneous leishmaniasis.

  9. Reactivation of cutaneous and mucocutaneous tegumentary leishmaniasis in rheumatoid arthritis patients: an emerging problem?

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    Regina Maia de Souza

    Full Text Available ABSTRACT Rheumatoid arthritis (RA is a chronic condition that is frequent in patients living in tropical areas exposed to leishmaniasis. RA therapy involves immunosuppressant drugs such as methotrexate (MTX, monoclonal antibodies (mAbs and prednisone. We report an unusual presentation of cutaneous (CL or mucocutaneous leishmaniasis (ML in RA patients from an endemic area of leishmaniasis. A 51-year-old woman noted a cutaneous ulcer on her left ankle during MTX and prednisone RA therapy. Initially diagnosed as a venous stasis ulcer, the aspirate of the injury revealed the presence of Leishmania DNA. A 73-year-old woman presenting non-ulcerated, infiltrated and painful erythematous nodules inside her nostrils while receiving MTX, anti-TNF mAb, and prednisone for RA, had also the aspirate of injuries showing the presence of Leishmania DNA. Both patients healed after the therapy with liposomal amphotericin. The RA therapy has changed to low-dose prednisone, without further reactivation episodes. Both cases suggest that CL or ML can reactivate after administration of an immunosuppressant for RA treatment. Therefore, immunosuppressive treatments for RA should be carefully prescribed in patients from endemic areas or with a history of CL and ML.

  10. Interferon-¿- and tumour necrosis factor-a-producing cells in humans who are immune to cutaneous leishmaniasis

    DEFF Research Database (Denmark)

    Kemp, K; Theander, T G; Hviid, L

    1999-01-01

    living in an area without the disease. The production of interferon (IFN)-gamma, tumour necrosis factor (TNF)-alpha and interleukin (IL)-10 was investigated in culture supernatants, and the cellular sources of IFN-gamma and TNF-alpha were identified. Cells from individuals with a history of cutaneous...... leishmaniasis produced significantly higher levels of IFN-gamma and TNF-alpha than cells from individuals without a history of the disease. Similar levels of IL-10 were found in the two groups. Flow cytometric analysis revealed high numbers of CD3+ cells producing IFN-gamma and TNF-alpha, and only a few CD3......+ cells containing IL-10, in the PBMC cultures from the individuals with a history of cutaneous leishmaniasis. Interferon-gamma and TNF-alpha were predominantly produced by CD4+ T cells rather than CD8+ T cells. The results suggest that cellular immunity against cutaneous leishmaniasis is mediated...

  11. Expression of Inducible Nitric Oxide Synthase in Skin Lesions of Patients with American Cutaneous Leishmaniasis

    Science.gov (United States)

    Qadoumi, Muna; Becker, Inge; Donhauser, Norbert; Röllinghoff, Martin; Bogdan, Christian

    2002-01-01

    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. PMID:12117977

  12. Spontaneous cure of American cutaneous leishmaniasis due to Leishmania naiffi in two Dutch infantry soldiers.

    Science.gov (United States)

    van der Snoek, E M; Lammers, A M; Kortbeek, L M; Roelfsema, J H; Bart, A; Jaspers, C A J J

    2009-12-01

    We report two Dutch infantry soldiers who acquired American cutaneous leishmaniasis (ACL) during military jungle training in Surinam. The lesions had existed for 3 and 5 months, respectively, before the soldiers presented for treatment. The lesions occurred on the head and right thigh, and were small, uncomplicated and symptomless. PCR for Leishmania revealed Leishmania naiffi in both patients. No treatment was given, and the lesions in both men healed spontaneously within 4 and 6 weeks, respectively, after presentation to our clinic. CL is one of the important 'tropical' diseases in The Netherlands, primarily due to the increasing numbers of cases in travellers and in military personnel serving overseas. ACL due to L. naiffi is thought to be a mild expression of CL with a self-limiting nature. Lesions seem to be single, mostly small, ulcerating and usually appear on the hands, arms and legs. No case of mucocutaneous leishmaniasis has yet been attributed to this parasite.

  13. Interventions for American cutaneous and mucocutaneous leishmaniasis: a systematic review update.

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    Ludovic Reveiz

    Full Text Available Leishmaniasis is an important public health problem in the Americas. A Cochrane review published in 2009 analyzed 38 randomized controlled trials (RCT. We conducted a systematic review to evaluate the effects of therapeutic interventions for American cutaneous and mucocutaneous leishmaniasis.All studies were extracted from PubMed, Embase, Lilacs (2009 to July, 2012 respectively, the Cochrane Central Register of Controlled Trials (6-2012 and references of identified publications. RCTs' risk of bias was assessed.We identified 1865 references of interest; we finally included 10 new RCTs. The risk of bias scored low or unclear for most domains. Miltefosine was not significantly different from meglumine antimoniate in the complete cure rate at 6 months (4 RCT; 584 participants; ITT; RR: 1.12; 95%CI: 0.85 to 1.47; I2 78%. However a significant difference in the rate of complete cure favoring miltefosine at 6 months was found in L. panamensis and L. guyanensis (2 RCTs, 206 participants; ITT; RR: 1.22; 95%CI: 1.02 to 1.46; I2 0%. One RCT found that meglumine antimoniate was superior to pentamidine in the rate of complete cure for L. braziliensis (80 participants, ITT; RR: 2.21; 95%CI: 1.41 to 3.49, while another RCT assessing L. guyanensis did not find any significant difference. Although meta-analysis of three studies found a significant difference in the rate of complete cure at 3 months favoring imiquimod versus placebo (134 participants; ITT; RR: 1.45; 95%CI: 1.12 to 1.88; I2 0%, no significant differences were found at 6 and 12 months. Thermotherapy and nitric oxide were not superior to meglumine antimoniate.Therapeutic interventions for American cutaneous and mucocutaneous leishmaniasis are varied and should be decided according to the context. Since mucosal disease is the more neglected form of leishmaniasis a multicentric trial should be urgently considered.

  14. Taurine improves the wound healing process in cutaneous leishmaniasis in mice model, based on stereological parameters

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    Soheil Ashkani-Esfahani

    2014-01-01

    Full Text Available Background: Cutaneous Leishmaniasis is a self-limiting disease caused by protozoan parasites of the genus Leishmania, which affects the skin with full-thickness wounds, which are prone to scar formation even after treatment. Taurine (Tu is one of the most abundant amino acids that has antioxidant and anti-inflammatory effects, which play an important role in the process of wound healing. Herein, we have investigated the effects of Tu on cutaneous Leishmaniasis wounds and L. major promastigotes. Materials and Methods: Eighteen mice were induced with Leishmaniasis wounds (with L. Major on the base of their tails and divided into three groups, T1: Treated with Tu injection, T2: Treated with Tu gel, and C: No treatment. Treatments were carried out every 24 hours for 21 days. The volume densities of the collagen bundles and vessels, vessel′s length density and diameter, and fibroblast populations were estimated by stereological methods. Flow cytometry was used in order to investigate the direct Tu effect on parasites. The Mann-Whitney U test was used and P ≤ 0.05 was considered to be statistically significant. Results: The numerical density of the fibroblasts, volume density of the collagen bundles, and length densities of the vessels in groups T1 and T2 were significantly higher than in group C (P < 0.05. The fibroblast numerical density of group T1 was higher than that of group T2 (P = 0.02. Incidentally, Tu had no direct effect on L. major parasites according to the flow cytometry analysis. Conclusion: Tu showed the ability to improve the wound healing process and tissue regeneration although it had no direct anti-leishmaniasis effect.

  15. INFLUENCE OF MICROBIOTA IN EXPERIMENTAL CUTANEOUS LEISHMANIASIS IN SWISS MICE

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    OLIVEIRA Marcia Rosa de

    1999-01-01

    Full Text Available Infection of Swiss/NIH mice with Leishmania major was compared with infection in isogenic resistant C57BL/6 and susceptible BALB/c mice. Swiss/NIH mice showed self-controlled lesions in the injected foot pad. The production of high levels of interferon-g (IFN-g and low levels of interleukin-4 (IL-4 by cells from these animals suggests that they mount a Th1-type immune response. The importance of the indigenous microbiota on the development of murine leishmaniasis was investigated by infecting germfree Swiss/NIH in the hind footpad with L. major and conventionalizing after 3 weeks of infection. Lesions from conventionalized Swiss/NIH mice were significantly larger than conventional mice. Histopathological analysis of lesions from conventionalized animals showed abscesses of variable shapes and sizes and high numbers of parasitized macrophages. In the lesions from conventional mice, besides the absence of abscess formation, parasites were rarely observed. On the other hand, cells from conventional and conventionalized mice produced similar Th1-type response characterized by high levels of IFN-g and low levels of IL-4. In this study, we demonstrated that Swiss/NIH mice are resistant to L. major infection and that the absence of the normal microbiota at the beginning of infection significantly influenced the lesion size and the inflammatory response at the site of infection.

  16. Nutritional status in patients with cutaneous leishmaniasis and a study of the effects of zinc supplementation together with antimony treatment

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    Miguel Guzman-Rivero

    2014-11-01

    Full Text Available Background: The role of micronutrient status for the incidence and clinical course of cutaneous leishmaniasis is not much studied. Still zinc supplementation in leishmaniasis has shown some effect on the clinical recovery, but the evidence in humans is limited. Objective: To compare biochemical nutritional status in cutaneous leishmaniasis patients with that in controls and to study the effects of zinc supplementation for 60 days. Design: Twenty-nine patients with cutaneous leishmaniasis were treated with antimony for 20 days. Fourteen of them got 45 mg zinc daily and 15 of them got placebo. Biomarkers of nutritional and inflammatory status and changes in size and characteristics of skin lesions were measured. Results: The level of transferrin receptor was higher in patients than in controls but otherwise no differences in nutritional status were found between patients and controls. No significant effects of zinc supplementation on the clinical recovery were observed as assessed by lesion area reduction and characteristics or on biochemical parameters. Conclusions: It is concluded that nutritional status was essentially unaffected in cutaneous leishmaniasis and that oral zinc supplementation administered together with intramuscular injection of antimony had no additional clinical benefit.

  17. Nutritional status in patients with cutaneous leishmaniasis and a study of the effects of zinc supplementation together with antimony treatment.

    Science.gov (United States)

    Guzman-Rivero, Miguel; Rojas, Ernesto; Verduguez-Orellana, Aleida; Pardo, Henry; Torrico, Mary Cruz; Cloetens, Lieselotte; Akesson, Björn; Sejas, Edgar

    2014-01-01

    The role of micronutrient status for the incidence and clinical course of cutaneous leishmaniasis is not much studied. Still zinc supplementation in leishmaniasis has shown some effect on the clinical recovery, but the evidence in humans is limited. To compare biochemical nutritional status in cutaneous leishmaniasis patients with that in controls and to study the effects of zinc supplementation for 60 days. Twenty-nine patients with cutaneous leishmaniasis were treated with antimony for 20 days. Fourteen of them got 45 mg zinc daily and 15 of them got placebo. Biomarkers of nutritional and inflammatory status and changes in size and characteristics of skin lesions were measured. The level of transferrin receptor was higher in patients than in controls but otherwise no differences in nutritional status were found between patients and controls. No significant effects of zinc supplementation on the clinical recovery were observed as assessed by lesion area reduction and characteristics or on biochemical parameters. It is concluded that nutritional status was essentially unaffected in cutaneous leishmaniasis and that oral zinc supplementation administered together with intramuscular injection of antimony had no additional clinical benefit.

  18. Expansion of gd T cells in patients infected with cutaneous leishmaniasis with and without glucantime therapy

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    Haideh Darabi

    Full Text Available The expansion of gd T cells in patients with active cutaneous leishmaniasis, with or without glucantime therapy, was investigated. Twenty patients with local cutaneous leishmaniasis including glucantime-treated (n=10 and untreated (n=10 patients were selected. The controls were healthy individuals (n=10 living in endemic areas. Whole blood was obtained and the T cell subpopulations were analyzed by flow cytometry. Significantly more gd CD3+ T cells were observed in untreated patients (15.9% ± 5.9, when compared with glucantime-treated patients (4.6% ± 1.4 and controls (5.3% ± 2.3. On the other hand, when the percentages of ab CD3+ T-cells were analyzed different results were obtained. A significant increase in ab T cells was seen in glucantime-treated patients (62.4% ± 7.6, when compared to the untreated patients (55.7% ± 5.5 and controls (55.1% ± 9.6. The percentage of total CD3+ T cells was statistically greater in both glucantime-treated (68.8% ± 7.4 and untreated patients (73.4% ± 5.9 when compared to the controls (61% ± 10.3. These results are consistent with previous results on the expansion of gdT cells during the course of cutaneous leishmaniasis. They also indicate that glucantime therapy can reverse the expansion of gdT cells and as a result increase the percentages of ab CD3+ T cells.

  19. Efficacy of thermotherapy to treat cutaneous leishmaniasis: a meta-analysis of controlled clinical trials.

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    Jaiberth Antonio Cardona-Arias

    Full Text Available The efficacy of thermotherapy for the treatment of cutaneous leishmaniasis presents diverse results with low statistical power.To evaluate the efficacy of thermotherapy to treat cutaneous leishmaniasis.A meta-analysis of controlled clinical trials in 12 databases based on the implementation of a research protocol with inclusion and exclusion criteria and an assessment of methodological quality. The reproducibility and completeness were guaranteed in the information search and extraction. Heterogeneity, sensitivity and publication bias were assessed by graphical methods (Galbraith, L'Abblé, funnel plot, Egger plot, and influence plot and analytical methods (DerSimonian-Laird, Begg and Egger. Random-effects forest plots were constructed, and a cumulative meta-analysis was performed.Eight studies were included with 622 patients who underwent thermotherapy, with an efficacy of 73.2% (95% confidence interval (CI = 69.6-76.7%, and with 667 patients who underwent systemic treatment, with an efficacy of 70.6% (95% CI=67.1-74.1%. Heterogeneity between studies, good sensitivity for the combined measure, and no publication bias were observed. The relative risk for comparison of the efficacy of treatment was 1.02 (95%CI=0.91, 1.15, showing that the effectiveness of thermotherapy is equal to that of pentavalent antimonial drugs.Due to its efficacy, greater safety and lower cost, thermotherapy should be the first treatment option for cutaneous leishmaniasis in areas where the prevalence of the mucocutaneous form is low and in patients with contraindications to systemic treatment, such as kidney, liver and heart diseases, as well as in pregnant women, infants, and patients with human immunodeficiency virus infection/acquired immune deficiency syndrome.

  20. Efficacy of thermotherapy to treat cutaneous leishmaniasis: a meta-analysis of controlled clinical trials.

    Science.gov (United States)

    Cardona-Arias, Jaiberth Antonio; Vélez, Iván Darío; López-Carvajal, Liliana

    2015-01-01

    The efficacy of thermotherapy for the treatment of cutaneous leishmaniasis presents diverse results with low statistical power. To evaluate the efficacy of thermotherapy to treat cutaneous leishmaniasis. A meta-analysis of controlled clinical trials in 12 databases based on the implementation of a research protocol with inclusion and exclusion criteria and an assessment of methodological quality. The reproducibility and completeness were guaranteed in the information search and extraction. Heterogeneity, sensitivity and publication bias were assessed by graphical methods (Galbraith, L'Abblé, funnel plot, Egger plot, and influence plot) and analytical methods (DerSimonian-Laird, Begg and Egger). Random-effects forest plots were constructed, and a cumulative meta-analysis was performed. Eight studies were included with 622 patients who underwent thermotherapy, with an efficacy of 73.2% (95% confidence interval (CI) = 69.6-76.7%), and with 667 patients who underwent systemic treatment, with an efficacy of 70.6% (95% CI=67.1-74.1%). Heterogeneity between studies, good sensitivity for the combined measure, and no publication bias were observed. The relative risk for comparison of the efficacy of treatment was 1.02 (95%CI=0.91, 1.15), showing that the effectiveness of thermotherapy is equal to that of pentavalent antimonial drugs. Due to its efficacy, greater safety and lower cost, thermotherapy should be the first treatment option for cutaneous leishmaniasis in areas where the prevalence of the mucocutaneous form is low and in patients with contraindications to systemic treatment, such as kidney, liver and heart diseases, as well as in pregnant women, infants, and patients with human immunodeficiency virus infection/acquired immune deficiency syndrome.

  1. An overview of a diagnostic and epidemiologic reappraisal of cutaneous leishmaniasis in Iran.

    Science.gov (United States)

    Farahmand, Mahin; Nahrevanian, Hossein; Shirazi, Hasti Atashi; Naeimi, Sabah; Farzanehnejad, Zahra

    2011-01-01

    Cutaneous leishmaniasis (CL) is a widespread tropical infection which has a high incidence rate in Iran. Leishmania tropica, the causative agent of anthroponotic cutaneous leishmaniasis (ACL), and Leishmania major, which causes zoonotic cutaneous leishmaniasis (ZCL), are endemic in various parts of Iran with a high incidence rate. The aim of this study was to evaluate the reappraisal of the diagnosis and epidemiology of CL in Iran, by different clinical, parasitological and molecular assays among patients suspected of CL referred to the Department of Parasitology, at the Pasteur Institute of Iran during 2006-2009. Two hundred samples from patients with ulcerative skin lesions were collected, clinical analyses were applied, data questionnaire was completed and samples were examined for CL by using both direct microscopic and culture methods. Moreover, PCR assay was applied for detection of Leishmania species in CL isolates resulting from parasitological assay. Clinical observation revealed that the majority (58%) of lesions was single; double lesions were observed in 22% of patients, and only 20% of CL had multiple lesions. Out of 200 patients, Leishman body was observed in 77 samples (38.5%) by direct smear and 40% by cultivation assay. Most patients (21.3%) had a travel history to the Isfahan province, one of the most important endemic areas of CL located in center of Iran. PCR assay by kDNA indicated 32 and 18 out of 50 isolates respectively had similar patterns with standard L. major and L. tropica. In conclusion, clinical manifestations and an appropriate diagnostic assay with a parallel molecular characterization of CL may lead to a screening evaluation of disease, prognosis, treatment and control strategies.

  2. An overview of a diagnostic and epidemiologic reappraisal of cutaneous leishmaniasis in Iran

    Directory of Open Access Journals (Sweden)

    Mahin Farahmand

    Full Text Available Cutaneous leishmaniasis (CL is a widespread tropical infection which has a high incidence rate in Iran. Leishmania tropica, the causative agent of anthroponotic cutaneous leishmaniasis (ACL, and Leishmania major, which causes zoonotic cutaneous leishmaniasis (ZCL, are endemic in various parts of Iran with a high incidence rate. The aim of this study was to evaluate the reappraisal of the diagnosis and epidemiology of CL in Iran, by different clinical, parasitological and molecular assays among patients suspected of CL referred to the Department of Parasitology, at the Pasteur Institute of Iran during 2006-2009. Two hundred samples from patients with ulcerative skin lesions were collected, clinical analyses were applied, data questionnaire was completed and samples were examined for CL by using both direct microscopic and culture methods. Moreover, PCR assay was applied for detection of Leishmania species in CL isolates resulting from parasitological assay. Clinical observation revealed that the majority (58% of lesions was single; double lesions were observed in 22% of patients, and only 20% of CL had multiple lesions. Out of 200 patients, Leishman body was observed in 77 samples (38.5% by direct smear and 40% by cultivation assay. Most patients (21.3% had a travel history to the Isfahan province, one of the most important endemic areas of CL located in center of Iran. PCR assay by kDNA indicated 32 and 18 out of 50 isolates respectively had similar patterns with standard L. major and L. tropica. In conclusion, clinical manifestations and an appropriate diagnostic assay with a parallel molecular characterization of CL may lead to a screening evaluation of disease, prognosis, treatment and control strategies.

  3. Protection against Cutaneous Leishmaniasis Induced by Recombinant Antigens in Murine and Nonhuman Primate Models of the Human Disease

    Science.gov (United States)

    Campos-Neto, Antonio; Porrozzi, Renato; Greeson, Kay; Coler, Rhea N.; Webb, John R.; Seiky, Yasir A. W.; Reed, Steven G.; Grimaldi, Gabriel

    2001-01-01

    Leishmaniasis affects approximately 2 million people each year throughout the world. This high incidence is due in part to the lack of an efficacious vaccine. We present evidence that the recombinant leishmanial antigens LmSTI1 and TSA, which we identified and characterized previously, induce excellent protection in both murine and nonhuman primate (rhesus monkey) models of human cutaneous leishmaniasis. The remarkable protection induced by LmSTI1 and TSA in an animal model that is evolutionarily close to humans qualifies this antigen combination as a promising candidate subunit vaccine against human leishmaniasis. PMID:11349082

  4. Report of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) in a cutaneous-leishmaniasis-endemic area of Panama.

    Science.gov (United States)

    Valderrama, Anayansi; Tavares, Mara Garcia; Andrade Filho, José Dilermando

    2011-12-01

    Lutzomyia longipalpis is the primary vector of the parasite responsible for visceral leishmaniasis in the Americas. In the present study, Lu. longipalpis was found in a domiciliary area in Limón, a district in Capira, a region in which cutaneous leishmaniasis is endemic in Panama. Previously, this species has been found in a humid forest in this same region. Finding Lu. longipalpis in domiciliary areas indicates that this species may be adapting to new habitats and that it may play a role in the transmission of leishmaniasis in Panama.

  5. Imaging of the host/parasite interplay in cutaneous leishmaniasis.

    Science.gov (United States)

    Millington, Owain R; Myburgh, Elmarie; Mottram, Jeremy C; Alexander, James

    2010-11-01

    An understanding of host-parasite interplay is essential for the development of therapeutics and vaccines. Immunoparasitologists have learned a great deal from 'conventional'in vitro and in vivo approaches, but recent developments in imaging technologies have provided us (immunologists and parasitologists) with the ability to ask new and exciting questions about the dynamic nature of the parasite-immune system interface. These studies are providing us with new insights into the mechanisms involved in the initiation of a Leishmania infection and the consequent induction and regulation of the immune response. Here, we review some of the recent developments and discuss how these observations can be further developed to understand the immunology of cutaneous Leishmania infection in vivo. (c) 2010 Elsevier Inc. All rights reserved.

  6. White starburst-like pattern as a dermoscopic clue in Old World cutaneous leishmaniasis *

    Science.gov (United States)

    Fernandez-Crehuet, Pablo; Ruiz-Villaverde, Ricardo

    2017-01-01

    A 70-year-old woman was referred to our dermatological unit by her general practitioner last summer, with a history of a two-month ulcerated purplish lesion on her left arm that spread centrifugally and that unsuccessfully treated with topical corticosteroids. The dermoscopic evaluation revealed an erythematous macula with central ulceration that showed the characteristic called "white starburst-like pattern" and some vascular structures (dotted vessels, polymorphous⁄ atypical vessels). The diagnosis of cutaneous leishmaniasis was made after histopathologic analysis and polymerase chain reaction essay. PMID:28538895

  7. White starburst-like pattern as a dermoscopic clue in Old World cutaneous leishmaniasis.

    Science.gov (United States)

    Fernandez-Crehuet, Pablo; Ruiz-Villaverde, Ricardo

    2017-01-01

    A 70-year-old woman was referred to our dermatological unit by her general practitioner last summer, with a history of a two-month ulcerated purplish lesion on her left arm that spread centrifugally and that unsuccessfully treated with topical corticosteroids. The dermoscopic evaluation revealed an erythematous macula with central ulceration that showed the characteristic called "white starburst-like pattern" and some vascular structures (dotted vessels, polymorphous⁄ atypical vessels). The diagnosis of cutaneous leishmaniasis was made after histopathologic analysis and polymerase chain reaction essay.

  8. Tissue Impression Smears as a Supplementary Diagnostic Method for Histopathology in Cutaneous Leishmaniasis in Sri Lanka.

    Science.gov (United States)

    Manamperi, Nuwani H; de Silva, M Vipula C; Pathirana, Nishantha; Abeyewickreme, Wimal; Karunaweera, Nadira D

    2018-01-15

    Cutaneous leishmaniasis (CL) is diagnosed mainly by light microscopy of smears made using lesion material. Histopathology is usually done in atypical presentations or when lesion smears are negative. Tissue impression smears (TIS) made from skin biopsy specimens were compared with histopathology for the diagnosis of CL. Out of the 111 patients included, 83 (74.8%) were positive by either methods. The TIS was positive in 70.3% whereas histopathology was positive in 56.8% of patients. Tissue impression smears can be used as a supplementary diagnostic test that gives sensitive and rapid results when tissue biopsies are used as the source of lesion material for diagnosis of CL.

  9. Sporotrichosis in Iran: A mini review of reported cases in patients suspected to cutaneous leishmaniasis

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    shahram mahmoudi

    2015-03-01

    Full Text Available Sporotrichosis is a chronic subcutaneous fungal infection with global distribution. It is a rare fungal infection with nine reported cases in Iran, including eight humans and one animal, within the past 30 years. Among the human cases, seven were of the fixed cutaneous type of sporotrichosis and one had sporotrichoid lymphocutaneous. The reported patients were within the age range of 23-60 years, and six of them were female. The most frequent sites of infection were forearms and hands, as well as the face and legs. In addition, the majority of the cases had previously been suspected of leishmaniasis and received treatment. Sporotrichosis is not a well-known condition in Iran and is often misdiagnosed and erroneously treated for other cutaneous parasitic or bacterial infections with similar clinical manifestations. Therefore, sporotrichosis should be taken into account in the differential diagnosis of nodular-ulcerative skin lesions.

  10. Joint spatial time-series epidemiological analysis of malaria and cutaneous leishmaniasis infection.

    Science.gov (United States)

    Adegboye, O A; Al-Saghir, M; Leung, D H Y

    2017-03-01

    Malaria and leishmaniasis are among the two most important health problems of many developing countries especially in the Middle East and North Africa. It is common for vector-borne infectious diseases to have similar hotspots which may be attributed to the overlapping ecological distribution of the vector. Hotspot analyses were conducted to simultaneously detect the location of local hotspots and test their statistical significance. Spatial scan statistics were used to detect and test hotspots of malaria and cutaneous leishmaniasis (CL) in Afghanistan in 2009. A multivariate negative binomial model was used to simultaneously assess the effects of environmental variables on malaria and CL. In addition to the dependency between malaria and CL disease counts, spatial and temporal information were also incorporated in the model. Results indicated that malaria and CL incidence peaked at the same periods. Two hotspots were detected for malaria and three for CL. The findings in the current study show an association between the incidence of malaria and CL in the studied areas of Afghanistan. The incidence of CL disease in a given month is linked with the incidence of malaria in the previous month. Co-existence of malaria and CL within the same geographical area was supported by this study, highlighting the presence and effects of environmental variables such as temperature and precipitation. People living in areas with malaria are at increased risk for leishmaniasis infection. Local healthcare authorities should consider the co-infection problem by recommending systematic malaria screening for all CL patients.

  11. Control of zoonotic cutaneous leishmaniasis vector, Phlebotomus papatasi, using attractive toxic sugar baits (ATSB.

    Directory of Open Access Journals (Sweden)

    Abedin Saghafipour

    Full Text Available Attractive Toxic Sugar Baits (ATSB is a new vector control method that meets Integrated Vector Management (IVM goals. In an experimental design, this study aimed to determine effects of ATSB on control of Phlebotomus papatasi, as a main vector of Zoonotic Cutaneous Leishmaniasis (ZCL, in Qom Province, center of Iran.In a cross-sectional design, boric acid was mixed with brown sugar solution and tested as toxic baits for P. papatasi. Two methods were utilized to use the baits: (a spraying ATSB on vegetation, bushes, and shrubs; and (b setting ATSB-treated barrier fences in front of colonies at 500 m distance from the houses in outskirts of villages. In order to examine the residual efficacy rate of ATSB-treated barrier fences, the bioassay test was used. Density of P. papatasi sandflies was measured using sticky and light traps biweekly. For data analysis, Mann-Whitney U Test and Kruskal-Wallis were used. Results ATSB-treated barrier fences led to 3 times reduction in P. papatasi population. Besides that, ATSB spraying on plants led to more than 5 times reduction in P. papatasi population.Comparing the incidence of leishmaniasis in treated villages before and after the study showed that the incidence was statistically reduced. Therefore, ATSB is an effective method to control vectors and prevent leishmaniasis.

  12. [Efficacy of pulsed-dye laser on residual red lesions of cutaneous leishmaniasis].

    Science.gov (United States)

    Slaoui, W; Chiheb, S; Benchikhi, H

    2015-01-01

    Cutaneous leishmaniasis caused by Leishmania tropica can leave troublesome and unsightly lesions. Treatment of these scars remains difficult. Pulsed-dye laser (PDL) is one therapeutic approach that may improve the clinical appearance of erythematosus lesions. The purpose of this retrospective study was to evaluate the effectiveness of PDL on the residual red lesions of erythematous facial leishmaniasis in three patients. Case no. 1: a 14-year-old girl presented an ulcerative and erythematous nodular lesion on her left cheek. One month after treatment, an erythematous lesion measuring 3 cm persisted on the patient's cheek, without atrophy or hyperpigmentation. PDL 595nm was used at the following settings: duration: 3ms; spot size: 7mm; energy: 8 j/cm(2). Case no. 2: a 43-year-old woman presented an erythematous papular lesion on her right cheek. Following treatment, a 4-cm hypertrophic, red telangiectasic lesion remained. PDL 595nm was used with the following settings: pulse duration: 3 ms; spot-size: 10mm; energy: 8 j/cm(2). Case no. 3: a 60-year-old woman presented an erythematous papular lesion on her cheek. After treatment, an infiltrated erythematous macule with surface telangiectasia measuring 3.5cm remained. PDL 595nm was also given using the following settings: pulse duration: 3 ms; spot size: 10mm; energy: 8 j/cm(2). All three patients underwent three sessions of PDL. The erythematous and telangiectasic lesions showed improvement after the initial session and had completely disappeared after the third session. Post-laser purpura subsided within around 10 days. Therapeutic response was assessed clinically by comparing photographs taken before and after treatment and follow-up lasted 12 months. Cutaneous leishmaniasis caused by L. tropica is endemo-epidemic in Morocco. A number of treatments are available for red residual lesions but thanks to its effect on erythematous and vascular lesions, PDL has been shown to provide the most reproducibly

  13. A novel non-invasive diagnostic sampling technique for cutaneous leishmaniasis.

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    Yasaman Taslimi

    2017-07-01

    Full Text Available Accurate diagnosis of cutaneous leishmaniasis (CL is important for chemotherapy and epidemiological studies. Common approaches for Leishmania detection involve the invasive collection of specimens for direct identification of amastigotes by microscopy and the culturing of promastigotes from infected tissues. Although these techniques are highly specific, they require highly skilled health workers and have the inherent risks of all invasive procedures, such as pain and risk of bacterial and fungal super-infection. Therefore, it is essential to reduce discomfort, potential infection and scarring caused by invasive diagnostic approaches especially for children. In this report, we present a novel non-invasive method, that is painless, rapid and user-friendly, using sequential tape strips for sampling and isolation of DNA from the surface of active and healed skin lesions of CL patients. A total of 119 patients suspected of suffering from cutaneous leishmaniasis with different clinical manifestations were recruited and samples were collected both from their lesions and from uninfected areas. In addition, 15 fungal-infected lesions and 54 areas of healthy skin were examined. The duration of sampling is short (less than one minute and species identification by PCR is highly specific and sensitive. The sequential tape stripping sampling method is a sensitive, non-invasive and cost-effective alternative to traditional diagnostic assays and it is suitable for field studies as well as for use in health care centers.

  14. Photochemistry-based immune modulation in the treatment of cutaneous leishmaniasis

    Science.gov (United States)

    Akilov, Oleg E.; Kosaka, Sachiko; Hasan, Tayyaba

    2009-06-01

    The destruction of infectious pathogens by photodynamic therapy (PDT) is an emerging modality. We demonstrated the efficacy of PDT for the management of cutaneous leishmaniasis in our previous studies. However, much remains to be done for the improvement of PDT regimens. The modulation of the immune response by photochemistry is an exciting but under-explored area of PDT research. The goal of this study is to understand the mechanisms of the augmentation of the host immune response after PDT of cutaneous leishmaniasis (CL). We found that PDT with phenoxiazine analogues was capable for induction of Th1 immune response due to stimulation of IL- 12 production by dendritic cells. Single PDT treatment facilitated fast healing of the CL lesions due to effective parasite eradication and augmentation of the immune system. Comparative study with different photosensitizers (PS) (porphyrins, pehnoxiazines) demonstrated different immunomodulating properties of PDT depending on chemical class of PS. Knowing the particular profiles and immunomodulating properties of the pertinent PSs allows us to select the optimal PS with regards to both the photodestructive and immunostimulating potential.

  15. Utility of Western Blot Analysis for the Diagnosis of Cutaneous Leishmaniasis

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    Marzieh ASHRAFMANSOURI

    2015-12-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is a parasitic disease with a relatively wide distribution in different areas of the world, including Iran. The parasite is mainly diagnosed microscopically, but serological approaches might be useful for diagnosis as well.  This study aimed to assess the efficacy of an immunoblotting system for serodiagnosis of cutaneous leishmaniasis in Iran.Methods: Sixty-one sera samples from parasitologically confirmed CL patients and 50 sera samples from healthy controls along with 50 sera sample from non-CL patients were collected. Native strain of Leishmania major was cultured in Schnei­der medium and soluble Leishmania antigens were prepared from amastigotes-like parasites. All of sera samples were evaluated by an immunoblot­ting system.Results: Components of 14 to 135 kDa were detectable by the sera of CL pa­tients. From 61 sera of CL patients, 59 cases (96.7% detected a 63 kDa subunit and 51 cases (83.6% recognized a 32-35 kDa component. Among all subunits, the 63 kDa band showed the highest sensitivity (96.7% and a 75 kDa band had the highest (98% specificity.Conclusion: Immunoblotting has a satisfactory performance in diagnosis of CL and this test can be used, as an aid, for proper diagnosis of CL.

  16. Wound healing genes and susceptibility to cutaneous leishmaniasis in Brazil: Role of COL1A1

    Science.gov (United States)

    Almeida, Lucas; Oliveira, Joyce; Guimarães, Luiz Henrique; Carvalho, Edgar M; Blackwell, Jenefer M

    2015-01-01

    Previous studies have demonstrated a role for wound healing genes in resolution of cutaneous lesions caused by Leishmania spp. in both mice and humans, including the gene FLI1 encoding Friend leukaemia virus integration 1. Reduction of Fli1 expression in mice has been shown to result in up-regulation of collagen type I alpha 1 (Col1a1) and alpha 2 (Col1a2) genes and, conversely, in down-regulation of the matrix metalloproteinase 1 (Mmp1) gene, suggesting that Fli1 suppression is involved in activation of the profibrotic gene program. Here we examined single nucleotide polymorphisms (SNPs) in these genes as risk factors for cutaneous (CL) and mucosal leishmaniasis (ML), and leishmaniasis per se, caused by L. braziliensis in humans. SNPs were genotyped in 168 nuclear families (250 CL; 87 ML cases) and replicated in 157 families (402 CL; 39 ML cases). Family-based association tests (FBAT) showed the strongest association between SNPs rs1061237 (combined P=0.002) and rs2586488 (combined P=0.027) at COL1A1 and CL disease. This contributes to our further understanding of the role of wound healing in the resolution of CL disease, providing potential for therapies modulating COL1A1 via drugs acting on FLI1. PMID:25562121

  17. Is the Dog a Possible Reservoir for Cutaneous Leishmaniasis in Suriname?

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    Alida Kent

    2013-01-01

    Full Text Available Cutaneous leishmaniasis (CL is an emerging disease in Suriname, with at least 200 cases per year. Little is known about the biology of CL in the country. The most important parasite species is Leishmania Viannia guyanensis, but possible vectors and reservoirs are hardly incriminated. In the present study, it was investigated whether the dog could possibly be a zoonotic reservoir for the disease in Suriname. Forty-seven dogs were examined for overt clinical signs of leishmaniasis, and blood samples were collected on filter paper for serology (direct agglutination test and molecular biology (by polymerase chain reaction. Three dogs had clinical signs that could be compatible with canine cutaneous leishmaniosis: dermatitis (two or nasal lesion (one. Two dogs were seropositive with DAT (titre > 1 : 1600, and three animals had a borderline titre (1 : 800. All other animals (n=42 were DAT negative. PCR analysis found Leishmania DNA equivalent to 1 parasite per mL in only one dog at a first round of analysis, but this animal was negative after retesting. The clinical, serological, and molecular data show some preliminary lines of evidence that canine leishmaniosis is present in Suriname, but further studies are needed to incriminate the reservoir, including a possible sylvatic cycle.

  18. Linking Climate to Incidence of Zoonotic Cutaneous Leishmaniasis (L. major) in Pre-Saharan North Africa

    Science.gov (United States)

    Bounoua, Lahouari; Kahime, Kholoud; Houti, Leila; Blakey, Tara; Ebi, Kristie L.; Zhang, Ping; Imhoff, Marc L.; Thome, Kurtis J.; Dudek, Claire; Sahabi, Salah A.; hide

    2013-01-01

    Shifts in surface climate may have changed the dynamic of zoonotic cutaneous leishmaniasis (ZCL) in the pre-Saharan zones of North Africa. Caused by Leishmania major, this form multiplies in the body of rodents serving as reservoirs of the disease. The parasite is then transmitted to human hosts by the bite of a Phlebotomine sand fly (Diptera: Psychodidae) that was previously fed by biting an infected reservoir. We examine the seasonal and interannual dynamics of the incidence of this ZCL as a function of surface climate indicators in two regions covering a large area of the semi-arid Pre-Saharan North Africa. Results suggest that in this area, changes in climate may have initiated a trophic cascade that resulted in an increase in ZCL incidence. We find the correlation between the rainy season precipitation and the same year Normalized Difference Vegetation Index (NDVI) to be strong for both regions while the number of cases of ZCL incidence lags the precipitation and NDVI by 2 years. The zoonotic cutaneous leishmaniasis seasonal dynamic appears to be controlled by minimum temperatures and presents a 2-month lag between the reported infection date and the presumed date when the infection actually occurred. The decadal increase in the number of ZCL occurrence in the region suggests that changes in climate increased minimum temperatures sufficiently and created conditions suitable for endemicity that did not previously exist. We also find that temperatures above a critical range suppress ZCL incidence by limiting the vector's reproductive activity.

  19. Topical terbinafine in the treatment of cutaneous leishmaniasis: triple blind randomized clinical trial.

    Science.gov (United States)

    Farajzadeh, Saeedeh; Heshmatkhah, Amireh; Vares, Behrooz; Mohebbi, Elham; Mohebbi, Azadeh; Aflatoonian, Mahin; Eybpoosh, Sana; Sharifi, Iraj; Aflatoonian, Mohammad Reza; Shamsi Meymandi, Simin; Fekri, Ali Reza; Mostafavi, Mahshid

    2016-12-01

    Leishmaniasis is a spectrum of disease condition with considerable health impacts, caused by different species of Leishmania . This disease is currently endemic in 98 countries and territories in the world. There are many treatment modalities for cutaneous leishmaniasis. The use of topical terbinafine in the treatment of cutaneous leishmaniasis has recently been considered. Eighty-eight participants more than two years old with proven acute CL by a positive direct smear were randomly allocated to one of the two study arms: first group received meglumine antimoniate (Glucantime) 20 mg/kg/day intramuscular injection (IM) plus a placebo ointment (Mahan Vaseline) for 20 days. The second group received meglumine antimoniate (Glucantime) 20 mg/kg/day IM plus topical terbinafine, for 20 days and were monitored closely by dermatologist during the course of the study. Crude regression analysis showed that there was no significant difference between placebo and intervention group regarding partial or complete treatment (partial treatment: HR crude  = 1.1, CI 95 % = 0.7-1.7; complete treatment: HR crude  = 1.1, CI 95 % = 0.8-1.7). Although, there was no statistically significant different between the two treatment groups, but clinically it seems that the treatment rate in those who receive glucantime plus terbinafine was more effective than the other group. However this rate depended on the type of lesions. As data indicated ulcerated nodules, papules and plaque in experimental group have been completely improved two times faster than placebo group. Ulcerated nodules, nodules and plaque were partially improved faster in those used tebinafine than placebo ointment.

  20. Prevalence of cutaneous leishmaniasis along the Nile River north of Khartoum (Sudan) in the aftermath of an epidemic in 1985

    DEFF Research Database (Denmark)

    Kadaro, A Y; Ghalib, H W; Ali, M S

    1993-01-01

    Based on a pilot clinical study of the prevalence of cutaneous leishmaniasis (CL) among school children in villages on both banks of the Nile River north of Khartoum, Sudan in the aftermath of a 1985 epidemic, we studied a random sample (303 individuals) from one of these villages to determine...

  1. Variation in clinical presentation and genotype of causative Leishmania major strain in cutaneous leishmaniasis in north and south Afghanistan

    NARCIS (Netherlands)

    van Thiel, Pieter-Paul A. M.; van Gool, Tom; Faber, William R.; Leenstra, Tjalling; Kager, Piet A.; Bart, Aldert

    2011-01-01

    A different clinical picture and therapeutic response were observed when data from Leishmania major-infected Dutch military personnel stationed in southern (N = 8) and northern (N = 169) Afghanistan were analyzed. Clinical presentation of cutaneous leishmaniasis in personnel in the south was milder

  2. Characterization of the local and systemic immune responses in patients with cutaneous leishmaniasis due to Leishmania major

    DEFF Research Database (Denmark)

    Gaafar, A; Veress, B; Permin, H

    1999-01-01

    In this study skin biopsies and peripheral blood samples were obtained from patients with cutaneous leishmaniasis caused by Leishmania major. Samples were obtained at diagnosis and during healing when the lesions had regressed to half the original size. At diagnosis most of the cells expressed HLA...

  3. Cutaneous Leishmaniasis: Knowledge, Attitude and Practices of the Inhabitants of the Kani Forest Tribal Settlements of Tiruvananthapuram District, Kerala, India

    Science.gov (United States)

    Nandha, B.; Srinivasan, R.; Jambulingam, P.

    2014-01-01

    Cutaneous leishmaniasis (CL) is reported among Kani tribes in forest settlements of Tiruvananthapuram district, Kerala, India. Epidemiological investigations are ongoing and 27 histopathologically confirmed cases of CL have been reported from five settlements indicating transmission of disease within settlements. One of the priorities for…

  4. Characterization of the local and systemic immune responses in patients with cutaneous leishmaniasis due to Leishmania major

    DEFF Research Database (Denmark)

    Gaafar, A; Veress, B; Permin, H

    1999-01-01

    In this study skin biopsies and peripheral blood samples were obtained from patients with cutaneous leishmaniasis caused by Leishmania major. Samples were obtained at diagnosis and during healing when the lesions had regressed to half the original size. At diagnosis most of the cells expressed HL...

  5. A 27-Year-Old Severely Immunosuppressed Female with Misleading Clinical Features of Disseminated Cutaneous Sporotrichosis

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    Atiyah Patel

    2016-01-01

    Full Text Available Sporotrichosis is a subacute or chronic granulomatous mycosis caused by fungus of the Sporothrix schenckii complex. It is considered to be a rare condition in most parts of the world. It mostly causes cutaneous infection but can also cause multisystemic disease. Unlike most deep cutaneous mycoses which have a primary pulmonary focus, it is usually caused by direct inoculation of the fungus into the skin causing a classical linear, lymphocutaneous nodular eruption. However, atypical presentations of the condition can occur especially in immunosuppressed individuals. We report the case of a severely immunosuppressed female who presented with disseminated cutaneous sporotrichosis which was initially diagnosed and treated as disseminated cutaneous Kaposi’s sarcoma.

  6. Parasitological and biochemical studies on cutaneous leishmaniasis in Shara'b District, Taiz, Yemen.

    Science.gov (United States)

    Asmaa, Qhtan; Al-Shamerii, Salwa; Al-Tag, Mohammed; Al-Shamerii, Adam; Li, Yiping; Osman, Bashir H

    2017-07-04

    The leishmaniasis is a group of diseases caused by intracellular haemoflagellate protozoan parasites of the genus Leishmania. Leishmaniasis has diverse clinical manifestations; cutaneous leishmaniasis (CL) is the most common form of leishmaniasis which is responsible for 60% of disability-adjusted life years. CL is endemic in Yemen. In Shara'b there is no reference study available to identify the prevalence of endemic diseases and no investigation has been conducted for diagnosing the diseases. This study was conducted in villages for CL which collected randomly. The study aimed at investigating the epidemiological factors of CL in Shara'b by using questioner. Symptoms of lesions in patients suffering from CL, confirmed by laboratory tests, gave a new evidence of biochemical diagnosis in 525 villagers aged between 1 and 60 years old. Venous bloods were collected from 99 patients as well as from 51 control after an overnight fast. The percentage prevalence of CL was found 18.8%. The prevalence rate of infection among males (19.3%) was higher than females (18.40%). Younger age group (1-15) had a higher prevalence rate (20.3%) than the other age groups. Furthermore, the population with no formal education had the higher rate of infection (61% of the total). A significant increase of serum malondialdehyde (P < 0.001) in CL patients was obtained. The highest level of MDA may be due to over production of ROS and RNS results in oxidative stress and the acceleration of lipid peroxidation in CL patients. There were high prevalence rates of CL in Shara'b. The patient who had CL has been found with many changes in some biochemical levels. This study provides a clear indication on the role of MDA as an early biochemical marker of peroxidation damage occurring during CL. Increased uric acid, and catalase activity was provided of free radical.

  7. Cutaneous Cryptococcosis: a marker of life threatening disseminated cryptococcosis in HIV AIDS

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    Hari Kishan Kumar Yadalla

    2011-10-01

    Full Text Available Cryptococcosis is an opportunistic infection caused by a ubiquitous encapsulated yeast, Cryptococcus neoformans. Affects 5 – 10 % of patients with HIV worldwide. Disseminated cryptococcosis is one of the AIDS defining criteria and the most common cause of life threatening meningitis. Upto 20% of patients with disseminated disease can have skin involvement. Cutaneous lesions in disseminated cryptococcosis are seldom pathognomonic and portent neurological involvement. The significance of skin lesions may provide the first evidence of dissemination and indicate a poor prognosis, however, earlier recognition and treatment would improve survival. Herein we report a case of cryptococcal meningitis with skin lesions in a HIV seropositive patient.

  8. Imported cutaneous leishmaniasis in a short-term traveler returning from Central Mali - The role of PCR.

    Science.gov (United States)

    Kelly, Patrick; Baudry, Thomas; Peyron, François

    2012-03-01

    Leishmaniasis is a parasitic infection caused by the obligate intracellular protazoa leishmania. The most commonly encountered form is cutaneous leishmaniasis (CL), which generally manifests as a chronic, painless ulcer. Recent increases in the incidence of CL worldwide due in large part to increased immigration and international travel, combined often with the lack of familiarity with the disease in non-endemic settings, pose the continued problems of delayed diagnosis and inappropriate treatment. A case is described of imported cutaneous leishmaniasis occurring in a 48 year-old male who presented with multiple painless, progressively ulcerating lesions after returning from a one week trip to Bandiagara, Mali, West Africa. After four months of misdiagnoses and ineffective treatments, he was referred to a tropical disease specialist where the diagnosis was made with a skin biopsy followed by a tissue impression smear, culture and PCR. Appropriate treatment was initiated and the lesions resolved with minimal scarring. The goals of this case report are threefold: first, to stress the importance of associating chronic ulcers in a traveler with potential cutaneous leishmaniasis; second, to emphasize the clinical utility of PCR for the diagnosis; and third, to discuss the clinical approach to treatment. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. FIRST REPORT OF CUTANEOUS LEISHMANIASIS CAUSED BY Leishmania (Leishmania infantum chagasi IN AN URBAN AREA OF RIO DE JANEIRO, BRAZIL

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    Marcelo Rosandiski LYRA

    2015-10-01

    Full Text Available SUMMARY American tegumentary leishmaniasis (ATL is an infectious disease caused by protozoa of the genus Leishmania, and transmitted by sandflies. In the state of Rio de Janeiro, almost all of the cases of American tegumentary leishmaniasis (ATL are caused by Leishmania (Viannia braziliensis, while cases of visceral leishmaniasis (VL are caused by Leishmania (Leishmania infantum chagasi. The resurgence of autochthonous VL cases in Rio de Janeiro is related to the geographic expansion of the vector Lutzomyia longipalpis and its ability to adapt to urban areas. We report the first case of leishmaniasis with exclusively cutaneous manifestations caused by L. (L. infantum chagasi in an urban area of Rio de Janeiro. An eighty-one-year-old woman presented three pleomorphic skin lesions that were not associated with systemic symptoms or visceromegalies. Multilocus enzyme electrophoresis identified L. (L. infantum chagasi, but direct smear and PCR of bone narrow were negative for Leishmania sp. (suggesting exclusively cutaneous involvement. We discuss the different dermatological presentations of viscerotropic leishmaniasis of the New and Old World, and the clinical and epidemiological importance of the case. Etiologic diagnosis of ATL based upon exclusive clinical criteria may lead to incorrect conclusions. We should be aware of the constant changes in epidemiological patterns related to leishmaniases.

  10. FIRST REPORT OF CUTANEOUS LEISHMANIASIS CAUSED BY Leishmania (Leishmania) infantum chagasi IN AN URBAN AREA OF RIO DE JANEIRO, BRAZIL.

    Science.gov (United States)

    Lyra, Marcelo Rosandiski; Pimentel, Maria Inês Fernandes; Madeira, Maria de Fátima; Antonio, Liliane de Fátima; Lyra, Janine Pontes de Miranda; Fagundes, Aline; Schubach, Armando de Oliveira

    2015-01-01

    American tegumentary leishmaniasis (ATL) is an infectious disease caused by protozoa of the genus Leishmania, and transmitted by sandflies. In the state of Rio de Janeiro, almost all of the cases of American tegumentary leishmaniasis (ATL) are caused by Leishmania (Viannia) braziliensis, while cases of visceral leishmaniasis (VL) are caused by Leishmania (Leishmania) infantum chagasi. The resurgence of autochthonous VL cases in Rio de Janeiro is related to the geographic expansion of the vector Lutzomyia longipalpis and its ability to adapt to urban areas. We report the first case of leishmaniasis with exclusively cutaneous manifestations caused by L. (L.) infantum chagasi in an urban area of Rio de Janeiro. An eighty-one-year-old woman presented three pleomorphic skin lesions that were not associated with systemic symptoms or visceromegalies. Multilocus enzyme electrophoresis identified L. (L.) infantum chagasi, but direct smear and PCR of bone narrow were negative for Leishmania sp. (suggesting exclusively cutaneous involvement). We discuss the different dermatological presentations of viscerotropic leishmaniasis of the New and Old World, and the clinical and epidemiological importance of the case. Etiologic diagnosis of ATL based upon exclusive clinical criteria may lead to incorrect conclusions. We should be aware of the constant changes in epidemiological patterns related to leishmaniases.

  11. AMERICAN CUTANEOUS LEISHMANIASIS WITH UNUSUAL CLINICAL PRESENTATION AND RESPONSE TO TREATMENT

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    Andrea Claudia Bekner Silva FERNANDES

    2016-01-01

    Full Text Available The clinical manifestations and prognosis of cutaneous leishmaniasis (CL can be influenced by the immune response of the patient and the species of the parasite. A case of atypical clinical presentation of CL, with development of non-characteristic lesions, poor response to therapy, and a long time to resolution is reported. Confirmatory laboratory tests included parasite detection, indirect immunofluorescence, Montenegro skin test, polymerase chain reaction, and parasite identification by multilocus enzyme electrophoresis. The parasite was identified as Leishmaniabraziliensis. The lesion was unresponsive to three complete courses of N-methylglucamine antimoniate intramuscular, and to treatment with pentamidine. The patient did not tolerate amphotericin B. The lesion finally receded after treatment with intravenous N-methylglucamine antimoniate. It is essential to ensure the accuracy of diagnosis and the appropriate treatment, which can include the use a second choice drug or a different route of administration.

  12. [American cutaneous leishmaniasis: phlebotomine transmission area in the Municipality of Uberlândia, MG].

    Science.gov (United States)

    Lemos, Jureth Couto; Lima, Samuel do Carmo

    2005-01-01

    From May 2000 to January 2001 four, 15 hour-long collections of phlebotomine were done to the insect monitoring. The collection was done in an area of infection of American cutaneous leishmaniasis in the basin of the Araguari River in the municipality of Uberlandia (MG). The first collection was made in May (a cold, damp month), the second in June 2000 (a cold, dry month) the third in October 2000 (a hot, dry month) and the fourth in January 2001 (a hot, rainy month). CDC and Shannon light traps were used 6551 phlebotomne were captured and identified, 1990 male and 4562 female, comprised of two lines (Lutzomyia and Brumptomyia) and 8 species. Lutzomyia intermedia predominated with the largest number of specimens (6531), which accounted for 99.7% of the collected insects. In the four collections, it was observed that Lutzomyia intermedia manifested a preference for the month preceding the rainy season, with its high temperatures and humidity.

  13. Survey of wild mammal hosts of cutaneous leishmaniasis parasites in panamá and costa rica.

    Science.gov (United States)

    González, Kadir; Calzada, José E; Saldaña, Azael; Rigg, Chystrie A; Alvarado, Gilbert; Rodríguez-Herrera, Bernal; Kitron, Uriel D; Adler, Gregory H; Gottdenker, Nicole L; Chaves, Luis Fernando; Baldi, Mario

    2015-03-01

    The eco-epidemiology of American cutaneous leishmaniasis (ACL) is driven by animal reservoir species that are a source of infection for sand flies that serve as vectors infecting humans with Leishmania spp parasites. The emergence and re-emergence of this disease across Latin America calls for further studies to identify reservoir species associated with enzootic transmission. Here, we present results from a survey of 52 individuals from 13 wild mammal species at endemic sites in Costa Rica and Panama where ACL mammal hosts have not been previously studied. For Leishmania spp. diagnostics we employed a novel PCR technique using blood samples collected on filter paper. We only found Leishmania spp parasites in one host, the two-toed sloth, Choloepus hoffmanni. Our findings add further support to the role of two-toed sloths as an important ACL reservoir in Central America.

  14. Wound healing in cutaneous leishmaniasis: A double edged sword of IL-10 and TGF-β.

    Science.gov (United States)

    Abdoli, Amir; Maspi, Nahid; Ghaffarifar, Fatemeh

    2017-04-01

    Immune responses have a crucial role during the wound healing process in cutaneous leishmaniasis (CL). However, there are several paradoxes in immunity against CL. On the one hand, regulatory cytokines interleukin (IL)-10 and transforming growth factor beta (TGF-β) increase susceptibility to CL through suppression of several proinflammatory cytokines that require for defense against CL. On the other hand, these cytokines play a pivotal role in the acceleration of wound healing process. This review discusses about the dual role of IL-10 and TGF-β during the wound healing process and immunity against CL to offer a new insight about wound healing in CL. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Cutaneous leishmaniasis in frequent in equines from an endemic area in Rio de Janeiro, Brazil

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    Cruz Manuel Aguilar

    1986-12-01

    Full Text Available In an endemic area of cutaneous leishmaniasis in Rio de Janeiro State where a mule had been found infected, a systematic search among equines was performed, resulting in the detection of Leishmania parasites in skin lesions of 30.8% of the animals, which included horses and mules. The eventual role of equines in the epidemiology of the human disease is being investigated.O achado de uma mula infectada num foco endêmico de leishmaniose tegumentar no Rio de Janeiro, levou-nos a procurar sistematicamente infecções por Leishmania em equinos, resultando no encontro de 30,8% de parasitados, incluindo cavalos e mulas. A possibilidade de esses animais participarem da cadeia epidemiológica da leishmaniose humana está sendo investigada.

  16. [Reaction of Leishmania (Leishmania) mexicana antigens by sera of patients with cutaneous leishmaniasis from Sinaloa, Mexico].

    Science.gov (United States)

    Salazar-Mejía, Patricia Guadalupe; Tejeda-Aguirre, Celia Rosa; López-Moreno, Héctor Samuel

    2010-01-01

    To detect Leishmania mexicana antigens reacting with sera of patients with cutaneous leishmaniasis (CL). A crude extract of L. mexicana was used as antigen for 2-D Western blot using sera from 5 patients with CL and controls from Sinaloa, Mexico during 2008. Five antigens were detected in the five infected patients analyzed; their molecular weights and isoelectric points were: 26 kDa (pI 7.8), 27 kDa (pI 8.1), 28 kDa (pI 8.6), 29 kDa (pI 8.5) and 31 kDa (pI 9.0). New potentially immunodominant L. mexicana antigens were detected, suggesting that this parasite could be the species responsible for human infection in Sinaloa.

  17. Linking Climate to Incidence of Zoonotic Cutaneous Leishmaniasis (L. major) in Pre-Saharan North Africa

    Energy Technology Data Exchange (ETDEWEB)

    Bounoua, Lahouari; Kahime, Kholoud; Houti, Leila; Blakey, Tara; Ebi, Kristie L.; Zhang, Ping; Imhoff, Marc L.; Thome, Kurtis; Dudek, Claire; Sahabi, Salah A.; Messouli, Mohammed; Makhlouf, Baghdad; EI Laamrani, Abderahmane; Boumezzough, Ali

    2013-08-20

    Shifts in surface climate may have changed the dynamic of zoonotic cutaneous leishmaniasis (ZCL) in the pre-Saharan zones of North Africa. Caused by Leishmania major, this form multiplies in the body of rodents serving as reservoirs of the disease. The parasite is then transmitted to human hosts by the bite of a Phlebotomine sand fly (Diptera: Psychodidae) that was previously fed by biting an infected reservoir. We examine the seasonal and interannual dynamics of the incidence of this ZCL as a function of surface climate indicators in two regions covering a large area of the semi-arid Pre-Saharan North Africa. Results suggest that in this area, changes in climate may have initiated a trophic cascade that resulted in an increase in ZCL incidence.

  18. New foci of cutaneous leishmaniasis in central Kenya and the Rift Valley.

    Science.gov (United States)

    Sang, D K; Okelo, G B; Ndegwa, C W; Ashford, R W

    1993-01-01

    Active case detection and investigations of sandfly resting places in suspected transmission sites of cutaneous leishmaniasis in central Kenya and the Rift Valley resulted in the identification of several foci of the disease in Samburu, Isiolo, Laikipia, Nakuru and Nyandarua districts. The foci occurred in areas ranging from semi-arid lowlands at 400 m altitude to highland plateaux at 2500 m, including the floor of the Rift Valley, and were mostly inhabited by recently settled communities, nomads and migrant charcoal burners. Four species of Phlebotomus, 3 of the subgenus Larroussius (P. pedifer, P. aculeatus and P. guggisbergi) and one Paraphlebotomus (P. saevus) were collected from caves, rock crevices and tree hollows found in river valleys and in lava flows.

  19. Clinical features and treatment response of cutaneous leishmaniasis in North-West Ethiopia.

    Science.gov (United States)

    Fikre, Helina; Mohammed, Rezika; Atinafu, Saba; van Griensven, Johan; Diro, Ermias

    2017-10-01

    Cutaneous leishmaniasis (CL) receives far less attention than visceral leishmaniasis. Nevertheless, CL is predominantly caused by a unique species in Ethiopia (L. aethiopica), which is known to cause severe forms such as diffuse (DCL) and mucocutaneous leishmaniasis (MCL). We report on the number and type of CL cases diagnosed, the clinical features, the treatments and treatment outcomes in North-West Ethiopia. This is a retrospective chart record analysis of CL patients treated at the Leishmania Research and Treatment Center (LRTC) of the University of Gondar, Ethiopia. From 178 CL patients seen between January 2014 and December 2015, a total of 154 chart records were retrieved. These included 80 localised CL (LCL), 7 DCL and 67 MCL. The median age was 23 years; 71.4% were male. Most (n = 121, 78.6%) of the lesions were on the face. The median time since onset was 12 months (6-24 months), and 28.6% presented after a trial of traditional medicine. The treatment of all forms of CL mainly consisted of 30 days of IM antimonial injections. Of these, 51/133 (38.3%) required treatment extension or change due to nonresponse. Three cases were treated with liposomal amphotericin B or miltefosine (two received the combination), of which two responded well. CL was found to be complicated and difficult to treat. MCL was common, and patients presented after long delays. There is an urgent need to look for better treatment options for CL and improve access to care. © 2017 John Wiley & Sons Ltd.

  20. An outbreak of cutaneous leishmaniasis in Modena province (Northern Italy): report of 35 cases.

    Science.gov (United States)

    Cesinaro, A M; Nosseir, S; Mataca, E; Mengoli, M C; Cavatorta, C; Gennari, W

    2017-12-01

    Canine Leishmaniasis is a disease endemic in many parts of Europe, carried by insects of phlebotomous species. Humans are occasional hosts of the parasites. Cases of human leishmaniasis have been registered in Italy, particularly in the southern and coastal regions. In the period 1997-2016, we collected a series of 35 patients affected by cutaneous leishmaniasis, uncovered by skin biopsy and histological examination, 21 of them found in last 3 years. The patients, 28 males and 7 female, aged between 19 and 91, resided in a restricted area of Northern Italy, and none, but two, had travelled abroad. Lesions presented clinically mostly as single nodule or plaque, often ulcerated, and involved predominantly head-neck and upper extremities. Histology showed a diffuse, granulomatous inflammation including numerous plasma cells. Variable numbers of amastigotes were visible, usually in the superficial part of the dermis, in all cases but two. In these two cases, highly suspicious by clinico-pathologic features, PCR analysis allowed to achieve the correct diagnosis. Our attention was then focused on the geographical residence of the patients, that turned out to be mostly in the piedmont area, whereas only one lived in the alluvial area corresponding to Padana plain. These data underline the diffusion of phlebotomus in northern areas of Italy, and particularly on the hills, characterized by a type of soil more favorable to vector survival; also, they indicate the adaptation of leishmania to hosts other than dogs, such as foxes and small rodents. Histology alone resulted sufficient to make diagnosis in most cases, but PCR analysis is recommended in those cases showing a suspicious background, in absence of amastigotes. © Copyright Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.

  1. Studies on the sand fly fauna (Diptera: Psychodidae) in high-transmission areas of cutaneous leishmaniasis in the Republic of Suriname

    NARCIS (Netherlands)

    Kent, Alida D.; Dos Santos, Thiago V.; Gangadin, Anielkoemar; Samjhawan, Ashok; Mans, Dennis R. A.; Schallig, Henk D. F. H.

    2013-01-01

    Sand flies (Diptera: Psychodidae) are the vectors of Leishmania parasites, the causative agents of leishmaniasis. Cutaneous leishmaniasis is an increasing public health problem in the Republic of Suriname and is mainly caused by Leishmania (Vianna) guyanensis, but L. (V.) braziliensis, L. (L.)

  2. Evaluation of the polymerase chain reaction in the diagnosis of cutaneous leishmaniasis due to Leishmania major: a comparison with direct microscopy of smears and sections from lesions

    DEFF Research Database (Denmark)

    Andresen, K; Gaafar, A; El-Hassan, A M

    1996-01-01

    We have compared the sensitivity of the polymerase chain reaction (PCR) as a diagnostic tool against conventional microscopical diagnostic techniques in patients with cutaneous leishmaniasis from the Sudan. Twenty-eight patients were diagnosed according to clinical criteria followed......%, respectively. The PCR should be considered as a valuable and sensitive diagnostic tool in the diagnosis of cutaneous leishmaniasis; it has the added advantage of identification of the species of Leishmania causing the lesion....

  3. Serodiagnosis of cutaneous leishmaniasis: assessment of an enzyme-linked immunosorbent assay using a peptide sequence from gene B protein

    DEFF Research Database (Denmark)

    Jensen, A T; Gaafar, A; Ismail, A

    1996-01-01

    An enzyme-linked immunosorbent assay (ELISA) using a 28 amino acid sequence of the repetitive element of gene B protein (GBP) from Leishmania major was developed for serodiagnosis of cutaneous leishmaniasis (CL). The assay was compared to ELISAs using crude amastigote and promastigote antigens from...... samples from healthy Sudanese individuals living in an area endemic for malaria but free of leish-maniasis were negative in all the assays. Significantly higher levels of antibodies were found in the patients who had suffered from the disease for more than eight weeks than in patients with a shorter...

  4. American cutaneous leishmaniasis in the Pontal of Paranapanema - SP, Brazil: ecological and entomological aspects.

    Science.gov (United States)

    Alessi, Claudia Alvares Calvo; Galati, Eunice Aparecida Bianchi; Alves, José Roberto; Corbett, Carlos Eduardo Pereira

    2009-01-01

    American cutaneous leishmaniasis (ACL) occurs in epidemic outbreaks and in sporadic cases with small annual variation in the Pontal of Paranapanema, SP. There is little research on the sandfly fauna of this region. The last outbreaks were related to the Movement of the Landless Workers (MST) and with the ecological tourism in preserved forest of the Parque Estadual do Morro do Diabo (PEMD). identification of the sandfly fauna within the PEMD, mainly anthropophilic species already incriminated as vectors of ACL, as well as their seasonality, hourly frequency and data of the behavior. M&M: The captures were undertaken with CDC light and Shannon traps from 6:00 pm to 10:00 pm, monthly from May 2000 to December 2001. The temperature and relative humidity data were registered at hourly intervals. The captured species were: Brumptomyia brumpti, Nyssomyia neivai, Nyssomyia whitmani, Pintomyia fischeri and Pintomyia pessoai. The P. pessoai predominated (34.39%) and N. neivai was less found (0.74%), only being captured in CDC traps. Shannon trap captured more sandflies (63.01%) than the CDC traps (36.99%). Despite the environmental degradation anthropophilic species, indicates favorable bioecological conditions for persistence of vectors and potential transmission of leishmaniasis.

  5. The potential economic value of a cutaneous leishmaniasis vaccine in seven endemic countries in the Americas.

    Science.gov (United States)

    Bacon, Kristina M; Hotez, Peter J; Kruchten, Stephanie D; Kamhawi, Shaden; Bottazzi, Maria Elena; Valenzuela, Jesus G; Lee, Bruce Y

    2013-01-07

    Cutaneous leishmaniasis (CL) and its associated complications, including mucocutaneous leishmaniasis (MCL) and diffuse CL (DCL) have emerged as important neglected tropical diseases in Latin America, especially in areas associated with human migration, conflict, and recent deforestation. Because of the limitations of current chemotherapeutic approaches to CL, MCL, and DCL, several prototype vaccines are in different states of product and clinical development. We constructed and utilized a Markov decision analytic computer model to evaluate the potential economic value of a preventative CL vaccine in seven countries in Latin America: Bolivia, Brazil, Colombia, Ecuador, Mexico, Peru, and Venezuela. The results indicated that even a vaccine with a relatively short duration of protection and modest efficacy could be recommended for use in targeted locations, as it could prevent a substantial number of cases at low-cost and potentially even result in cost savings. If the population in the seven countries were vaccinated using a vaccine that provides at least 10 years of protection, an estimated 41,000-144,784 CL cases could be averted, each at a cost less than the cost of current recommended treatments. Further, even a vaccine providing as little as five years duration of protection with as little as 50% efficacy remains cost-effective compared with chemotherapy; additional scenarios resembling epidemic settings such as the one that occurred in Chaparral, Colombia in 2004 demonstrate important economic benefits. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Characterisation of cutaneous leishmaniasis in Matara district, southern Sri Lanka: evidence for case clustering.

    Science.gov (United States)

    Kariyawasam, K K G D U L; Edirisuriya, C S; Senerath, U; Hensmen, D; Siriwardana, H V Y D; Karunaweera, N D

    2015-01-01

    Leishmaniasis is a neglected tropical disease transmitted by Phlebotomus spp. sand flies. Cutaneous leishmaniasis (CL) in Sri Lanka is caused by Leishmania donovani. Transmission patterns are different in Southern and Northern Sri Lanka. Current study examined the prevalence, risk factors and distribution of CL in Matara District, Southern Sri Lanka. Total of 2260 individuals from four District Secretariat divisions (DSDs) were screened by house to house surveys using an interviewer administered questionnaire. The study population had an age range of 1-90 years (median  =  43  ±  17.31), low monthly income ( 4 hours/day) spent outdoors. However, exposure of limbs while outdoors, unawareness about the disease, type of occupation, common water source as the mode of water supply and presence of animal shelters within 200 m were not associated with the risk of acquiring the disease. Peri-domestic transmission is likely to contribute to the observed case clustering with all age groups at risk of acquiring the infection. Human behavioural habits coinciding with that of the vector, sand fly are likely to enable host-vector contact promoting its spread. Appropriate vector control measures, improvement of housing conditions, public education regarding preventive measures are required to contain the spread of disease.

  7. Impact of climate variability on the occurrence of cutaneous leishmaniasis in Khuzestan Province, southwestern Iran

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    Farideh Azimi

    2017-05-01

    Full Text Available Leishmaniasis, one of the most important parasitic diseases worldwide, is frequently cited with respect to health risks related to climate change. The current variability of the climate may have different impacts on the transmission of cutaneous leishmaniasis (CL depending on the various Leishmania species. The number and distribution of CL cases in Khuzestan Province, Southwestern Iran was analysed over the 2010-2014 period with regard to temperature, humidity, rainfall, sunshine hours, evaporation and wind-related climate issues. During the study period, there were 4672 recorded clinical cases of CL, the incidence of which was found to fall into three types of areas, such as high, intermediate and low-level endemic areas. Compared to the intermediate and low-endemic areas, the hyper-endemic areas showed significantly variable meteorological data with regard to rainy days, maximum/minimum temperature and humidity. Decreased temperatures in the eastern part of this province were found to promote the disease towards its centre. We conclude that the meteorological variables and incidence data of CL indicate that the number of rainy days, maximum and minimum temperatures and relative humidity are significant variables that can predict CL incidence. Indeed, the substantial climatic variability occurring during the recent 5-year period (2010-2014 in Khuzestan Province could be the main reason for the change in epidemiology and transmission of CL.

  8. Histopathological and immunohistochemical aspects of American cutaneous leishmaniasis before and after different treatments*

    Science.gov (United States)

    Viana, Agostinho Gonçalves; Mayrink, Wilson; Fraga, Carlos Alberto de Carvalho; Silva, Luciana Maria; Domingos, Patrícia Luciana Batista; Bonan, Paulo Rogério Ferreti; de Paula, Alfredo Maurício Batista; Botelho, Ana Cristina de Carvalho

    2013-01-01

    BACKGROUND The histopathology and immune responses of the healing process of leishmaniasis are still poorly studied. OBJECTIVES This study aimed to examine the histopathological and immunological aspects of lesions of patients with cutaneous leishmaniasis before and after different therapeutic methods. METHODS We studied 23 individuals grouped according to the treatments: Glucantime, Glucantime + Leishvacin and Glucantime + Leishvacin associated with Bacillus Calmette-Guerin. For analysis of the histopathological changes present in the dermis and epidermis, histological sections were stained with hematoxylin and eosin. The samples were immunostained before and after treatment to analyze the expression of interferon (IFN)-γ, interleukin (IL) 12, IL-10 and IL-4. RESULTS Before treatment the presence of intense infiltrates of mononuclear cells was noticed and after treatment, even with a diagnosis of clinical cure, the subjects still showed a moderate inflammatory process. In the immunohistochemical analyses, we noticed a difference between the cytokines, with increased expression of cytokines IFN-γ and IL-12 compared to IL 10 and IL-4, both before and after treatment and, comparatively, the difference in this expression was more intense before treatment. However, the cytokine expression analyzed by treatment group showed no statistically significant difference. CONCLUSION We conclude that a clinical cure does not always coincide with the histopathological one, and that before treatment there is a predominance of Th1 cytokines. In terms of treatment type, there was no difference in the progression of healing for all the three types of treatment, indicating their clinical equivalence. PMID:23539001

  9. Histopathological and immunohistochemical aspects of American cutaneous leishmaniasis before and after different treatments.

    Science.gov (United States)

    Viana, Agostinho Gonçalves; Mayrink, Wilson; Fraga, Carlos Alberto de Carvalho; Silva, Luciana Maria; Domingos, Patrícia Luciana Batista; Bonan, Paulo Rogério Ferreti; Paula, Alfredo Maurício Batista de; Botelho, Ana Cristina de Carvalho

    2013-01-01

    The histopathology and immune responses of the healing process of leishmaniasis are still poorly studied. This study aimed to examine the histopathological and immunological aspects of lesions of patients with cutaneous leishmaniasis before and after different therapeutic methods. We studied 23 individuals grouped according to the treatments: Glucantime, Glucantime + Leishvacin and Glucantime + Leishvacin associated with Bacillus Calmette-Guerin. For analysis of the histopathological changes present in the dermis and epidermis, histological sections were stained with hematoxylin and eosin. The samples were immunostained before and after treatment to analyze the expression of interferon (IFN)-γ, interleukin (IL) 12, IL-10 and IL-4. Before treatment the presence of intense infiltrates of mononuclear cells was noticed and after treatment, even with a diagnosis of clinical cure, the subjects still showed a moderate inflammatory process. In the immunohistochemical analyses, we noticed a difference between the cytokines, with increased expression of cytokines IFN-γ and IL-12 compared to IL 10 and IL-4, both before and after treatment and, comparatively, the difference in this expression was more intense before treatment. However, the cytokine expression analyzed by treatment group showed no statistically significant difference. We conclude that a clinical cure does not always coincide with the histopathological one, and that before treatment there is a predominance of Th1 cytokines. In terms of treatment type, there was no difference in the progression of healing for all the three types of treatment, indicating their clinical equivalence.

  10. Evidence for Seroprevalence in Human Localized Cutaneous Leishmaniasis Caused by Leishmania donovani in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Yamuna Deepani Siriwardana

    2018-01-01

    Full Text Available Visceral leishmaniasis (VL is considered as a major health threat in the Indian subcontinent. Leishmania donovani, a usually visceralizing species, causes cutaneous leishmaniasis (CL in Sri Lanka. However, visceralizing potential of the local L. donovani is not yet fully understood. This project studied the seroprevalence of local CL by using an in-house ELISA. An IgG-based ELISA using crude Leishmania antigen (Ag was developed and validated. A total of 50 laboratory confirmed cases of locally acquired CL were examined using the newly developed ELISA. According to the optimized ELISA, seroprevalence of anti-Leishmania IgG antibodies in the study group was 34.0% (n=17/50. Majority of seropositive individuals were males (n=13/17, representing 76%. Nearly half of the seropositive individuals were young adults (20–40 years, n=9/17, 53%. Higher proportions of single lesions, large lesions, and nodular lesions were associated with a seroconversion. A proportion of local L. donovani infections leading to CL have the ability to raise an antibody response in the host. This may indicate early systemic involvement as one possibility. Study of a large number of patients with adequate follow-up would be useful.

  11. Effect of the Syrian Civil War on Prevalence of Cutaneous Leishmaniasis in Southeastern Anatolia, Turkey.

    Science.gov (United States)

    Inci, Rahime; Ozturk, Perihan; Mulayim, Mehmet Kamil; Ozyurt, Kemal; Alatas, Emine Tugba; Inci, Mehmet Fatih

    2015-07-20

    Cutaneous leishmaniasis (CL) is a vector-mediated skin disease, characterized by chronic wounds on the skin and caused by macrophages in protozoan parasites. It is an endemic disease in the southern and southeastern Anatolia region and is still an important public health problem in Turkey. Because of the civil war in Syria, immigrants to this region in the last 3 years have begun to more frequently present with this disease. The aim of this study was to draw attention to the dramatic increase in new cases with CL after the beginning of the civil war in Syria. In this retrospective study, we evaluated demographic, epidemiological, and clinical features of 110 patients diagnosed with cutaneous leishmaniasis who were admitted to the Department of Dermatology at Kahramanmaras Sutcu Imam University Faculty of Medicine between January 2011 and June 2014. A total of 110 patients included in the study; 50 (45%) were males, and 60 (55%) were females. The age range of the study group was 1-78 years, and the infection was more prevalent in the 0-20 year age group. Of these patients, 76 (69%) were Syrian refugees living in tent camps and 34 (31%) were Turkish citizens. The majority of the cases were diagnosed between October and December. Immigrations to endemic regions of Turkey from neighbouring countries where CL incidence is higher may lead to large increases in case numbers. In order to decrease the risk of exposure, housing conditions of the refugees must be improved, routine health controls must be performed, effective measures must be set in place for vector control, and infected individuals must be diagnosed and treated to prevent spread of the infection.

  12. Progressive increasing of cutaneous leishmaniasis in Kashan district, central of Iran

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    Doroodgar A

    2012-08-01

    Full Text Available Objective: To investigate the prevalence of cutaneous leishmaniasis in important endemic focus of Kashan district, central of Iran during 2007-2008. Methods: This was a cross-sectional study and 5 098 individuals were selected from thirteen rural and urban districts of Kashan city. Information of positive cases including age, sex, job, number and sites of ulcers or scars, date and place of the ulcer, and results of clinical examination and laboratory tests were recorded. Diagnoses of affected cases were based on clinical examination and microscopic observation of the ulcer parasite. The results were analyzed with statistical Chi-square test. Results: An infection prevalence rate of 6.4% was obtained among 5 098 individuals. Regarding to 326 affected cases, 103 (2.0% and 223 (4.4% persons were observed with active lesion and scars, respectively. The highest frequency of active ulcer rate (23.3% was associated with age group of 20-29 years old, while the lowest rate was related to age group of 0-9 years old with 7.8% infection. About 49.5% of the infected cases were under 30 years old. This study showed 64.1% of cases with one and the rest of them with two or more ulcers. Hands (46.6% were the most affected parts of body. Conclusions: There is a progressive increasing of cutaneous leishmaniasis in Kashan district and this is a warning to local health workers to provide prevention as well as control program of the disease.

  13. The frequency of old world cutaneous leishmaniasis in skin ulcers in Peshawar

    International Nuclear Information System (INIS)

    Rahman, S.; Abdullah, F.H.; Khan, J.A.

    2009-01-01

    Old World Cutaneous Leishmaniasis (OWCL) is a preventable skin infection that leads to morbidity and social isolation. It is spreading rapidly. The sore of OWCL may be a non-ulcerative red papule, nodule or a large mutilating ulcer. The ulcer is typically painless and can leave a disfiguring scar. Methods: This was a descriptive study. The diagnosis of OWCL was established by finding LD bodies in skin smear preparation. Results: This study identified 1680 cutaneous leishmaniasis in 1767 skin ulcers. Children (n=924) were infected more than other age groups (n=756). There were typical skin sore of OWCL in 1512 cases while 168 patients had atypical presentation. The ulcers were painless in 1603 patients. History of insect bite was present in 1366 cases, thorn prick in 156 patients, religious visit to endemic areas in 256 patients, and 4 patients had post surgical non healing wound. Lesions with 4 to 6 months of age had a maximum yield of LD bodies. There were 498 patients from different areas of Peshawar; 688 cases from leishmania endemic belt of FATA while 89 patients came from other urban and rural areas of NWFP. Conclusions: There is a tremendous increase in cases of OWCL and the disease became endemic in many regions of Pakistan. The bordering areas along Afghanistan have constituted an endemic belt that had invaded the neighboring urban and rural areas. Several chronic non healing ulcers had been diagnosed as OWCL. Many cases have been detected in Peshawar. People need education about the nature of the diseases and the efficacy of personal protective measures. Spray with suitable insecticides is required in all residential areas. (author)

  14. Efficacy of cryotherapy for the treatment of cutaneous leishmaniasis: meta-analyses of clinical trials.

    Science.gov (United States)

    López-Carvajal, Liliana; Cardona-Arias, Jaiberth Antonio; Zapata-Cardona, María Isabel; Sánchez-Giraldo, Vanesa; Vélez, Iván Darío

    2016-07-26

    Cryotherapy is a local treatment for cutaneous leishmaniasis with variable efficacy and greater safety than conventional treatment. The objective of this study is to evaluate the efficacy and safety of cryotherapy for the treatment of cutaneous leishmaniasis and to compare it with pentavalent antimonials. A meta-analysis based on a search of nine databases with eight strategies was conducted. Inclusion and exclusion criteria were applied, the methodological quality of each article was evaluated, and the reproducibility of the study selection and information extraction from each clinical trial was assured. The per lesion and per patient efficacy was calculated, and a meta-analysis of relative risks with the random effects model and the Dersimonian and Laird's, Begg, and Egger tests, along with a sensitivity analysis, were performed. A meta-regression based on the methodological quality of the trials included was also performed. Eight studies were included in which respective per lesion efficacies of 67.3 % and 67.7 % were reported for cryotherapy and pentavalent antimonials. In 271 patients treated with cryotherapy and in 199 with pentavalent antimonials, respective per protocol and intent to treat efficacies of 63.6 % and 54.2 % were found in the first group, and per protocol and intent to treat efficacies of 74.7 % and 68.3 % were found in the second group. The relative risk for the comparison of efficacy in the two groups was 0.73 (0.42-1.29). The results of the sensitivity analysis and the meta-regression analysis of relative risks were statistically equal to the overall results. This investigation provides evidence in favor of the use of cryotherapy given that its efficacy is similar to that of pentavalent antimonials.

  15. The severity of cutaneous leishmaniasis before and after the earthquake in Bam, southeastern Iran.

    Science.gov (United States)

    Sharifi, Iraj; Aflatoonian, Mohammad Reza; Aflatoonian, Behnaz; Kermanizadeh, Alireza

    2015-12-01

    Cutaneous leishmaniasis (CL) is a major disease with significant public health concerns in Iran. The objective of this study was to compare the severity of CL among the patients before and after the earthquake in the city and suburbs of Bam, southeastern Iran. This study was carried out as a descriptive-analytical manner by house-to-house visits in 2010 in Bam, southeastern Kerman province of Iran, where a massive earthquake has recently occurred. Overall, 1,481 individuals were selected as a cluster random sampling. Suspected lesions were detected by direct smear preparation and X(2) test was used for statistical significance at P < 0.05. Overall, 1,481 individuals (mean age; 25.7 ± 17.6 years) consisting of 51.4 % males and 48.6 % females were randomly selected. 549 individuals showed history of CL; 23.4 % belonged to before and 13.7 % belonged to after the earthquake. When the overall severity in terms of location, number, size and duration of lesions was considered, the lesions were less severe in the time period after the earthquake (P < 0.05) than those before the earthquake. Cutaneous leishmaniasis is currently considered as a growing public health concern worldwide, mainly due to creation of various risk factors particularly after a major natural disaster. Possibly the establishment of the CL health clinic to serve patients and to coordinate various activities had a major role in planning control strategies and thus reduction in severity of the CL disease.

  16. Efficacy of intralesional amphotericin B for the treatment of cutaneous leishmaniasis

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    Vahid Mashayekhi Goyonlo

    2014-01-01

    Full Text Available Background: Antimoniate compounds have been used as gold standard treatment for cutaneous leishmaniasis since many years ago, but with increase in incidence of drug as well as individual contraindications, more attention has been given to alternative treatments. Aim: The aim of this study was to evaluate the efficacy of intralesional amphotericin B as an alternative treatment for cutaneous leishmaniasis in Mashhad, Iran, during 2007-2009. Materials and Methods: Non-random sampling from both sexes and without any age limitation of cases eligible for this alternative treatment was done. Size and induration of lesions were measured before beginning and weakly during the treatment. Amphotericin B (2 mg/ml was injected into lesions weekly for up to 12 weeks and the cases were followed up for the treatment responses, possible side effects and recurrence of the disease. Results: A total of 93 patients with a mean age of 20.81 ± 15.26 years were included in this study. At the end of 12 th week, 61.4% of the patients were recovered completely (more than 90% reduction in size and induration, 21.6% had partial remission (60-90% reduction in size and induration, and 17% had less than 60% reduction in size and induration of skin lesions. Injection side effects were insignificant and did not lead to premature discontinuation of treatment in any patients. Conclusion: Weekly intralesional injection of amphotericin B looks promising, considering the fact that most of the patients in this study were resistant to antimoniates.

  17. Intranasal Vaccination against Cutaneous Leishmaniasis with a Particulated Leishmanial Antigen or DNA Encoding LACK

    Science.gov (United States)

    Pinto, Eduardo Fonseca; Pinheiro, Roberta Olmo; Rayol, Alice; Larraga, Vicente; Rossi-Bergmann, Bartira

    2004-01-01

    We have previously demonstrated that oral delivery of a disease-promoting particulated antigen of Leishmania amazonensis (LaAg) partially protects mice against cutaneous leishmaniasis. In the present work, we sought to optimize a mucosal vaccine by using the intranasal route for delivery of different antigen preparations, including (i) LaAg, (ii) soluble recombinant p36/LACK leishmanial antigen (LACK), and (iii) plasmid DNA encoding LACK (LACK DNA). BALB/c mice that received two intranasal doses of 10 μg of LaAg and were challenged 1 week postvaccination with L. amazonensis developed delayed but effective control of lesion growth. A diminished parasite burden was accompanied by enhancement of both gamma interferon (IFN-γ) and interleukin-10 levels in the lesion-draining lymph nodes. The vaccine efficacy improved with time. At 4 months postvaccination, when a strong parasite-specific TH1-type response was present in vivo, the infection was controlled for at least 5 months after challenge. In contrast to the particulated LaAg, soluble LACK (10 μg/dose) had no effect. Interestingly, LACK DNA (30 μg/dose), but not empty DNA, promoted rapid and durable protective immunity. Parasite growth was effectively controlled, and at 5 months after challenge LACK-reactive cells in both the mucosal and lesion-draining lymph nodes produced high levels of IFN-γ. These results demonstrate for the first time the feasibility of using the intranasal route for long-lived memory vaccination against cutaneous leishmaniasis with adjuvant-free crude antigens or DNA. PMID:15271911

  18. Leishmaniose cutânea em cobaias (Cavia porcellus Cutaneous leishmaniasis in guinea pigs (Cavia porcellus

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    Roselene Ecco

    2000-06-01

    Full Text Available São descritos três casos de leishmaniose cutânea em cobaias (Cavia porcellus machos de dois anos de idade que eram criadas como animais de estimação. As lesões macroscópicas eram semelhantes em duas cobaias e consistiam de nódulos cutâneos ulcerados no aspecto dorsal do pavilhão auricular de ambas as orelhas. Na outra cobaia, a lesão consistia de engrossamentos irregulares na pele do escroto que apareceram após uma orquiectomia realizada dois meses antes. A histopatologia era semelhante nos três casos e consistia de acentuada dermatite granulomatosa, com ulceração e numerosas formas protozoárias amastigotas no citoplasma de macrófagos, sugestivas de Leishmania sp. A microscopia eletrônica confirmou o diagnóstico de leishmaniose.Three cases of cutaneous leishmaniasis in three two-year-old male guinea pigs (Cavia porcellus raised as pets are described. Gross lesions were similar in two of the guinea pigs and consisted of raised and ulcerated cutaneous nodules in the dorsal aspect of the pinna of both ears. In another guinea pig the lesion consisted of irregular thickenning in the skin of the scrotum which followed an orchiectomy performed two months before. Histopathology was similar in the three cases and consisted of severe diffuse granulomatous dermatitis with ulceration and numerous intrahistiocytic protozoal amastigotes resembling Leishmania sp. Electron microscopy confirmed the diagnosis of leishmaniasis.

  19. Cutaneous Leishmaniasis

    Science.gov (United States)

    2011-06-01

    intracellular amastigotes are usually abundant. Diagnosis The different parasitologic techniques for confirming Leishmania infection are variously...effective, depending on whether the syndrome under examination is oligoparasitic or polyparasitic. A confirmed parasitologic diagnosis is es- tablished by...1990;43:257-259. 23. Grimaldi G Jr, Tesh RB. Leishmaniases of the New World: current concepts and implications for future research . Clin Microbiol Rev

  20. [Disseminated cutaneous sporotrichosis with joint involvement in a woman with type 2 diabetes].

    Science.gov (United States)

    Solorzano, Sendy; Ramirez, Renán; Cabada, Miguel M; Montoya, Manuel; Cazorla, Ernesto

    2015-01-01

    Disseminated sporotrichosis is a rare presentation of this mycosis. Although it has been described in immunocompetent individuals, there is often T cell-mediated immune compromise. We report the case of a woman with uncontrolled Type 2 diabetes who developed disseminated cutaneous sporotrichosis. The course of the disease presented several complications including hepatitis secondary to itraconazole and knee arthritis with culture positive for Sporothrix schenckii during treatment with saturated solution of potassium iodide. The case discussion includes aspects of the pathogenesis of disseminated sporotrichosis and management of the infection and its complications.

  1. Cutaneous leishmaniasis caused by members of Leishmania braziliensis complex in Nayarit, State of Mexico

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    Gustavo Sanchez-Tejeda

    2001-01-01

    Full Text Available An epidemiological study was carried out in the northern Mexican state, Nayarit. Fourteen patients with possible cutaneous leishmaniasis skin lesions gave positive Montenegro skin tests. Biopsies were taken from the skin ulcer and analyzed by polymerase chain reaction (PCR with specific primers for the Leishmania mexicana complex; however all biopsies were not amplified. PCR carried out with specific primers for the L. braziliensis complex resulted in the amplification of all patient DNA. DNA from 12 out of 14 biopsies gave positive amplification with primers species specific for L. (Viannia braziliensis and hybridized with a species specific L. (V. braziliensis probe. These results demonstrate the presence in Nayarit of at least two members of the L. braziliensis complex. Most of the cutaneous lesions were caused by L. (V. braziliensis and two by another species belonging to the L. braziliensis complex. As far as we are aware, this is the first report of L. (V. braziliensis in Nayarit. The main risk factor associated with the contraction of this disease in Nayarit is attributed to working on coffee plantations.

  2. Cutaneous Leishmaniasis Induces a Transmissible Dysbiotic Skin Microbiota that Promotes Skin Inflammation.

    Science.gov (United States)

    Gimblet, Ciara; Meisel, Jacquelyn S; Loesche, Michael A; Cole, Stephen D; Horwinski, Joseph; Novais, Fernanda O; Misic, Ana M; Bradley, Charles W; Beiting, Daniel P; Rankin, Shelley C; Carvalho, Lucas P; Carvalho, Edgar M; Scott, Phillip; Grice, Elizabeth A

    2017-07-12

    Skin microbiota can impact allergic and autoimmune responses, wound healing, and anti-microbial defense. We investigated the role of skin microbiota in cutaneous leishmaniasis and found that human patients infected with Leishmania braziliensis develop dysbiotic skin microbiota, characterized by increases in the abundance of Staphylococcus and/or Streptococcus. Mice infected with L. major exhibit similar changes depending upon disease severity. Importantly, this dysbiosis is not limited to the lesion site, but is transmissible to normal skin distant from the infection site and to skin from co-housed naive mice. This observation allowed us to test whether a pre-existing dysbiotic skin microbiota influences disease, and we found that challenging dysbiotic naive mice with L. major or testing for contact hypersensitivity results in exacerbated skin inflammatory responses. These findings demonstrate that a dysbiotic skin microbiota is not only a consequence of tissue stress, but also enhances inflammation, which has implications for many inflammatory cutaneous diseases. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Interleukin-4 Receptor Alpha: From Innate to Adaptive Immunity in Murine Models of Cutaneous Leishmaniasis

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    Ramona Hurdayal

    2017-11-01

    Full Text Available The interleukin (IL-4 receptor alpha (IL-4Rα, ubiquitously expressed on both innate and adaptive immune cells, controls the signaling of archetypal type 2 immune regulators; IL-4 and IL-13, which elicit their signaling action by the type 1 IL-4Rα/gamma common and/or the type 2 IL-4Rα/IL-13Rα complexes. Global gene-deficient mouse models targeting IL-4, IL-13, or the IL-4Rα chain, followed by the development of conditional mice and generation of important cell-type-specific IL-4Rα-deficient mouse models, were indeed critical to gaining in-depth understanding of detrimental T helper (Th 2 mechanisms in type 1-controlled diseases. A primary example being cutaneous leishmaniasis, which is caused by the protozoan parasite Leishmania major, among others. The disease is characterized by localized self-healing cutaneous lesions and necrosis for which, currently, not a single vaccine has made it to a stage that can be considered effective. The spectrum of human leishmaniasis belongs to the top 10 infectious diseases according to the World Health Organization. As such, 350 million humans are at risk of infection and disease, with an incidence of 1.5–2 million new cases being reported annually. A major aim of our research is to identify correlates of host protection and evasion, which may aid in vaccine design and therapeutic interventions. In this review, we focus on the immune-regulatory role of the IL-4Rα chain from innate immune responses to the development of beneficial type 1 and detrimental type 2 adaptive immune responses during cutaneous Leishmania infection. We discuss the cell-specific requirements of the IL-4Rα chain on crucial innate immune cells during L. major infection, including, IL-4Rα-responsive skin keratinocytes, macrophages, and neutrophils, as well as dendritic cells (DCs. The latter, contributing to one of the paradigm shifts with respect to the role of IL-4 instructing DCs in vivo, to promote Th1 responses against L

  4. A Cross-Sectional Survey of Knowledge, Attitude and Practices Related to Cutaneous Leishmaniasis and Sand Flies in Punjab, Pakistan.

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    Ayesha Akram

    Full Text Available Recent outbreaks of cutaneous leishmaniasis make the disease a public health concern in Punjab, Pakistan. The knowledge of how the population perceives the disease and its vector is essential in order to design an effective management strategy, but such studies are rare in Pakistan.The present study was based on a cross-sectional self-administered survey comprising 250 household samples collected from five localities including Bhawalpur, Multan, Jhang, Faisalabad and Lahore. The results revealed that the respondents had a poor knowledge of the vector and disease. Few of the respondents were aware about the identification of sand flies, their breeding place, biting time, transmission of leishmaniasis and control measures. Skin infection and sandflies as the main disease symptom and vector of the disease, respectively, were known to some of the respondents. Some believed that summer was the main peak incidence of the disease and it could be transmitted from man to man via contact. However, most of the respondents believed that the disease could be cured. Admission to hospitals, cleanliness and use of bed nets were the treatment measures for the disease in suspected patients, whereas some thought that the use of bed nets could be helpful in preventing leishmaniasis infection.Poor knowledge of the disease and its vector in the study population emphasize the need to initiate health education and awareness campaigns to minimize the risks of cutaneous leishmaniasis outbreaks in the future.

  5. Sand fly population dynamics and cutaneous leishmaniasis among soldiers in an Atlantic forest remnant in northeastern Brazil.

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    Filipe Dantas-Torres

    2017-02-01

    Full Text Available Outbreaks of cutaneous leishmaniasis are relatively common among soldiers involved in nocturnal activities in tropical forests. We investigated the population dynamics of sand flies in a military training camp located in a remnant of Atlantic rainforest in northeastern Brazil, where outbreaks of cutaneous leishmaniasis have sporadically been described. From July 2012 to July 2014, light traps were monthly placed in 10 collection sites, being nine sites located near the forest edge and one near a sheep and goat stable. Light traps operated from 5:00 pm to 6:00 am, during four consecutive nights. Leishmania infection in sand flies was assessed using a fast real-time PCR assay. Cases of cutaneous leishmaniasis among soldiers were also investigated. In total, 24,606 sand flies belonging to 25 species were identified. Males (n = 12,683 predominated over females (n = 11,923. Sand flies were present during all months, being more numerous in March (n = 1,691 and April 2013 (n = 3,324. Lutzomyia choti (72.9% was the most abundant species, followed by Lutzomyia longispina (13.8%, Lutzomyia complexa (5.3%, representing together >90% of the sand flies collected. Forty cases of cutaneous leishmaniasis were recorded among soldiers from January 2012 to December 2014. Leishmania isolates were obtained from eight patients and were all characterized as Leishmania braziliensis. Soldiers and anyone overnighting in Atlantic rainforest remnants should adopt preventative measures such as the use of repellents on bare skin or clothes and insecticide-treated tents.

  6. Clinical and Parasitological Features of Patients with American Cutaneous Leishmaniasis that Did Not Respond to Treatment with Meglumine Antimoniate

    OpenAIRE

    Perez-Franco, Jairo E.; Cruz-Barrera, M?nica L.; Robayo, Marta L.; Lopez, Myriam C.; Daza, Carlos D.; Bedoya, Angela; Mari?o, Maria L.; Saavedra, Carlos H.; Echeverry, Maria C.

    2016-01-01

    Background American cutaneous leishmaniasis (ACL) is a complicated disease producing about 67.000 new cases per year. The severity of the disease depends on the parasite species; however in the vast majority of cases species confirmation is not feasible. WHO suggestion for ACL produced by Leishmania braziliensis, as first line treatment, are pentavalent antimonial derivatives (Glucantime or Sodium Stibogluconate) under systemic administration. According to different authors, pentavalent antim...

  7. MOLECULAR CHARACTERIZATION OF AMERICAN CUTANEOUS LEISHMANIASIS IN THE TRI‑BORDER AREA OF ASSIS BRASIL, ACRE STATE, BRAZIL

    OpenAIRE

    TELES,Carolina Bioni Garcia; MEDEIROS,Jansen Fernandes; SANTOS,Ana Paula de Azevedo dos; FREITAS,Luís Antônio Rodrigues de; KATSURAGAWA,Tony Hiroshi; CANTANHÊDE,Lilian Motta; FERREIRA,Ricardo de Godoi Mattos; CAMARG,Luís Marcelo Aranha

    2015-01-01

    SUMMARYIn this study, Leishmaniaspecies were identified by Polymerase Chain Reaction (PCR). The epidemiology of patients suspected of having American Cutaneous Leishmaniasis in the municipality of Assis Brasil, Acre State, located in the Brazil/Peru/Bolivia triborder was also investigated. By PCR, the DNA of Leishmaniawas detected in 100% of the cases (37 samples) and a PCR-Restriction Fragment Length Polymorphism (RFLP) of the hsp 70gene identified the species in 32 samples: Leishmania (Vian...

  8. Type I signal peptidase from Leishmania is a target of the immune response in human cutaneous and visceral leishmaniasis.

    Science.gov (United States)

    Rafati, Sima; Salmanian, Ali-Hatef; Taheri, Tahere; Masina, Slavica; Schaff, Cedric; Taslimi, Yasaman; Fasel, Nicolas

    2004-05-01

    The gene encoding type I signal peptidase (Lmjsp) has been cloned from Leishmania major. Lmjsp encodes a protein of 180 amino residues with a predicted molecular mass of 20.5 kDa. Comparison of the protein sequence with those of known type I signal peptidases indicates homology in five conserved domains A-E which are known to be important, or essential, for catalytic activity. Southern blot hybridisation analysis indicates that there is a single copy of the Lmjsp gene. A recombinant SPase protein and a synthetic peptide of the L. major signal peptidase were used to examine the presence of specific antibodies in sera from either recovered or active individuals of both cutaneous and visceral leishmaniasis. This evaluation demonstrated that sera from cutaneous and visceral forms of leishmaniasis are highly reactive to both the recombinant and synthetic signal peptidase antigens. Therefore, the Leishmania signal peptidase, albeit localised intracellularly, is a significant target of the Leishmania specific immune response and highlights its potential use for serodiagnosis of cutaneous and visceral leishmaniasis.

  9. Leishmaniasis

    Science.gov (United States)

    ... What is the FOD? Foundation Levels of Giving Governance By-Laws Committees Committee Service Conflict of Interest ... in which leishmaniasis is found range from rain forests in Central and South America (sometimes referred to ...

  10. Polarity-sensitive nanocarrier for oral delivery of Sb(V and treatment of cutaneous leishmaniasis

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    Lanza JS

    2016-05-01

    Full Text Available Juliane S Lanza,1 Flaviana R Fernandes,1 José D Corrêa-Júnior,2 José MC Vilela,3 Rogério Magalhães-Paniago,4 Lucas AM Ferreira,5 Margareth S Andrade,3 Cynthia Demicheli,6 Maria N Melo,7 Frédéric Frézard1 1Department of Physiology and Biophysics, 2Department of Morphology, Instituto de Ciências Biológicas (ICB, Universidade Federal de Minas Gerais (UFMG, 3Innovation and Technology Center SENAI FIEMG – Campus CETEC, 4Department of Physics, Instituto de Ciências Exatas (ICEX, 5Department of Pharmaceutical Products, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG, 6Department of Chemistry, Instituto de Ciências Exatas (ICEX, 7Department of Parasitology, Instituto de Ciências Biológicas (ICB, Universidade Federal de Minas Gerais (UFMG, Belo Horizonte, Brazil Abstract: There is a great need for orally active drugs for the treatment of the neglected tropical disease leishmaniasis. Amphiphilic Sb(V complexes, such as 1:3 Sb–N-octanoyl-N-methylglucamide complex (SbL8, are promising drug candidates. It has been previously reported that SbL8 forms kinetically stabilized nanoassemblies in water and that this simple dispersion exhibits antileishmanial activity when given by oral route to a murine model of visceral leishmaniasis. The main objective of the present work was to interfere in the structural organization of these nanoassemblies so as to investigate their influence on the oral bioavailability of Sb, and ultimately, optimize an oral formulation of SbL8 for the treatment of cutaneous leishmaniasis. The structural organization of SbL8 nanoassemblies was manipulated through addition of propylene glycol (PG to the aqueous dispersion of SbL8. The presence of 50% (v/v PG resulted in the loss of hydrophobic microenvironment, as evidenced by fluorescence probing. However, nanostructures were still present, as demonstrated by dynamic light scattering, small-angle X-ray scattering, and atomic force microscopy (AFM. A

  11. Treatment of Cutaneous Leishmaniasis Caused by Leishmania aethiopica: A Systematic Review.

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    Johan van Griensven

    2016-03-01

    Full Text Available Leishmania aethiopica is the etiological agent of cutaneous leishmaniasis (CL in Ethiopia and can cause severe and complicated cases such as diffuse CL (DCL, mucocutaneous leishmaniasis or extensive CL, requiring systemic treatment. Despite the substantial burden, evidence-based treatment guidelines are lacking. We conducted a systematic review of clinical studies reporting on treatment outcomes of CL due to L aethiopica in order to help identify potentially efficacious medications on CL that can be taken forward for clinical trials. We identified a total of 24 records reporting on 506 treatment episodes of CL presumably due to L aethiopica. The most commonly used drugs were antimonials (n = 201, pentamidine (n = 150 and cryotherapy (n = 103. There were 20 case reports/series, with an overall poor study quality. We only identified two small and/or poor quality randomized controlled trials conducted a long time ago. There were two prospective non-randomized studies reporting on cryotherapy, antimonials and pentamidine. With cryotherapy, cure rates were 60-80%, and 69-85% with antimonials. Pentamidine appeared effective against complicated CL, also in cases non-responsive to antimonials. However, all studies suffered from methodological limitations. Data on miltefosine, paromomycin and liposomal amphotericin B are extremely scarce. Only a few studies are available on DCL. The only potentially effective treatment options for DCL seem to be antimonials with paromomycin in combination or pentamidine, but none have been properly evaluated. In conclusion, the evidence-base for treatment of complicated CL due to L aethiopica is extremely limited. While antimonials remain the most available CL treatment in Ethiopia, their efficacy and safety in CL should be better defined. Most importantly, alternative first line treatments (such as miltefosine or paromomycin should be explored. High quality trials on CL due to L aethiopica are urgently needed, exploring

  12. Courtship behaviour of Phlebotomus papatasi the sand fly vector of cutaneous leishmaniasis

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    Chelbi Ifhem

    2012-08-01

    Full Text Available Abstract Background The sand fly Phlebotomus papatasi is an Old World vector of Leishmania major, the etiologic agent of zoonotic cutaneous leishmaniasis. This study describes the courtship behaviour of P. papatasi and compares it with that of Lutzomyia longipalpis, the New World vector of visceral leishmaniasis. Understanding the details of courtship behaviour in P. papatasi may help us to understand the role of sex pheromones in this important vector. Results P. papatasi courtship was found to start with the female touching the male, leading him to begin abdomen bending and wing flapping. Following a period of leg rubbing and facing, the male flaps his wings while approaching the female. The female then briefly flaps her wings in response, to indicate that she is willing to mate, thereby signaling the male to begin copulation. Male P. papatasi did not engage in parading behaviour, which is performed by male L. longipalpis to mark out individual territories during lekking (the establishment and maintenance of mating aggregations, or wing-flap during copulation, believed to function in the production of audio signals important to mate recognition. In P. papatasi the only predictor of mating success for males was previous copulation attempts and for females stationary wing-flapping. By contrast, male L. longipalpis mating success is predicted by male approach-flapping and semi-circling behaviour and for females stationary wing-flapping. Conclusions The results show that there are important differences between the mating behaviours of P. papatasi and L. longipalpis. Abdomen bending, which does not occur in L. longipalpis, may act in the release of sex pheromone from an as yet unidentified site in the male abdomen. In male L. longipalpis wing-flapping is believed to be associated with distribution of male pheromone. These different behaviours are likely to signify significant differences in how pheromone is used, an observation that is consistent

  13. Treatment of Cutaneous Leishmaniasis in Murine Model by Hydro Alcoholic Essence of Artemisia sieberi

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    A Doroodgar

    2008-12-01

    Full Text Available Background: Considering the prevalence of leishmaniasis in Iran and many side effects associated with pentavalent antimony compounds use in its treatment, this study was designed to evaluate the effect of Artemisia sieberi essence on the experimental ulcers of cutaneous leishmaniasis on BALB/c mice."nMethods: This experimental research was performed to determine the effect of various concentrations of  Artemisia essence in BALB/c mice previously infected with active Leishmania major promastigote. A total of 50 infected BALB/c mice were randomly divided into 5 groups. Three groups (30 mice were used in the experimental condi­tions and the others were assigned as the control groups. The experimental groups received 1%, 3% and 5% of Ar­temisia, respectively. One of the control groups received ethanol 80% and the other received no treatment. The drug was administered by dropping the liquid on the top lesions, three times daily for maximum of 30 d. Every 10 days the ulcers diameter were measured and sampled for amastigote in all groups. Ulcers diameter changes were deter­mined by statistical tests."nResults: After 30 days, diameter of CL lesions increased in 1%, 3% and 5% Artemisia concentrations and the control groups. Ulcers got bigger with the more concentration. Treatments could not reduce the diameter or caused small lesions. In addition, the mice direct smears in microscopic studies were positive."nConclusion: To find the effective concentration and the mechanism of the effectiveness of the drug, further investi­gations with less concentrates of A. sieberi essence are recommended.

  14. Treatment of Cutaneous Leishmaniasis in Murine Model by Hydro Alcoholic Essence of Artemisia sieberi

    Directory of Open Access Journals (Sweden)

    A Doroodgar

    2008-12-01

    Full Text Available Background: Considering the prevalence of leishmaniasis in Iran and many side effects associated with pentavalent antimony compounds use in its treatment, this study was designed to evaluate the effect of Artemisia sieberi essence on the experimental ulcers of cutaneous leishmaniasis on BALB/c mice.Methods: This experimental research was performed to determine the effect of various concentrations of  Artemisia essence in BALB/c mice previously infected with active Leishmania major promastigote. A total of 50 infected BALB/c mice were randomly divided into 5 groups. Three groups (30 mice were used in the experimental condi­tions and the others were assigned as the control groups. The experimental groups received 1%, 3% and 5% of Ar­temisia, respectively. One of the control groups received ethanol 80% and the other received no treatment. The drug was administered by dropping the liquid on the top lesions, three times daily for maximum of 30 d. Every 10 days the ulcers diameter were measured and sampled for amastigote in all groups. Ulcers diameter changes were deter­mined by statistical tests.Results: After 30 days, diameter of CL lesions increased in 1%, 3% and 5% Artemisia concentrations and the control groups. Ulcers got bigger with the more concentration. Treatments could not reduce the diameter or caused small lesions. In addition, the mice direct smears in microscopic studies were positive.Conclusion: To find the effective concentration and the mechanism of the effectiveness of the drug, further investi­gations with less concentrates of A. sieberi essence are recommended.

  15. An outbreak of suspected cutaneous leishmaniasis in Ghana: lessons learnt and preparation for future outbreaks

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    Daniel Boakye

    2011-07-01

    Full Text Available Human cutaneous leishmaniasis (CL has previously been reported in West Africa, but more recently, sporadic reports of CL have increased. Leishmania major has been identified from Mauritania, Senegal, Mali, and Burkina Faso. Three zymodemes (MON-26, MON-117, and MON-74, the most frequent have been found. The geographic range of leishmaniasis is limited by the sand fly vector, its feeding preferences, and its capacity to support internal development of specific species of Leishmania. The risk of acquiring CL has been reported to increase considerably with human activity and epidemics of CL have been associated with deforestation, road construction, wars, or other activities where humans intrude the habitat of the vector. In the Ho Municipality in the Volta Region of Ghana, a localised outbreak of skin ulcers, possibly CL, was noted in 2003 without any such documented activity. This outbreak was consistent with CL as evidenced using various methods including parasite identification, albeit, in a small number of patients with ulcers.This paper reports the outbreak in Ghana. The report does not address a single planned study but rather a compilation of data from a number of ad-hoc investigations in response to the outbreak plus observations and findings made by the authors. It acknowledges that a number of the observations need to be further clarified. What is the detailed epidemiology of the disease? What sparked the epidemic? Can it happen again? What was the causative agent of the disease, L. major or some other Leishmania spp.? What were the main vectors and animal reservoirs? What are the consequences for surveillance of the disease and the prevention of its reoccurrence when the communities see a self-healing disease and may not think it is important?

  16. [Necessity to adopt and disseminate therapeutic schemes for the treatment of American tegumentary leishmaniasis in Paraná].

    Science.gov (United States)

    Teodoro, U; Spinoza, R P; La Salvia Filho, V; Guilherme, A L; Lima, A P; Junqueira, G M; Misuta, N M; Nerilo Sobrinho, A; de Lima, E M

    1991-01-01

    American cutaneous leishmaniasis has shown an endemic character in areas of North-North-west Paraná State, which were populated in 40's, where residual forests persist with intense modifications. The infection has been found mainly in males, but was found also in females and children and in many individuals of a same family. 513 cases of cutaneous leishmaniasis notified to SUCAM by clinical diagnosis were investigated. Treatment was begun with Glucantime at State Health Centers or at SUCAM. Of 513 treated patients 260 (50.67%) were considered clinically cured. The remaining 253 (49.33%) abandoned treatment. The quantity of Glucantime supplied to the patients varied from 10 vials to more than 200, with or without intervals during the treatment. Two hundred and seventeen (85.46%) patients among 260 received from 10 to 75 vials. The occurrence of leishmaniasis in 163 (31.75%) women and in 34 (6.62%) children, of both sexes, up to 10 years old, suggests domiciliary transmission. It's not known if the 253 (49.33%) individuals who abandoned the treatment recovered. This high number shows the necessity of better knowledge of the consequences that can occur due to incomplete treatment.

  17. New epidemiological pattern of cutaneous leishmaniasis in two pre-Saharan arid provinces, southern Morocco.

    Science.gov (United States)

    Ait Kbaich, Mouad; Mhaidi, Idriss; Ezzahidi, Abdelkacem; Dersi, Nouredine; El Hamouchi, Adil; Riyad, Myriam; Akarid, Khadija; Lemrani, Meryem

    2017-09-01

    Three Leishmania species are responsible of cutaneous leishmaniasis (CL) in Morocco. Zoonotic CL due to Leishmania major and Leishmania infantum, the first is known as established in the eastern arid regions, whereas the latter evolves sporadically, especially in the North. While Leishmania tropica, classically considered anthroponotic, is endemic in the semi-arid regions and is largely distributed throughout the country. The aim of this study was to identify the Leishmania species causing CL in two Provinces in arid pre-Saharan region known as zoonotic CL foci, and to contribute an update to the national data concerning the distribution of Leishmania species in both regions. The recruitment of patients was done in six localities in Ouarzazate and Zagoura provinces in 2015 and 2016. Out of 81 samples collected, 66 were positive (81%) by ITS1-PCR amplification of Leishmania DNA extracted from stained smears. The highest rate of Leishmania infection was registered in children aged 9 years or less (71,2%). The ITS1-PCR- RFLP analysis revealed the predominance of L. major infecting 52 patients (79%), followed by L. tropica in 12 patients (18%) and L. infantum in 2 patients who had no history of travel outside the studied area (3%). The sequencing of the ITS1 of both L. infantum, showed 100% similarities with L. infantum strains isolated from dogs and visceral leishmaniasis patients from the south and north of Morocco. The coexistence of the 3 Leishmania species in the same focus, and the difficult distinction of infections associated to the different Leishmania species based only on clinical lesions' aspects complicate the diagnosis and then the national control strategy, as well as the therapeutic management. The epidemiological pattern of CL in the studied areas appears to have changed during the last decades, from a predominant zoonotic CL caused by L. major to a polymorphic disease that can be due to any of the 3 Leishmania species. The expansion of L. infantum and

  18. Familial disseminated cutaneous glomuvenous malformation: Treatment with polidocanol sclerotherapy

    Directory of Open Access Journals (Sweden)

    Aditi Jha

    2016-01-01

    Full Text Available Glomuvenous malformations (GVMs present as asymptomatic multiple pink-to-blue nodules or plaques. Disseminated lesions are rare, representing 10% of all the cases. Familial cases are caused by mutations in the glomulin gene. A young male presented with multiple bluish-to-dusky red-coloured nodules 10-15 in numbers over the trunk, limbs and buttocks since 12 years of age. They ranged in size from 1 to 3 cm, partially to non-compressible and tender on palpation. There was no history of any systemic complaint. His sister and mother had similar lesions but in a limited distribution. Biopsy showed multiple ectatic dilated vascular channels lined by multiple layers of glomus cells consistent with the diagnosis of GVM. The biopsy of the lesions from the mother and sister also showed similar features. Mutation analysis for glomulin gene could not be done because of the unavailability of the facility at our setting. He underwent sclerotherapy with 3% polidocanol every 2 weeks, and there was significant improvement in the lesions after six sessions of sclerotherapy. The patient is under follow-up and there is no recurrence of the lesions over treated sites after 6 months.

  19. Study of an outbreak of cutaneous leishmaniasis in Venezuela: the role of domestic animals

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    Cruz Manuel Aguilar

    1984-06-01

    Full Text Available During an outbreak of cutaneous leishmaniasis in a locality (Las Rosas, Cojedes State, venezuela previously non-endemic, 12.9% of humans, 7% of dogs and 21.4% of donkeys (Equus asinus had lesions with paraites. The agent in the three hosts was identified as Leishmania braziliensis, subspecies braziliensis at least in man and donkey. The probable vector was Lutzomyia panamensis. No infection was found in a small sample of wild mammals examined. The outbreak was apparently linked with the importation of donkeys with ulcers, from endemic areas. The Authors call attention to the fact that not only in the foci of "uta", but also in areas of the other forms of American cutaneous leishmaniasis, dogs are frequently found infected. They emphasize the necessity of searching for the infection in donkeys and of performing hemocultures and xenodiagnosis with sandflies in human, canine and equine cases, to verify their possible role as sources of infection, and not merely as dead ends in the epidemiological chain of the disease.Durante um surto de leishmaniose tegumentar em Las Rosas, localidade previamente não endêmica do Estado Cojedes, Venezuela, 12,9% dos habitantes, 7% dos cães e 21,4% dos asnos (Equus asinus apresentavam lesões com parasitos. O agente etiológico nos tres hospedeiros foi identificado como Leishmania braziliensis, sendo da subespécie braziliensis pelo menos em pessoas e asnos. O transmissor provável foi Lutzomyia panamensis. Não comprovamos a infecção numa pequena amostra de mamíferos silvestres examinados. O surto esteve aparentemente relacionado com a importação de asnos com úlceras de áreas endêmicas. Chamamos a atenção para o fato de que não é apenas nos fócos de "uta", mas também nos de outras formas de leishmaniose tegumentar americana que os cães estão freqüentemente parasitados. Enfatizamos a necessidade de se procurar a infecção em asnos e de se proceder a hemoculturas e a xenodiagnósticos com

  20. Cutaneous leishmaniasis in Syria: clinical features, current status and the effects of war.

    Science.gov (United States)

    Hayani, Kinan; Dandashli, Anwar; Weisshaar, Elke

    2015-01-01

    Cutaneous leishmaniasis (CL) is a worldwide disease caused by an infection with the protozoan parasite Leishmania transmitted via sand flies. It is endemic in many of the poorest countries of all continents. "Aleppo boil" is one of the recognised names given to this disease in the medical literature. Although CL used to be well-controlled and well-documented in Syria, its incidence has dramatically increased since the beginning of the war; however, there is lack of documentation. Here, we present the past and current epidemiological situation of the disease in Syria. We also draw attention to gross and highly unusual clinical variants of CL presented to the Department of Dermatology in Aleppo covering the important differential clinical diagnoses, since this disease is already known to mimic other conditions. Diagnostic procedures and treatment as well as prevention are summarised. Due to the increased ability to travel, and especially the flight of Syrians to neighbouring countries, as well as to Europe, CL may become a new threat in formerly unaffected regions. Through this account, we hope to give weight to the aspiration that CL does not remain a neglected and often clinically overlooked tropical dermatosis.

  1. Clinical and histopathological characteristics of cutaneous Leishmaniasis in Sanliurfa City of Turkey including Syrian refugees

    Directory of Open Access Journals (Sweden)

    Sezen Koçarslan

    2013-01-01

    Full Text Available Background: The aim of our study was to investigate the clinical and histopathological characteristics of cutaneous leishmaniasis (CL in the city of Sanliurfa in Turkey, where Syrian refugees also reside. Materials and Methods: At the Harran University Hospital outpatient clinics between 2012 and 2013, 54 CL cases, including 24 Syrian patients, underwent punch biopsy of the skin and/or a touch imprint. Patients in whom leishmania parasites were detected were included in the study. The clinical and histopathological data of the patients were obtained by a review of the patients′ medical records. All the slides of each patient were re-evaluated histopathologically. Results: Fifty-four cases (mean age; 17 ± 12 years, consisting of 32 males (59.3% and 22 females (40.7%, were examined. The most common site of involvement was the face (63%. The most common presentation was noduloulcerative lesions (57.4%. Histopathologically, the majority of the cases exhibited hyperkeratosis, follicular plugging of the epidermis, chronic inflammatory infiltration, leishmania amastigotes and non-caseating granulomatous inflammation in the dermis. Conclusion: CL presents with a wide spectrum of expression, both clinically and histologically, and may mimic other inflammatory and neoplastic diseases. The diagnosis of CL relies on the identification of leishmania amastigotes in either a direct smear of the lesion or in a tissue section.

  2. Clinical and histopathological characteristics of cutaneous Leishmaniasis in Sanliurfa City of Turkey including Syrian refugees.

    Science.gov (United States)

    Koçarslan, Sezen; Turan, Enver; Ekinci, Turan; Yesilova, Yavuz; Apari, Rabia

    2013-01-01

    The aim of our study was to investigate the clinical and histopathological characteristics of cutaneous leishmaniasis (CL) in the city of Sanliurfa in Turkey, where Syrian refugees also reside. At the Harran University Hospital outpatient clinics between 2012 and 2013, 54 CL cases, including 24 Syrian patients, underwent punch biopsy of the skin and/or a touch imprint. Patients in whom leishmania parasites were detected were included in the study. The clinical and histopathological data of the patients were obtained by a review of the patients' medical records. All the slides of each patient were re-evaluated histopathologically. Fifty-four cases (mean age; 17 ± 12 years), consisting of 32 males (59.3%) and 22 females (40.7%), were examined. The most common site of involvement was the face (63%). The most common presentation was noduloulcerative lesions (57.4%). Histopathologically, the majority of the cases exhibited hyperkeratosis, follicular plugging of the epidermis, chronic inflammatory infiltration, leishmania amastigotes and non-caseating granulomatous inflammation in the dermis. CL presents with a wide spectrum of expression, both clinically and histologically, and may mimic other inflammatory and neoplastic diseases. The diagnosis of CL relies on the identification of leishmania amastigotes in either a direct smear of the lesion or in a tissue section.

  3. Cutaneous leishmaniasis: An emerging infection in a non-endemic area and a brief update

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    Rastogi V

    2007-01-01

    Full Text Available We report here the emergence of a new focus of cutaneous leishmaniasis (CL due to Leishmania tropica (L. tropica in the Ajmer city of Rajasthan, India, a previously non-endemic area. Between January-February 2006, 13 new indigenously acquired cases of CL were diagnosed among the patients attending the Skin and STD department, JLN Hospital, Ajmer. The diagnosis was based on clinical presentation, demonstration of amastigotes (LT bodies in Giemsa stained smear of the lesion and response to intralesional / local anti-leishmanial drug therapy. In addition, culture of the promastigote forms of L. tropica from the lesion was successfully attempted in four of the smear negatives cases. By retrospective analysis, 23 new indigenous cases of CL have been diagnosed in the same setting during the period January 2004 - December 2005, based on clinical and therapeutic response alone. There was no clear-cut history of sandfly bite and travel outside the district or state to endemic area in any of the cases. However, all of them came from a common residential area (famous dargah of Ajmer and the peak incidence was seen in January, four months after the famous Urs fair of Ajmer, the location was urban and the lesions were characteristic of L. tropica. Therefore, the disease is suspected to be anthroponotic. These features are suggestive of a common mode of transmission, source and/or vector signalling introduction of this infection into a non-endemic area.

  4. Cutaneous leishmaniasis in red kangaroos: isolation and characterisation of the causative organisms.

    Science.gov (United States)

    Rose, K; Curtis, J; Baldwin, T; Mathis, A; Kumar, B; Sakthianandeswaren, A; Spurck, T; Low Choy, J; Handman, E

    2004-05-01

    This is the first report of cutaneous leishmaniasis in kangaroos where infection was acquired within Australia. The diagnosis is based on the clinical criteria used for humans, the lesion histopathology, the detection and isolation of parasites from the lesions, and the analysis of the small subunit ribosomal RNA genes using the polymerase chain reaction. Despite a clear indication that the parasites belong to the genus Leishmania, no assignation to a known Leishmania species could be made using these or other less conserved genetic loci such as the non-transcribed spacer of the mini-exon repeat. As is the case in humans, some but not all animals harbouring lesions had antibodies to the isolated parasites or to several other Leishmania species. The isolated parasites displayed two well characterised Leishmania glycoconjugates, the lipophosphoglycan and proteophosphoglycan. They were infectious for mouse macrophages in vitro and established long-term infection at 33 degrees C but not at 37 degrees C. Our findings raise the possibility of transmission to humans, which may be unrecognised and suggest the possibility that imported species of Leishmania could become endemic in Australia.

  5. Molecular epidemiology of cutaneous leishmaniasis and heterogeneity of Leishmania major strains in Iran.

    Science.gov (United States)

    Mahmoudzadeh-Niknam, Hamid; Ajdary, Soheila; Riazi-Rad, Farhad; Mirzadegan, Ebrahim; Rezaeian, Abdolhossein; Khaze, Vahid; Djadid, Navid D; Alimohammadian, Mohammad H

    2012-11-01

    To determine the geographical distribution of Leishmania species causing cutaneous leishmaniasis (CL) and to study the genetic heterogeneity of Leishmania major isolates from different endemic areas of Iran. A total of 341 isolates from lesions of patients living in 11 provinces of Iran were grown in culture medium and inoculated to BALB/c mice to detect possible visceralisation. The species were identified by isoenzyme analysis using a battery of six enzymes and kinetoplast (k) DNA-PCR technique. Genetic variation among L. major isolates was analysed by random amplified polymorphic DNA (RAPD) technique. Of the total 341 isolates, 283 isolates were L. major and 58 isolates were Leishmania tropica. In rural areas, the causative agent of CL was mainly L. major (95%L. major vs. 5%L. tropica), in urban areas it was L. tropica (65%L. tropica vs. 35%L. major). All isolates of L. major and 8.6% of L. tropica isolates showed visceralisation in BALB/c mice. There is considerable genetic diversity between L. major strains from different endemic areas and even between some isolates of the same endemic area. Leishmania major is the most frequent species in the endemic areas of CL in eleven provinces of Iran, and genetic diversity is a common feature of L. major in the country. © 2012 Blackwell Publishing Ltd.

  6. Spontaneous regional heading of extensive skin lesions in diffuse cutaneous leishmaniasis (DCL

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    Jackson M.L. Costa

    1995-03-01

    Full Text Available The authors report a case of diffuse cutaneous leishmaniasis, with longstanding evolution and presenting with diffuse infiltrated lesions rich in amastigotes in the absence of mucosal involvement. In situ characterization with monoclonal antibodies revealed Leishmania amazonensis. Large regional lesions have presented spontaneous healing without specific therapy. Considering that DCL presents with a defect in the cellular immune response, thisfact demonstrate that this patient may develop a regional cellular immune response enough to destroy the parasites and to produce clearing of some lesions.Os autores relatam um caso de leishmaniose cutânea difusa, com longa evolução epresençade lesões infiltradas difusas ricas em amastigotas havendo ausência de envolvimento mucoso. A caracterização in situ com anticorpos monocbnais revelou Leishmania amazonensis. Durante a evolução de sua doença, extensas lesões regionais apresentaram cicatrizaçâo espontânea, Considerando que a LCD apresenta-se com um déficit na resposta imune celular, este fato demonstra que o paciente pode ter desenvolvido uma resposta imune celular regional capaz de destruir os parasitas e produzir cicatrizaçâo de algumas lesões.

  7. Situation analysis of cutaneous leishmaniasis in an endemic area, south of Iran.

    Science.gov (United States)

    Nazari, Mansour; Nazari, Saman; Hanafi-Bojd, Ahmad Ali; Najafi, Ali; Nazari, Sasan

    2017-01-01

    To update current situation of the cutaneous leishmaniasis (CL) in Kazerun County, southwest of Iran and to analyse the epidemiological aspects of the disease during 2005-2015. Data on CL were obtained from the Health Center of Kazerun County, and then were analysed and mapped using SPSS and Arc GIS 10.3. A total of 700 cases of CL were recorded during the study period with an overall decreasing trend from 2005 to 2015. More than 60% of the patients were inhabitants of rural areas and males were infected more than females. Although there was not a significant difference between gender, job categories, residence and CL infection (P > 0.05), age groups were significantly different (P  0.05). Most of the acute lesions were found to be present on the hand, leg and face, respectively. The average CL incidence in the study area was calculated as 24.9/100000 population. A hot spot for the disease was found in southern part of the area (P < 0.05). This study revealed that CL is present in Kazerun country. Thus, effective monitoring and sustained surveillance system is crucial in counteracting the disease, and if possible, to eliminate it. Copyright © 2017 Hainan Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  8. Environmental factors associated with American cutaneous leishmaniasis in a new Andean focus in Colombia.

    Science.gov (United States)

    Ocampo, C B; Ferro, M C; Cadena, H; Gongora, R; Pérez, M; Valderrama-Ardila, C H; Quinnell, R J; Alexander, N

    2012-10-01

    To evaluate the environmental and ecological factors associated with Leishmania transmission and vector abundance in Chaparral, Tolima-Colombia. First, we compared the ecological characteristics, abundance of phlebotomies and potential reservoir hosts in the peridomestic environment (100 m radius) of randomly selected houses, between two townships with high and low cutaneous leishmaniasis incidence. Second, we examined peridomestic correlates of phlebotomine abundance in all 43 houses in the higher risk township. The high transmission township had higher coverage of forest (23%vs. 8.4%) and shade coffee (30.7%vs. 11%), and less coffee monoculture (16.8%vs. 26.2%) and pasture (6.3%vs. 12.3%), compared to the low transmission township. Lutzomyia were more abundant in the high transmission township 2.5 vs. 0.2/trap/night. Lutzomyia longiflocosa was the most common species in both townships: 1021/1450 (70%) and 39/80 (49%). Numbers of potential wild mammal reservoirs were small, although four species were found to be infected with Leishmania (Viannia) spp. In the high transmission township, the overall peridomiciliary capture rate of L. longiflocosa was 1.5/trap/night, and the abundance was higher in houses located nearer to forest (ρ = -0.30, P = 0.05). The findings are consistent with a domestic transmission cycle with the phlebotomies dependent on dense vegetation near the house. © 2012 Blackwell Publishing Ltd.

  9. Dispersal and memory of sand flies in an endemic area of cutaneous leishmaniasis, southern Brazil.

    Science.gov (United States)

    Silva, Natália Maria Maciel Guerra; De Melo, Simone Cristina Castanho Sabaini; Massafera, Rubens; Rossi, Robson Marcelo; Silveira, Thaís Gomes Verzignassi; Teodoro, Ueslei

    2013-09-01

    The dispersal of and the existence of memory in sand flies were measured in a transmission area of cutaneous leishmaniasis, in the municipality of Bandeirantes, Paraná, Brazil. Sand flies were caught in a rural area, with Shannon trap installed in the forest and three Falcão traps installed in a human-inhabited environment (HIE) and three others in an impacted environment presently uninhabited by humans (EUH), from 1800 to 0600 hours. The captured sand flies were marked with yellow, blue, or red fluorescent powder, according to the environments where they were captured. All marked sand flies were released at 0700 hours at a point between the three environments. The recaptures were made with 28 Falcão traps, distributed in the environments from for 10 consecutive days. The sand flies recaptured were examined under a stereomicroscope and later identified. It was concluded that sand flies are able to disperse over an average distance of 73 m, reaching 130 m in 24 h, showing that: 1) the sand flies were attracted with different intensities to each environment, and the ability to move among different environments allows the existence of enzootic cycle of Leishmania; 2) the sand flies possess a spatial memory, olfactory memory, or both, that enable them to return to the environment where they were captured initially, although the distances were different.

  10. Transmission of cutaneous leishmaniasis by sand flies is enhanced by regurgitation of fPPG

    Science.gov (United States)

    Rogers, Matthew E.; Ilg, Thomas; Nikolaev, Andrei V.; Ferguson, Michael A. J.; Bates, Paul A.

    2010-01-01

    Sand flies are the exclusive vectors of the protozoan parasite Leishmania1, but the mechanism of transmission by fly bite has not been determined nor incorporated into experimental models of infection. In sand flies with mature Leishmania infections the anterior midgut is blocked by a gel of parasite origin, the promastigote secretory gel (PSG)2,3. Here, we analyse for the first time the inocula from Leishmania mexicana infected Lutzomyia longipalpis sand flies. This revealed the size of the infectious dose, the underlying mechanism of parasite delivery by regurgitation, and the novel contribution made to infection by filamentous proteophosphoglycan (fPPG), a component of PSG found to accompany the parasites during transmission. Collectively, these results have important implications for understanding the relationship between parasite and its vector, the pathology of cutaneous leishmaniasis in humans and also the development of effective vaccines and drugs. These findings emphasise that to fully understand transmission of vector-borne diseases the interaction between all three participants must be considered. PMID:15269771

  11. Nasal polyps: a predisposing factor for cutaneous leishmaniasis of the lips?

    Science.gov (United States)

    Veraldi, Stefano; D'Agostino, Antonio; Pontini, Paolo; Guanziroli, Elena; Gatt, Paul

    2016-04-01

    Cutaneous leishmaniasis (CL) of the lips is rare. This study was conducted to investigate findings in patients with this condition. From 2007 to date, we observed 10 patients (nine males and one female), with a median age of 45.2 years (range: 8-77 years), with CL of the lips. Six of the 10 patients suffered from nasal polyps, three from bronchial asthma, and one from chronic obstructive pulmonary disease (COPD). Three of the patients with nasal polyps also had asthma. Three patients had none of nasal polyps, asthma, or COPD. In all patients with nasal polyps, diagnosis was confirmed by anterior rhinoscopy and nasal endoscopy. It is possible that, in patients with nasal polyps, asthma, and COPD, the need to breathe through the mouth rather than the nose facilitates the sting by sandflies. Subjects with nasal polyps living in areas endemic for CL should be warned about the risk for being stung by sandflies on the lips, in addition to other uncovered areas. © 2015 The International Society of Dermatology.

  12. Antimonial Therapy Induces Circulating Proinflammatory Cytokines in Patients with Cutaneous Leishmaniasis

    Science.gov (United States)

    Kocyigit, Abdurrahim; Gur, Selahaddin; Gurel, Mehmet S.; Bulut, Vedat; Ulukanligil, Mustafa

    2002-01-01

    The objective of this study was to evaluate the association between antimonial therapy and circulating levels of proinflammatory cytokines in patients with cutaneous leishmaniasis (CL). Patients were treated with conventional chemotherapy by using pentavalent antimonium salts (Glucantime) for 3 weeks. Circulating plasma levels of the proinflammatory cytokines interleukin-1β (IL-1β), IL-6, IL-8, and tumor necrosis factor alpha (TNF-α) were determined for CL patients and healthy subjects before and 3 weeks after the treatment was started. Plasma IL-1β, IL-6, IL-8, and TNF-α levels were significantly higher for pretreatment CL patients than for healthy subjects. Proinflammatory cytokines significantly increased after 21 days postinfection compared to levels for the pretreatment patients. These increments were approximately 3-fold for IL-1β and TNF-α levels, 10-fold for IL-6 levels, and 20-fold for IL-8 levels in patients with CL. Taken together these results indicate that circulating proinflammatory cytokine levels were increased in patients with CL as a consequence of host defense strategies, and antimonial therapy may induce these cytokines by affecting the macrophage or other components of the host defense system. PMID:12438329

  13. Meglumine antimoniate is more effective than sodium stibogluconate in the treatment of cutaneous leishmaniasis.

    Science.gov (United States)

    Yesilova, Yavuz; Surucu, Hacer Altın; Ardic, Nurittin; Aksoy, Mustafa; Yesilova, Abdullah; Oghumu, Steve; Satoskar, Abhay R

    2016-01-01

    Sodium stibogluconate (SSG, Pentostam) and meglumine antimoniate (MA, Glucantime) are two antimonials that are widely used to treat cutaneous leishmaniasis (CL), but the relative efficacies of these treatments are not clear. The aim of this study is to compare the efficacy of intralesional SSG with intralesional MA therapy in the treatment of CL. One month after completion of the therapy, 1431 of 1728 patients (82%) who received intralesional MA showed complete clinical cure compared to 1157 of 1728 patients (67%) in the SSG group. Patients who did not respond to the first round of therapy were re-administered the same treatment but with twice weekly injections. Following completion of the second course of therapy, 237 of 297 patients (80%) in the MA group and 407 of 561 patients (72%) in the SSG group healed their lesions by 1-month post-treatment. At both times, the differences in cure rates between MA and SSG groups were statistically significant (p < 0.05). Cure rates in the MA group were always significantly higher than SSG groups irrespective of other parameters including age, gender, lesion site and type of lesion. Intralesional MA is more effective than intralesional SSG in the treatment of CL.

  14. First detection of Leishmania major DNA in Sergentomyia (Spelaeomyia) darlingi from cutaneous leishmaniasis foci in Mali.

    Science.gov (United States)

    Berdjane-Brouk, Zohra; Koné, Abdoulaye K; Djimdé, Abdoulaye A; Charrel, Rémi N; Ravel, Christophe; Delaunay, Pascal; del Giudice, Pascal; Diarra, Adama Z; Doumbo, Siala; Goita, Siaka; Thera, Mahamadou A; Depaquit, Jérôme; Marty, Pierre; Doumbo, Ogobara K; Izri, Arezki

    2012-01-01

    Leishmania major complex is the main causative agent of zoonotic cutaneous leishmaniasis (ZCL) in the Old World. Phlebotomus papatasi and Phlebotomus duboscqi are recognized vectors of L. major complex in Northern and Southern Sahara, respectively. In Mali, ZCL due to L. major is an emerging public health problem, with several cases reported from different parts of the country. The main objective of the present study was to identify the vectors of Leishmania major in the Bandiagara area, in Mali. An entomological survey was carried out in the ZCL foci of Bandiagara area. Sandflies were collected using CDC miniature light traps and sticky papers. In the field, live female Phlebotomine sandflies were identified and examined for the presence of promastigotes. The remaining sandflies were identified morphologically and tested for Leishmania by PCR in the ITS2 gene. The source of blood meal of the engorged females was determined using the cyt-b sequence. Out of the 3,259 collected sandflies, 1,324 were identified morphologically, and consisted of 20 species, of which four belonged to the genus Phlebotomus and 16 to the genus Sergentomyia. Leishmania major DNA was detected by PCR in 7 of the 446 females (1.6%), specifically 2 out of 115 Phlebotomus duboscqi specimens, and 5 from 198 Sergentomyia darlingi specimens. Human DNA was detected in one blood-fed female S. darlingi positive for L. major DNA. Our data suggest the possible involvement of P. duboscqi and potentially S. darlingi in the transmission of ZCL in Mali.

  15. An ecosystem approach to human health and the prevention of cutaneous leishmaniasis in Tumaco, Colombia

    Directory of Open Access Journals (Sweden)

    Rojas Carlos A.

    2001-01-01

    Full Text Available A study was conducted during 1996-1997 in 20 villages of Tumaco, Colombia, to evaluate the effectiveness of personal protective measures against cutaneous leishmaniasis (CL. The intervention was effective, but the high costs of the preventive measures and the lack of a more holistic approach hampered the intervention's sustainability. This paper analyzes the results using an ecosystem approach to human health. Using this approach, we found that CL has been present in the study area for a long time and affects farmers and those living closest to the forest. The forest constitutes the habitat for insect vectors (sandflies and parasite reservoirs (wild mammals. Four spatial scales were identified in this ecosystem: residential, village, regional, and global. From the ecosystem perspective, three interventions are proposed to prevent CL in the 20 villages: improve housing construction, organize village housing in clusters, and make diagnosis and treatment of CL more accessible. The design and implementation of these interventions require active involvement by people with the disease (village inhabitants and decision-makers (local authorities.

  16. Cutaneous Leishmaniasis in dogs: is high seroprevalence indicative of a reservoir role?

    Science.gov (United States)

    Calzada, José E; Saldaña, Azael; González, Kadir; Rigg, Chystrie; Pineda, Vanessa; Santamaría, Ana María; Rodríguez, Indra; Gottdenker, Nicole L; Laurenti, Marcia D; Chaves, Luis F

    2015-08-01

    American cutaneous leishmaniasis (ACL) is a complex disease with a rich diversity of animal host species. This diversity imposes a challenge, since understanding ACL transmission requires the adequate identification of reservoir hosts, those species able to be a source of additional infections. In this study we present results from an ACL cross-sectional serological survey of 51 dogs (Canis familiaris), where we used diagnostic tests that measure dog's exposure to Leishmania spp. parasites. We did our research in Panamá, at a village that has undergone significant ecosystem level transformations. We found an ACL seroprevalence of 47% among dogs, and their exposure was positively associated with dog age and abundance of sand fly vectors in the houses of dog owners. Using mathematical models, which were fitted to data on the proportion of positive tests as function of dog age, we estimated a basic reproductive number (R 0 ± s.e.) of 1·22 ± 0·09 that indicates the disease is endemically established in the dogs. Nevertheless, this information by itself is insufficient to incriminate dogs as ACL reservoirs, given the inability to find parasites (or their DNA) in seropositive dogs and previously reported failures to experimentally infect vectors feeding on dogs with ACL parasites.

  17. Leishmania (Viannia) panamensis-induced cutaneous leishmaniasis in Balb/c mice: pathology.

    Science.gov (United States)

    Rojas, J. I.; Tani, E.; Orn, A.; Sánchez, C.; Goto, H.

    1993-01-01

    Leishmania (Viannia) panamensis infected Balb/c mice developed a progressive swelling in the injected footpad that grew to a tumour-like lesion from day 80 onwards. We did not observe any typical ulcera, necrosis or metastasis to other parts of the skin. Neither did we observe any histopathological changes in liver or spleen during the experiment. At the site of injection, we observed progressive changes ranging from a moderate, mixed inflammatory infiltrate with few leishmania amastigotes in the macrophages to an extensive inflammation composed of monomorphic vacuolated macrophages containing large numbers of parasites. A granulomatous pattern with presence of epithelioid cells and a few multinucleated giant cells was observed at the initial phase of the infection. During later stages, focal necrosis with polymorphonuclear neutrophils was seen. Lymph nodes presented granulomatous lesions in the subcapsular area, numerous plasma cells in the medullary cords and macrophages with leishmania organisms in dilated cortical sinuses at the 4th and the 6th months of infection. This Leishmania (Viannia) panamensis infected Balb/c mice seems to be a good model for continued studies of the pathogenesis of cutaneous leishmaniasis and also for drug trials in the development of new therapeutic tools. Images Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 PMID:8217783

  18. Role for Lyt-2+ T cells in resistance to cutaneous leishmaniasis in immunized mice

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    Farrell, J.P.; Muller, I.; Louis, J.A.

    1989-03-15

    The role of Lyt-2+ T cells in immunologic resistance to cutaneous leishmaniasis was analyzed by comparing infection patterns in resistant C57BL/6 mice and susceptible BALB/c mice induced to heal their infections after sub-lethal irradiation or i.v. immunization, with similar mice treated in vivo with anti-Lyt-2 antibodies. Administration of anti-Lyt-2 mAb resulted in a dramatic reduction in the number of lymphoid cells expressing the Lyt-2+ phenotype. Such treatment led to enhanced disease in both resistant C57BL/6 and irradiated BALB/c mice, as assessed by lesion size, but did not affect the capacity of these mice to ultimately resolve their infections. In contrast, anti-Lyt-2 treatment totally blocked the induction of resistance in i.v. immunized mice. These results suggest, that Lyt-2+ T cells may play a role in immunity to a Leishmania major infection and that their relative importance to resistance may depend on how resistance is induced.

  19. A Comparison of Demographic and Clinical Characteristics of Syrian and Turkish Patients with Cutaneous Leishmaniasis.

    Science.gov (United States)

    Turan, Enver; Yeşilova, Yavuz; Sürücü, Hacer Altun; Ardic, Nurittin; Doni, Nebiye; Aksoy, Mustafa; Yesilova, Abdullah; Oghumu, Steve; Varikuti, Sanjay; Satoskar, Abhay R

    2015-09-01

    Cutaneous leishmaniasis (CL) is a significant public health problem with increasing incidence, especially in extreme circumstances. In this study, we compared the sociodemographic and clinical characteristics of 685 Syrian CL patients afflicted by the Syrian conflict and 685 Turkish CL patients in 2012. Patient age, gender, duration of disease, lesion size, type, and localization were evaluated. The duration of CL disease in Syrian CL patients (4.5 ± 4.3 weeks) was shorter than that of Turkish CL patients (11.9 ± 9.7 weeks). The number of lesions was greater in Syrian patients (2.46 ± 2.43) than in Turkish patients (1.93 ± 1.47). Lesion sizes were comparable between both groups (Syrian, 11.2 ± 8.7 mm; Turkish, 10.7 ± 7.7 mm). In Syrian CL patients, nodular type lesions were the most common (325 patients, 49.1%), whereas, in Turkish CL patients, ulcer type lesions were the most common (352 patients, 51.5%). Our results indicate variations in the clinicoepidemiological features of CL between Turkish and Syrian patients within Sanliurfa province. This highlights the impact of social unrest and environmental conditions on the epidemiology of CL within this region. Approaches to prevention, control, and treatment of CL in these areas should take into consideration the emerging changes in clinicoepidemiological parameters of the disease. © The American Society of Tropical Medicine and Hygiene.

  20. Role for Lyt-2+ T cells in resistance to cutaneous leishmaniasis in immunized mice

    International Nuclear Information System (INIS)

    Farrell, J.P.; Muller, I.; Louis, J.A.

    1989-01-01

    The role of Lyt-2+ T cells in immunologic resistance to cutaneous leishmaniasis was analyzed by comparing infection patterns in resistant C57BL/6 mice and susceptible BALB/c mice induced to heal their infections after sub-lethal irradiation or i.v. immunization, with similar mice treated in vivo with anti-Lyt-2 antibodies. Administration of anti-Lyt-2 mAb resulted in a dramatic reduction in the number of lymphoid cells expressing the Lyt-2+ phenotype. Such treatment led to enhanced disease in both resistant C57BL/6 and irradiated BALB/c mice, as assessed by lesion size, but did not affect the capacity of these mice to ultimately resolve their infections. In contrast, anti-Lyt-2 treatment totally blocked the induction of resistance in i.v. immunized mice. These results suggest, that Lyt-2+ T cells may play a role in immunity to a Leishmania major infection and that their relative importance to resistance may depend on how resistance is induced

  1. Pro- and anti-inflammatory cytokines in cutaneous leishmaniasis: a review

    Science.gov (United States)

    Ghaffarifar, Fathemeh

    2016-01-01

    Cutaneous leishmaniasis (CL) is caused by different species of the genus Leishmania. Pro- and anti-inflammatory cytokines play different roles in resistance/susceptibility and the immunopathogenesis of Leishmania infection. The balance and dynamic changes in cytokines may control or predict clinical outcome. T helper 1 (Th1) inflammatory cytokines (especially interferon-γ, tumor necrosis factor-α and interleukin-12) are the crucial factors in the initiation of protective immunity against L. major infection, whereas T helper 2 cytokines including IL-5, IL-4, and IL-13 facilitate the persistence of parasites by downregulating the Th1 immune response. On the other hand, aggravation of inflammatory reactions leads to collateral tissue damage and formation of ulcer. For this reason, immunity system such as T regulatory cells produce regulatory cytokines such as transforming growth factor-β and IL-10 to inhibit possible injures caused by increased inflammatory responses in infection site. In this article, we review the role of pro- and anti-inflammatory cytokines in the immunoprotection and immunopathology of CL. PMID:27660895

  2. Control of cutaneous leishmaniasis caused by Leishmania major in south-eastern Morocco.

    Science.gov (United States)

    Bennis, Issam; De Brouwere, Vincent; Ameur, Btissam; El Idrissi Laamrani, Abderrahmane; Chichaoui, Smaine; Hamid, Sahibi; Boelaert, Marleen

    2015-10-01

    The incidence of cutaneous leishmaniasis (CL) caused by Leishmania major has increased in Morocco over the last decade, prompting the Ministry of Health to take intersectoral response measures including vector and reservoir control. The aim of this article was to describe the CL outbreak response measures taken in the province of Errachidia, where the reservoir of L. major, a sand rat (Meriones shawi), was targeted using strychnine-poisoned wheat baits from 2010 to 2012. We analysed routine surveillance data and other information using the data of the CL control programme. We present data on the evolution and the extension of CL in this province as well as the epidemiological profile of the disease. Between 2004 and 2013, 7099 cases of CL were recorded in Errachidia Province, gradually affecting all districts. Our results demonstrate that more women were affected than men and that all age groups were represented. Errachidia Province was the epicentre of the recent CL outbreak in Morocco. A notable decline in incidence rates was observed after 2011. The outbreak control measures may have contributed to this decline, as well as climatic trends or progressing herd immunity. © 2015 John Wiley & Sons Ltd.

  3. Evidence of a Prototheca Zopfii Genotype 2 Disseminated Infection in a Dog with Cutaneous Lesions.

    Science.gov (United States)

    Carfora, Virginia; Noris, Gloria; Caprioli, Andrea; Iurescia, Manuela; Stravino, Fiorentino; Franco, Alessia

    2017-06-01

    Protothecosis is a disease caused by saprophyte aerobic unicellular algae belonging to the genus Prototheca. In dogs, it mainly occurs as a disseminated form, with initial clinical manifestations often referable to the gastrointestinal tract, followed by typical ocular and neurological signs. So far, Prototheca zopfii genotype 2 infection has been reported in severe forms of disseminated protothecosis, while in dogs has never been associated with cutaneous forms. In this study, we describe a case of Prototheca zopfii genotype 2 infection in a dog characterized by nodular and ulcerative dermatitis and with evidence of dissemination. In December 2015, a 5-year-old unneutered male English Setter dog was presented with a 4-month history of footpads ulcerations and multifocal nodular lesions (3-5 cm diameter) on both front limbs. Cytological examination of the aspirated fluid collected from all nodules revealed the presence of sporangic forms compatible with Prototheca spp. organisms. Suspected Prototheca spp. colonies were isolated from the aspirated fluid and identified as Prototheca zopfii genotype 2 by molecular methods. Few days after the visit, the patient developed serious neurological and ocular signs, and the owners elected humane euthanasia. To the authors' knowledge, this case could represent the first report of a disseminated Prototheca zopfii genotype 2 infection associated with cutaneous lesions in a dog. This study underlines the importance of considering Prototheca zopfii genotype 2 infection in the differential etiological diagnosis of nodular and ulcerative dermatitis in dogs.

  4. Environmental Risk Factors for the Incidence of American Cutaneous Leishmaniasis in a Sub-Andean Zone of Colombia (Chaparral, Tolima)

    Science.gov (United States)

    Valderrama-Ardila, Carlos; Alexander, Neal; Ferro, Cristina; Cadena, Horacio; Marín, Dairo; Holford, Theodore R.; Munstermann, Leonard E.; Ocampo, Clara B.

    2010-01-01

    Environmental risk factors for cutaneous leishmaniasis were investigated for the largest outbreak recorded in Colombia. The outbreak began in 2003 in Chaparral, and in the following five years produced 2,313 cases in a population of 56,228. Candidate predictor variables were land use, elevation, and climatic variables such as mean temperature and precipitation. Spatial analysis showed that incidence of cutaneous leishmaniasis was higher in townships with mean temperatures in the middle of the county's range. Incidence was independently associated with higher coverage with forest or shrubs (2.6% greater for each additional percent coverage, 95% credible interval [CI] = 0.5–4.9%), and lower population density (22% lower for each additional 100 persons/km2, 95% CI = 7–41%). The extent of forest or shrub coverage did not show major changes over time. These findings confirmed the roles of climate and land use in leishmaniasis transmission. However, environmental variables were not sufficient to explain the spatial variation in incidence. PMID:20134000

  5. Forecasting the number of zoonotic cutaneous leishmaniasis cases in south of Fars province, Iran using seasonal ARIMA time series method.

    Science.gov (United States)

    Sharafi, Mehdi; Ghaem, Haleh; Tabatabaee, Hamid Reza; Faramarzi, Hossein

    2017-01-01

    To predict the trend of cutaneous leishmaniasis and assess the relationship between the disease trend and weather variables in south of Fars province using Seasonal Autoregressive Integrated Moving Average (SARIMA) model. The trend of cutaneous leishmaniasis was predicted using Mini tab software and SARIMA model. Besides, information about the disease and weather conditions was collected monthly based on time series design during January 2010 to March 2016. Moreover, various SARIMA models were assessed and the best one was selected. Then, the model's fitness was evaluated based on normality of the residuals' distribution, correspondence between the fitted and real amounts, and calculation of Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC). The study results indicated that SARIMA model (4,1,4)(0,1,0) (12) in general and SARIMA model (4,1,4)(0,1,1) (12) in below and above 15 years age groups could appropriately predict the disease trend in the study area. Moreover, temperature with a three-month delay (lag3) increased the disease trend, rainfall with a four-month delay (lag4) decreased the disease trend, and rainfall with a nine-month delay (lag9) increased the disease trend. Based on the results, leishmaniasis follows a descending trend in the study area in case drought condition continues, SARIMA models can suitably measure the disease trend, and the disease follows a seasonal trend. Copyright © 2017 Hainan Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  6. Arginase I, polyamine, and prostaglandin E2 pathways suppress the inflammatory response and contribute to diffuse cutaneous leishmaniasis.

    Science.gov (United States)

    França-Costa, Jaqueline; Van Weyenbergh, Johan; Boaventura, Viviane S; Luz, Nívea F; Malta-Santos, Hayna; Oliveira, Murilo Cezar Souza; Santos de Campos, Daniela Conceição; Saldanha, Ana Cristina; dos-Santos, Washington L C; Bozza, Patrícia T; Barral-Netto, Manoel; Barral, Aldina; Costa, Jackson M; Borges, Valeria M

    2015-02-01

    Diffuse cutaneous leishmaniasis (DCL) is a rare clinical manifestation of tegumentary leishmaniasis. The molecular mechanisms underlying DCL pathogenesis remain unclear, and there is no efficient treatment available. This study investigated the systemic and in situ expression of the inflammatory response that might contribute to suppression in DCL. The plasma levels of arginase I, ornithine decarboxylase (ODC), transforming growth factor β (TGF-β), and prostaglandin E2 (PGE2) were higher in patients with DCL, compared with patients with localized cutaneous leishmaniasis (LCL) or with controls from an area of endemicity. In situ transcriptomic analyses reinforced the association between arginase I expression and enzymes involved in prostaglandin and polyamine synthesis. Immunohistochemistry confirmed that arginase I, ODC, and cyclooxygenase2 expression was higher in lesion biopsy specimens from patients with DCL than in those from patients with LCL. Inhibition of arginase I or ODC abrogates L. amazonensis replication in infected human macrophages. Our data implicate arginase I, ODC, PGE2, and TGF-β in the failure to mount an efficient immune response and suggest perspectives in the development of new strategies for therapeutic intervention for patients with DCL. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  7. Linfocitos T citotóxicos CD8+ en la leishmaniasis cutánea CD8+ cytotoxic lymphocytes in cutaneous leishmaniasis

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    Joselín Hernández-Ruiz

    2006-10-01

    Full Text Available OBJETIVO: Examinar la bibliografía relacionada con la participación de los linfocitos T CD8+ en la reacción inmunitaria a especies de Leishmania causantes de leishmaniasis cutánea. En esta enfermedad se ha resaltado la intervención de macrófagos, células dendríticas, NK y células T CD4+; sin embargo, es poco lo que se conoce de las células T CD8+. Los trabajos en modelos murinos señalan que la participación de las células CD8+ sucede a través de la producción de IFN-gamma, aunque su capacidad citotóxica puede desempeñar una función importante, como lo demuestran los hallazgos en seres humanos. La forma como se activan las células citotóxicas CD8+ es un enigma. Es posible que las células dendríticas realicen esa labor a través de mecanismos que incluyen transpresentación de antígenos. Comprender la contribución de este subtipo celular en la respuesta inmunitaria a Leishmania aportará novedosos conocimientos sobre la fisiopatogenia de la leishmaniasis, lo cual hará posible desarrollar nuevos enfoques terapéuticos para esta parasitosis.OBJECTIVE: Review of the literature on the role of CD8+ T cell in the immune response against Leishmania species that cause cutaneous leishmaniasis. The role of macrophages, dendritic cells, CD4 T cells and NK cells has been extensively analyzed in leishmaniasis, yet very little knowledge has been gained on CD8+ T cells in this disease. Murine models of leishmaniasis suggest that CD8+ T cells participate through IFNg production, yet their cytotoxic capacity may also play a crucial role, as has been found in human disease. It is an enigma what mechanisms underlie the CD8+ T cell activation. It is possible that dendritic cells activate CD8+ T cells through mechanisms that include antigen traspresentation. A better understanding of CD8+ T cells in the immune response against Leishmania will undoubtedly provide new insights into the physiopathogenesis of the disease that could lead to new

  8. A new focus of cutaneous leishmaniasis in the central area of Paraná State, southern Brazil.

    Science.gov (United States)

    Soccol, Vanete Thomaz; de Castro, Edilene Alcântara; Schnell e Schühli, Guilherme; de Carvalho, Yanê; Marques, Ellen; Pereira, Elisângela de Fátima; Alcantara, Fernanda de Souza; Machado, Angela Maria; Kowalthuk, Wolodymir; Membrive, Norberto; Luz, Ennio

    2009-09-01

    We report a new endemic zone of cutaneous leishmaniasis (CL) in the central area of the State of Paraná (Municipality of Prudentópolis), in southern Brazil. This region was not previously considered endemic for CL, and this work constitutes the first report of CL endemicity there. Leishmaniasis was confirmed by smear, culture, and ELISA. Parasites were isolated and identified by random amplification of polymorphic DNA (PCR-RAPD). Phylogeographical analysis, based on two different criteria, was able to distinguish between RAPD profiles from different geographical regions. In total, 100 patients were diagnosed with leishmaniasis by culture and serology methods. The reported incidence rate was 4.32%. Of the 100 patients, 92% of the patients had single lesions, and 79.98% of these lesions were located on their limbs. The fact that 61% of patients were male rural workers points to an extradomiciliar type of transmission. In houses where human leishmaniasis was diagnosed, 29% of the dogs presented anti-Leishmania antibodies. A total of 1663 phlebotomines, representing 5 species, were captured in the studied area with CDC-like light minitraps. Lutzomyia intermedia s.l. was the most prevalent species (94.40%). The isolated parasites were grouped with Leishmania (V.) braziliensis. The epidemiological implications are discussed in the present article.

  9. Molecular characterization of leishmania infection from naturally infected sand flies caught in a focus of cutaneous leishmaniasis (eastern iran.

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    Mohammad Akhoundi

    2013-12-01

    Full Text Available Cutaneous leishmaniasis due to Leishmania major is a serious and increasing problem affecting many rural areas of 17 out of 31 provinces in Iran. Little is known about sand fly fauna and leishmaniases in Eastern Iran and no study has been carried out in Sarbisheh County. The aim of this study was to determine sand flies composition and probable Leishmania infection to find the probable vectors of leishmaniasis in Sarbisheh district.Sand flies were caught using both sticky papers and CDC light traps in August 2010. They were identified morphologically and analyzed for Leishmania infection by amplification of ITS-rDNA.Totally, 842 specimens were caught and 8 species recorded. They belonged to the genera Phlebotomus and Sergentomyia: P. (Phlebotomus papatasi, P. (Paraphlebotomus sergenti, P. (Pa. caucasicus, P. (Pa. mongolensis, P. (Pa. jacusieli, S. (Sergentomyia dentata, S. (Se. sintoni and S. (Sintonius clydei. All collected females were processed for Leishmania DNA detection by PCR amplifying of Internal Transcribed Spacer1 (partial sequence, 5.8S (complete sequence and ITS2 (partial sequence fragments. Thirteen females were positive for Leishmania DNA. The sequencing of the 430 bp amplicons indicated that 9 P. papatasi and 3 females belonging to the Caucasicus group carried L. major DNA whereas one P. sergenti carried L. tropica DNA.Phlebotomus papatasi and P. sergenti are, like in several places, the probable vectors of cutaneous leishmaniases in this emerging or unknown focus of cutaneous leishmaniases.

  10. Phlebotomus sergenti in a Cutaneous Leishmaniasis Focus in Azilal Province (High Atlas, Morocco): Molecular Detection and Genotyping of Leishmania tropica, and Feeding Behavior

    OpenAIRE

    Ajaoud , Malika; Es-Sette , Nargys; Charrel , Rémi N.; Laamrani-Idrissi , Abderahmane; Nhammi , Haddou; Riyad , Myriam; Lemrani , Meryem

    2015-01-01

    International audience; Background Phlebotomus (Paraphlebotomus) sergenti is at least one of the confirmed vectors for the transmission of cutaneous leishmaniasis caused by Leishmania tropica and distributed widely in Morocco. This form of leishmaniasis is considered largely as anthroponotic, although dogs were found infected with Leishmania tropica, suggestive of zoonosis in some rural areas. Methodology and Findings This survey aimed at (i) studying the presence of Leishmania in field caugh...

  11. Evaluation of the polymerase chain reaction in the diagnosis of cutaneous leishmaniasis due to Leishmania major: a comparison with direct microscopy of smears and sections from lesions

    DEFF Research Database (Denmark)

    Andresen, K; Gaafar, A; El-Hassan, A M

    1996-01-01

    We have compared the sensitivity of the polymerase chain reaction (PCR) as a diagnostic tool against conventional microscopical diagnostic techniques in patients with cutaneous leishmaniasis from the Sudan. Twenty-eight patients were diagnosed according to clinical criteria followed by microscopi......We have compared the sensitivity of the polymerase chain reaction (PCR) as a diagnostic tool against conventional microscopical diagnostic techniques in patients with cutaneous leishmaniasis from the Sudan. Twenty-eight patients were diagnosed according to clinical criteria followed......%, respectively. The PCR should be considered as a valuable and sensitive diagnostic tool in the diagnosis of cutaneous leishmaniasis; it has the added advantage of identification of the species of Leishmania causing the lesion....

  12. Molecular characterization ofLeishmaniaparasites isolated from sandflies species of a zoonotic cutaneous leishmaniasis in Musiyan south west Iran.

    Science.gov (United States)

    Kavarizadeh, Farzaneh; Khademvatan, Shahram; Vazirianzadeh, Babak; Feizhaddad, Mohammad Hossein; Zarean, Mehdi

    2017-03-01

    Cutaneous leishmaniasis (CL) is vector borne parasitic disease, considered as public health problem especially in border of Iran and Iraq, Dehloran County (Musian district). The aim of this study was molecular identification of Leishmania parasites in sandfly as vectors of Leishmaniasis. Totally 280 female sandflies were trapped by sticky traps from 7 rural areas of Musiyan in September-November 2012. All sandflies were identified using morphological characters of the head and abdominal terminalia. DNA was extracted from female sandflies and Leishmania was identified using PCR and sequencing. All 280 trapped sandflies were identified as Phelobotumus Papatasi and Leishmania infections were detected in 3.2 % out of 280 female sandflies. All leishmania were identified as L. major and submitted in Gene bank as: LC014642.1, LC014641.1, LC014640.1 and LC014639.1. Frequency of Phlebotomus Papatasi and infection with L. major in studied regions showed that this vector is dominant in these areas.

  13. Intralesional Versus Oral Chloroquine in Cutaneous Leishmaniasis: Comparison of Outcome, Duration of Treatment and Total Dose of Drug

    International Nuclear Information System (INIS)

    Hanif, M. M.; Akram, K.; Mustafa, G.

    2016-01-01

    Objective: To compare intralesional versus oral chloroquine in cutaneous leishmaniasis and determine the cure rate, duration of treatment, and total dose of drug. Study Design: Randomized controlled study. Place and Duration of Study: Department of Dermatology, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, from November 2013 to June 2014. Methodology: Consecutive 86 patients of cutaneous leishmaniasis, with single to multiple lesions of various sizes were enrolled and divided randomly into group A and B for the purpose of intralesional and oral chloroquine administration, respectively to compare the effect of the two routes on duration of treatment and total dose of the drug. SPSS version 16 was used for data analysis after data entry into it. Quantitative variables like, duration, cost and total dose of treatment were calculated as mean and standard deviation and compared by using T-test. P-value of less than 0.05 was taken as significant. Results: Cure rate was 100% in both groups towards the end of treatment. Mean duration of treatment was 9.17 ± 3 weeks in intralesional (A) group as against 11.37 ± 3 weeks in oral (B) group (p = 0.0028). Mean total dose of the drug given to each patient in group A was 5.8 ± 0.5 gm and in group B, it was 19.2 ± 1.5 gm, which is significantly higher (p=0.001). The total cost of treatment in group A was Rs. 90 ± 8 and in group B it was Rs. 91 ± 1 (p=0.446). Conclusion: Duration of treatment is significantly shorter and total dose is lesser with intralesional compared to oral chloroquine in treatment of cutaneous leishmaniasis. (author)

  14. Cutaneous presentation of disseminated histoplasmosis as a solitary peri-anal ulcer. Case report and discussion.

    Science.gov (United States)

    Hong, Janet H; Stetsenko, Galina Y; Pottinger, Paul S; George, Evan

    2016-05-01

    Disseminated histoplasmosis has a diverse and non-specific range of clinical signs and symptoms. In a significant minority of patients, cutaneous lesions are apparent at the time of initial presentation, affording an opportunity to establish the diagnosis from a skin biopsy. The most frequently reported clinical scenario in immunocompromised patients with cutaneous involvement is that of multiple papulo-nodular lesions on the face, trunk or extremities. The following report features an immunocompetent patient who presented with a solitary ulcerated plaque on the buttocks close to the anal verge. This case presentation underscores the broad spectrum of clinical presentations as well as the potential for diagnostic confusion with protozoa such as Leishmania or Trypanosoma species during histopathologic examination if special stains for fungal organisms are not performed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Identification of species of leishmania isolated from patients with cutaneous leishmaniasis in Kermanshah; using RAPD-PCR technique

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    Yazdan Hamzavi

    2010-09-01

    Full Text Available Annually many numbers of pationts with Cutaneous Leishmaniasis (CL have been reported in Kermanshah province- IRAN. The study aimed to identify species of Leishmania isolated from patients with CT in Kermanshah. Seven isolates of Leishmania obtained from patients with CL, without any travelling to other provinces, were cultured in NNN medium. After mass production of leptomonads in RPMI 1640 medium DNA was purified and the species were diagnosed using RAPD-PCR technique. The study of electrophoretic fingerprints of the product of RAPD-PCR in seven isolates showed that Leshmania major was the causative agent of CL patients in Kermanshah province. More studies in this field recommended.

  16. Photodynamic Vaccination of BALB/c Mice for Prophylaxis of Cutaneous Leishmaniasis Caused by Leishmania amazonensis

    Directory of Open Access Journals (Sweden)

    Sayonara M. Viana

    2018-02-01

    Full Text Available Background: Photosensitizers (PS, like porphyrins and phthalocyanines (PC are excitable by light to generate cytotoxic singlet oxygen and other reactive oxygen species in the presence of atmospheric O2. Photodynamic inactivation of Leishmania by this means renders them non-viable, but preserves their effective use as vaccines. Leishmania can be photo-inactivated after PS-sensitization by loading via their endocytic uptake of PC or endogenous induction of transgenic mutants with delta-aminolevulinate (ALA to accumulate cytosolic uroporphyrin I (URO. Here, PS-sensitization and photo-inactivation of Leishmaniaamazonensis was further examined in vitro and in vivo for vaccination against cutaneous leishmaniasis (CL.Methods and Results:Leishmania amazonensis promastigotes were photodynamically inactivated in vitro by PC-loading followed by exposure to red light (1–2 J/cm2 or ALA-induction of uroporphyrinogenic transfectants to accumulate cytosolic URO followed by longwave UV exposure. When applied individually, both strategies of photodynamic inactivation were found to significantly, albeit incompletely abolish the MTT reduction activities of the promastigotes, their uptake by mouse bone marrow-derived macrophages in vitro and their infectivity to mouse ear dermis in vivo. Inactivation of Leishmania to completion by using a combination of both strategies was thus used for the sake of safety as whole-cell vaccines for immunization of BALB/c mice. Different cutaneous sites were assessed for the efficacy of such photodynamic vaccination in vivo. Each site was inoculated first with in vitro doubly PS-sensitized promastigotes and then spot-illuminated with white light (50 J/cm2 for their photo-inactivation in situ. Only in ear dermis parasites were photo-inactivated beyond detection. Mice were thus immunized once in the ear and challenged 3 weeks later at the tail base with virulent L. amazonensis. Prophylaxis was noted in mice photodynamically

  17. Epidemiological study of cutaneous leishmaniasis in southwest of Iran during 2001–2011

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    Mohammad Hossien Feiz Haddad

    2016-06-01

    Full Text Available Objective: To examine the prevalence process and epidemiological characteristics of cutaneous leishmaniasis (CL during 2001–2011. Methods: This was a cross-sectional epidemiologic study examining 2 637 patients with CL in Susangerd county during 2001–2011. The data of all patients who referred to the Prevention Unit of Susangerd Health Center were registered in CL epidemiologic data summary forms. The data and parameters included age, gender, occupation, season, residence (urban, rural, and lesion location. Results: Out of 2 637 patients, 1 174 cases (44.5% were females and 1463 patients (55.5% were males. The maximum rate of infection was recorded in under 10-year-old age group (45.32% and its minimum rate was seen among those aged over 60 years (0.87%. Among them, 1 557 patients (59.0% were living in urban and 1 080 (41.0% were in rural areas. The maximum and minimum occupational frequency distributions were seen in students (49.9% and farmers (0.6%, respectively. The study showed that the maximum and minimum frequencies were observed in winter (52.33% and summer (7.62% correspondingly. The most lesion frequencies from lesion location point of view were related to hands (37.5%, faces (30.0%, feet (26.3% and other organs (6.2% and the number of lesions ranged from 1–5 and sized varied from 0.5–5.5 cm Conclusions: Epidemiological parameters such as age, gender, occupation, season, residence (urban, rural and lesion location in endemic regions have had significant effects on the prevalence of CL in Susangerd county and the findings can be effective for assessing disease prevention programs. In addition, CL might become a serious dermatological health problem in the near future due to a great population movement to the neighboring country Iraq with a high incidence to an endemic area.

  18. Epidemiological study on sand flies in an endemic focus of cutaneous leishmaniasis, bushehr city, southwestern iran.

    Science.gov (United States)

    Darvishi, Mohammad; Yaghoobi-Ershadi, Mohammad Reza; Shahbazi, Farideh; Akhavan, Amir Ahmad; Jafari, Reza; Soleimani, Hassan; Yaghoobi-Ershadi, Nastaran; Khajeian, Mohammad; Darabi, Hossein; Arandian, Mohammad Hossein

    2015-01-01

    Cutaneous leishmaniasis is the most important health problem in the city of Bushehr, southwestern Iran. The objective of the study was to determine some ecological aspects of sand flies in the city during 2010-2011. Sand flies were collected monthly from outdoors and indoors by sticky traps at four selected districts of the city. They were also dissected and examined by nested-PCR for identification of the parasite during August-September of 2011. A total of 1234 adult sand flies were collected and 6 species including 3 of Genus Phlebotomus and 3 of Genus Sergentomyia were identified. Four species including P. papatasi (3.98%), P. sergenti (1.14%), S. tiberiadis (87.18%), and S. baghdadis (7.7%) were found indoors. Six species including P. papatasi (3.47%), P. sergenti (3.17%), P. alexandri (0.1%), S. tiberiadis (77.74%), S. baghdadis (15.41%), and one female of S. clydei (0.11%) were collected from outdoors. Sand flies started to appear from March and disappear at the end of January. There was only one peak in the density curve in July. The study revealed that S. tiberiadis and S. baghdadis could enter indoors which 89 and 81.8% of them were found blood-fed, respectively. Moreover, P. papatasi, S. tiberiadis, and S. baghdadis were active indoors and outdoors in most months of the year. Nested-PCR of P. papatasi females was positive against kinetoplast DNA of L. major and L. turanica and also mixed natural infections were found by L. gerbilli and L. turanica. Moreover, mixed infections by L. major and L. turanica were observed in this species. Sergentomyia clydei and S. tiberiadis were found to be negative to any DNA of Leishmania species. Phlebotomus sergenti females were found infected with DNA of L. turanica and this is the first report of natural infection and detection of the parasite from this sand fly species in worldwide.

  19. First Detection of Leishmania major DNA in Sergentomyia (Spelaeomyia) darlingi from Cutaneous Leishmaniasis Foci in Mali

    Science.gov (United States)

    Berdjane-Brouk, Zohra; Koné, Abdoulaye K.; Djimdé, Abdoulaye A.; Charrel, Rémi N.; Ravel, Christophe; Delaunay, Pascal; del Giudice, Pascal; Diarra, Adama Z.; Doumbo, Siala; Goita, Siaka; Thera, Mahamadou A.; Depaquit, Jérôme; Marty, Pierre; Doumbo, Ogobara K.; Izri, Arezki

    2012-01-01

    Background Leishmania major complex is the main causative agent of zoonotic cutaneous leishmaniasis (ZCL) in the Old World. Phlebotomus papatasi and Phlebotomus duboscqi are recognized vectors of L. major complex in Northern and Southern Sahara, respectively. In Mali, ZCL due to L. major is an emerging public health problem, with several cases reported from different parts of the country. The main objective of the present study was to identify the vectors of Leishmania major in the Bandiagara area, in Mali. Methodology/Principal Findings An entomological survey was carried out in the ZCL foci of Bandiagara area. Sandflies were collected using CDC miniature light traps and sticky papers. In the field, live female Phlebotomine sandflies were identified and examined for the presence of promastigotes. The remaining sandflies were identified morphologically and tested for Leishmania by PCR in the ITS2 gene. The source of blood meal of the engorged females was determined using the cyt-b sequence. Out of the 3,259 collected sandflies, 1,324 were identified morphologically, and consisted of 20 species, of which four belonged to the genus Phlebotomus and 16 to the genus Sergentomyia. Leishmania major DNA was detected by PCR in 7 of the 446 females (1.6%), specifically 2 out of 115 Phlebotomus duboscqi specimens, and 5 from 198 Sergentomyia darlingi specimens. Human DNA was detected in one blood-fed female S. darlingi positive for L. major DNA. Conclusion Our data suggest the possible involvement of P. duboscqi and potentially S. darlingi in the transmission of ZCL in Mali. PMID:22276095

  20. Rearing and Biology of Phlebotomus sergenti, the Main Vector of Anthroponotic Cutaneous Leishmaniasis in Iran

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    Arshad Veysi

    2017-12-01

    Full Text Available Background: Establishment of sand flies laboratory colonies is essential to understand various biological aspects of Phlebotominae sand flies. The aims of the current study were to establish the colony of Phlebotomus sergenti Parrot (1917, the main vector of anthroponotic cutaneous leishmaniasis in old world, and to study biological parameters of this species.Methods: The sand flies were reared at 26–28 °C temperature, 14:10 (light: dark photoperiod and 70–80% relative humidity. Larval diet was a composted mixture of rabbit faces and rabbit pellets which is prepared through a special process. First to fifth generations of P. sergenti were used to define biological parameters.Results: Results showed that, P. sergenti blood feeding percentage were 42% on chicken, 21% on BALB/c and 37% on golden hamster. Average time of blood digestion, egg incubation, 1st instar larva, pupa and adult emerging was recorded at 3.4, 8.7, 15, 33.3 and 41.2 days after blood feeding, respectively. Mean number of laid eggs was 55.1 and retained eggs were 35 per a female. Fecundity and production rate were 61.6%, and 42.2% respectively. Average longevity recorded at 15.2 days for females and 14.8 days for males.Conclusion: Colony of P. sergenti has been established for the first time in Iran. Average interval time from egg to adult of this species was 32.5 days. Chicken and golden hamster were recommended as a blood source for colony initiation and routine blood feeding, respectively. 

  1. Breeding sites of Phlebotomus sergenti, the sand fly vector of cutaneous leishmaniasis in the Judean Desert.

    Science.gov (United States)

    Moncaz, Aviad; Faiman, Roy; Kirstein, Oscar; Warburg, Alon

    2012-01-01

    Phlebotomine sand flies transmit Leishmania, phlebo-viruses and Bartonella to humans. A prominent gap in our knowledge of sand fly biology remains the ecology of their immature stages. Sand flies, unlike mosquitoes do not breed in water and only small numbers of larvae have been recovered from diverse habitats that provide stable temperatures, high humidity and decaying organic matter. We describe studies designed to identify and characterize sand fly breeding habitats in a Judean Desert focus of cutaneous leishmaniasis. To detect breeding habitats we constructed emergence traps comprising sand fly-proof netting covering defined areas or cave openings. Large size horizontal sticky traps within the confined spaces were used to trap the sand flies. Newly eclosed male sand flies were identified based on their un-rotated genitalia. Cumulative results show that Phlebotomus sergenti the vector of Leishmania tropica rests and breeds inside caves that are also home to rock hyraxes (the reservoir hosts of L. tropica) and several rodent species. Emerging sand flies were also trapped outside covered caves, probably arriving from other caves or from smaller, concealed cracks in the rocky ledges close by. Man-made support walls constructed with large boulders were also identified as breeding habitats for Ph. sergenti albeit less important than caves. Soil samples obtained from caves and burrows were rich in organic matter and salt content. In this study we developed and put into practice a generalized experimental scheme for identifying sand fly breeding habitats and for assessing the quantities of flies that emerge from them. An improved understanding of sand fly larval ecology should facilitate the implementation of effective control strategies of sand fly vectors of Leishmania.

  2. Breeding sites of Phlebotomus sergenti, the sand fly vector of cutaneous leishmaniasis in the Judean Desert.

    Directory of Open Access Journals (Sweden)

    Aviad Moncaz

    Full Text Available Phlebotomine sand flies transmit Leishmania, phlebo-viruses and Bartonella to humans. A prominent gap in our knowledge of sand fly biology remains the ecology of their immature stages. Sand flies, unlike mosquitoes do not breed in water and only small numbers of larvae have been recovered from diverse habitats that provide stable temperatures, high humidity and decaying organic matter. We describe studies designed to identify and characterize sand fly breeding habitats in a Judean Desert focus of cutaneous leishmaniasis. To detect breeding habitats we constructed emergence traps comprising sand fly-proof netting covering defined areas or cave openings. Large size horizontal sticky traps within the confined spaces were used to trap the sand flies. Newly eclosed male sand flies were identified based on their un-rotated genitalia. Cumulative results show that Phlebotomus sergenti the vector of Leishmania tropica rests and breeds inside caves that are also home to rock hyraxes (the reservoir hosts of L. tropica and several rodent species. Emerging sand flies were also trapped outside covered caves, probably arriving from other caves or from smaller, concealed cracks in the rocky ledges close by. Man-made support walls constructed with large boulders were also identified as breeding habitats for Ph. sergenti albeit less important than caves. Soil samples obtained from caves and burrows were rich in organic matter and salt content. In this study we developed and put into practice a generalized experimental scheme for identifying sand fly breeding habitats and for assessing the quantities of flies that emerge from them. An improved understanding of sand fly larval ecology should facilitate the implementation of effective control strategies of sand fly vectors of Leishmania.

  3. Trend of cutaneous leishmaniasis in kermanshah province, west of iran from 1990 to 2012.

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    Yazdan Hamzavi

    2015-03-01

    Full Text Available This study was conducted to explain the trend of Cutaneous Leishmaniasis (CL in Kermanshah Province, western Iran from 1991-2012.In this analytical-descriptive study, all of the patients suspected to CL in Kermanshah Province were studied. Smears were prepared from most of them, stained with Giemsa, and examined microscopically for Leishman bodies. A few of the patients were diagnosed according to physician diagnosis and response to glucantime. Questionnaires were completed for all of them. Collected data were analyzed using SPSS-21 and Spearman and Kendall tests.From 1991 to 2012, 1684 cases of CL were recorded. In the years 2011-12 the frequency of CL in the province reached to 7.4/100,000, which showed a remarkable increase in the frequency of new cases CL in the province. In the years 2011-12 about 47% of total cases of CL in the province, was seen in Ghasr-e-Shirin district,which the frequency of CL in this district reached to 264.5/100,000. Frequency of CL in males and females was 57% and 43% respectively. The most cases of CL were seen in housewives (32.1% and age groups of 20 to 29 years old (19.9%. In addition, the most cases of disease were seen in winter (41.8% and fall (28.9%.CL is increasing remarkably in warm climates of the province, and Ghasr-e-Shirin must be of particular interest, as the most infected district in the province.

  4. Spatial and temporal distribution of American cutaneous leishmaniasis in Acre state, Brazil.

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    Melchior, Leonardo Augusto Kohara; Brilhante, Andréia Fernandes; Chiaravalloti-Neto, Francisco

    2017-06-07

    Acre has reported the highest incidence of American cutaneous leishmaniasis (ACL) in Brazil in recent years. The present study seeks to identify high and low risk agglomerations of ACL in space and space-time during the period from 2007 to 2013 in Acre, and also to characterize the occurrence of the disease in time and according to sociodemographic variables. This is an ecological study, the study population of which consisted of autochthonous ACL cases notified in the municipalities of Acre by an epidemiological surveillance system. Scan statistics of SaTScan™ software were used to identify spatial and space-time clusters. In addition, the cases were characterized by sex, age, home situation (in a rural or urban area), and temporal tendency. Acre reported an incidence rate of 12.4 cases per 10 000 inhabitant-years in the study period, with the rates varied greatly (standard deviation of 21.8) among their 22 municipalities. One agglomeration of high risk and three of low risk were detected in space and space-time. Four of the five micro-regions of Acre presented a stationary temporal tendency. The profile of transmission varied according to the micro-region. Generally speaking, the disease occurred more often among young people, those of male gender, and those living in rural areas. Acre has stood out within the Brazilian national context due to its high rates of ACL incidence in the central region of the Acre Valley. The high rates in the micro-region of Brasiléia are related to the disease's intra/peridomiciliary occurrence, and it would seem that the municipality of Sena Madureira is approaching a transmission pattern similar to that of Brasiléia. In other micro-regions, the profile of the disease's transmission is mainly related to the forest/sylvatic cycle of ACL.

  5. Psychosocial impact of scars due to cutaneous leishmaniasis on high school students in Errachidia province, Morocco.

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    Bennis, Issam; Thys, Séverine; Filali, Hind; De Brouwere, Vincent; Sahibi, Hamid; Boelaert, Marleen

    2017-04-07

    In Morocco, cutaneous leishmaniasis (CL) is usually known to be a slowly healing localized skin disease, but in some cases, it can lead to mutilating scars. The outbreak of CL due to Leishmania major in the Errachidia province in southeastern Morocco between 2008 and 2010 left many adolescents with permanent scar tissue on the face or other exposed body parts. We studied the psychosocial impact of CL on these young people. In 2015 we conducted a cross-sectional survey among high-school students living in boarding schools in two CL-endemic areas of Errachidia: Rissani and Tinejdad. A self-administered questionnaire elicited responses about general knowledge of CL and related scars. An open-ended question focused on the possible psychosocial effects associated with these scars. The quantitative data were analyzed with Epi Info™ and the text data with NVivo software. Almost 20% of 448 respondents reported they had experienced a CL lesion and 87% said it could possibly or definitely lead to psychological consequences. The text analysis showed that girls more often than boys expanded on the negative psychological effects of CL. The students considered CL as "dangerous", "serious", and "deathly", and said it sometimes led to extreme suicidal ideations. The burden of CL in this age group is not negligible. The indelible CL scars lead to self-stigma and social stigma, and the emergence of negative psychological effects in this age group. While some students accepted their CL scars and related suffering as their "destiny", others were eagerly demanding protective measures against CL and treatment for the scars.

  6. Ecological Niche Modeling of main reservoir hosts of zoonotic cutaneous leishmaniasis in Iran.

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    Gholamrezaei, Mostafa; Mohebali, Mehdi; Hanafi-Bojd, Ahmad Ali; Sedaghat, Mohammad Mehdi; Shirzadi, Mohammad Reza

    2016-08-01

    Zoonotic cutaneous leishmaniasis (ZCL), caused by Leishmania major, is a common zoonotic vector-borne disease in Iran. Close contact with infected reservoir hosts increases the probability of transmission of Leishmania parasite infections to susceptible humans. Four gerbil species (Rodentia: Gerbillidae) serve as the main reservoir hosts for ZCL in different endemic foci of Iran. These species include Rhombomys opimus, Meriones libycus, Meriones hurrianae and Tatera indica; while notable infection has been reported in Nesokia indica as well. The purpose of this study is to model the distribution of these reservoirs to identify the risk areas of ZCL. A data bank was developed including all published data during the period of 1970-2015. Maximum entropy model was used to find the most appropriate ecological niches for each species. The areas under curve obtained were 0.961, 0.927, 0.922, 0.997 and 0.899, instead of 1, for training test in R. opimus, M. libycus, T. indica, M. hurrianae and N. indica, respectively. The environmental variable with the highest gain when used in isolation was slope for R. opimus and N. indica, annual mean temperature for M. libycus, and seasonal precipitation for T. indica and M. hurrianae. Summation of presence probabilities for three main species, i.e., R. opimus, M. libycus and T. indica revealed favorable ecological niches in wide areas of 16 provinces. This is the first study to predict the distribution of ZCL reservoir hosts in Iran. Climatology and topography variables had high contributions toward the prediction of potential distribution of the main reservoir species; therefore, as climate changes, the models should be updated periodically with novel data, and the results should be used in disease-monitoring programs. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Aerobic bacterial flora of biotic and abiotic compartments of a hyperendemic Zoonotic Cutaneous Leishmaniasis (ZCL) focus.

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    Maleki-Ravasan, Naseh; Oshaghi, Mohammad Ali; Afshar, Davoud; Arandian, Mohammad Hossein; Hajikhani, Sara; Akhavan, Amir Ahmad; Yakhchali, Bagher; Shirazi, Mohammad Hasan; Rassi, Yavar; Jafari, Reza; Aminian, Koorosh; Fazeli-Varzaneh, Reza Ali; Durvasula, Ravi

    2015-01-29

    Identification of the microflora of the sand fly gut and the environmental distribution of these bacteria are important components for paratransgenic control of Leishmania transmission by sand flies. Biotic and abiotic bacterial communities of four compartments of a hyper-endemic focus of Zoonotic Cutaneous Leishmaniasis (ZCL) were investigated using 16S ribosomal DNA sequencing and phylogenetic tree construction. These compartments include Phlebotomus papatasi's gut, skin and intestinal tract of great gerbil Rhombomys opimus, the gerbil nest supplies, and plant food sources of the vectors and reservoirs. Sequence homology analysis using nine available 16S rDNA data bases revealed 40, 24, 15 and 14 aerobic bacterial species from the vector guts, the gerbil bodies, the gerbil nests, and the plants, respectively. The isolated bacteria belong to wide ranges including aerobic to facultative anaerobic, pathogen to commensals, sand fly oviposition inducers, land to air and ocean habitats, animal and human probiotics, and plant growth-promoting rhizobacteria. Matching data analysis suggested that the adult P. papatasi gut bacteria could be acquired from three routes, adult sugar feeding on the plant saps, adult blood feeding on the animal host, and larval feeding from nest supplies. However, our laboratory experiment showed that none of the bacteria of the reservoir skin was transmitted to female sand fly guts via blood feeding. The microflora of sand fly guts were associated with the sand fly environment in which the predominant bacteria were Microbacterium, Pseudomonas, and Staphylococcus in human dwellings, cattle farms, and rodent colonies, respectively. Staphylococcus aureus was the most common bacterium in sand fly guts. Presence of some sand fly ovipoisition inducers such Bacillus spp. and Staphylococcus saprophyticus support association between gut flora and oviposition induction. Results of this study showed that Bacillus subtilis and Enterobacter cloacae

  8. Phenotypic and functional characteristics of HLA-DR+neutrophils in Brazilians with cutaneous leishmaniasis.

    Science.gov (United States)

    Davis, Richard E; Sharma, Smriti; Conceição, Jacilara; Carneiro, Pedro; Novais, Fernanda; Scott, Phillip; Sundar, Shyam; Bacellar, Olivia; Carvalho, Edgar M; Wilson, Mary E

    2017-03-01

    The protozoan Leishmania braziliensis causes cutaneous leishmaniasis (CL) in endemic regions. In murine models, neutrophils (PMNs) are recruited to the site of infection soon after parasite inoculation. However, the roles of neutrophils during chronic infection and in human disease remain undefined. We hypothesized that neutrophils help maintain a systemic inflammatory state in subjects with CL. Lesion biopsies from all patients with CL tested contained neutrophils expressing HLA-DR, a molecule thought to be restricted to professional antigen-presenting cells. Although CL is a localized disease, a subset of patients with CL also had circulating neutrophils expressing HLA-DR and the costimulatory molecules CD80, CD86, and CD40. PMNs isolated from a low-density leukocyte blood fraction (LD-PMNs) contained a higher percentage of HLA-DR + PMNs than did normal-density PMNs. In vitro coculture experiments suggested LD-PMNs do not suppress T cell responses, differentiating them from MDSCs. Flow-sorted HLA-DR + PMNs morphologically resembled conventional PMNs, and they exhibited functional properties of PMNs. Compared with conventional PMNs, HLA-DR + PMNs showed increased activation, degranulation, DHR123 oxidation, and phagocytic capacity. A few HLA-DR + PMNs were observed in healthy subjects, and that proportion could be increased by incubation in either inflammatory cytokines or in plasma from a patient with CL. This was accompanied by an increase in PMN hladrb1 mRNA, suggesting a possible connection between neutrophil "priming" and up-regulation of HLA-DR. These data suggest that PMNs that are primed for activation and that also express surface markers of antigen-presenting cells emerge in the circulation and infected tissue lesions of patients with CL. © Society for Leukocyte Biology.

  9. Leishmania species and zymodemes isolated from endemic areas of cutaneous leishmaniasis in Jordan

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    Nimri, Laila; Soubani, Radwan; Gramiccia, Marina

    2002-01-01

    Background Cutaneous leishmaniasis (CL) is endemic in the Middle Eastern countries. New cases are emerging in areas previously free of the disease. In Jordan, the diagnosis of cases during the 1960s and 1970s was mainly reported in military hospitals in Amman. Endemicity of the disease was ascertained after reporting a total of 524 cases during 1973–1978. Results Leishmania major and Leishmania tropica were isolated from seventy-six autochthonous and imported cases of CL, during eight-year period. The highest infection rates recorded were in the central part of Jordan (60.5%), in males (72.4%) and in the age group 21–30 years (30.5%). Lesions were on the exposed sites of the body, mainly on the face (40%). Both Leishmania spp. were isolated from all parts of the country, although L. major was the predominant species (75% of cases) in all areas except in the north part of Jordan. Isoenzyme characterization of the isolates identified four previously undescribed zymodemes (Z). Four Leishmania major zymodemes were found, one of which was a new zymodeme (ZMON-103 variant in GLUD220); L. major ZMON-103 was the most common zymodeme. Four Leishmania tropica zymodemes were identified, of which three were previously unreported. Of these, ZMON-54 var PGD96–97 was isolated from autochthonous cases, whereas ZMON-59 var MDH100 and ZMON-75 var FH110 were obtained from both autochthonous and imported cases, or from an imported CL case, respectively. Conclusion The findings of this study indicate the emergence of the CL disease in new areas. New foci are reported, where the sporadic nature of the cases indicates recent spread of the disease to these areas and the urge for the implementation of control measures. PMID:12473179

  10. Spatial distribution of cutaneous leishmaniasis in the state of Paraná, Brazil.

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    Helen Aline Melo

    Full Text Available The geographic distribution of cutaneous leishmaniasis (CL makes it a disease of major clinical importance in Brazil, where it is endemic in the state of Paraná. The objective of this study was to analyze the spatial distribution of CL in Paraná between 2001 and 2015, based on data from the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases regarding autochthonous CL cases. Spatial autocorrelation was performed using Moran's Global Index and the Local Indicator of Spatial Association (LISA. The construction of maps was based on categories of association (high-high, low-low, high-low, and low-high. A total of 4,557 autochthonous cases of CL were registered in the state of Paraná, with an annual average of 303.8 (± 135.2 and a detection coefficient of 2.91. No correlation was found between global indices and their respective significance in 2001 (I = -0.456, p = 0.676, but evidence of spatial autocorrelation was found in other years (p< 0.05. In the construction and analysis of the cluster maps, areas with a high-high positive association were found in the Ivaí-Pirapó, Tibagi, Cinzas-Laranjinha, and Ribeira areas. The state of Paraná should keep a constant surveillance over CL due to the prominent presence of socioeconomic and environmental factors such as the favorable circumstances for the vectors present in peri-urban and agriculture áreas.

  11. Comparative genomics of Tunisian Leishmania major isolates causing human cutaneous leishmaniasis with contrasting clinical severity.

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    Ghouila, Amel; Guerfali, Fatma Z; Atri, Chiraz; Bali, Aymen; Attia, Hanene; Sghaier, Rabiaa M; Mkannez, Ghada; Dickens, Nicholas J; Laouini, Dhafer

    2017-06-01

    Zoonotic cutaneous leishmaniasis caused by Leishmania (L.) major parasites affects urban and suburban areas in the center and south of Tunisia where the disease is endemo-epidemic. Several cases were reported in human patients for which infection due to L. major induced lesions with a broad range of severity. However, very little is known about the mechanisms underlying this diversity. Our hypothesis is that parasite genomic variability could, in addition to the host immunological background, contribute to the intra-species clinical variability observed in patients and explain the lesion size differences observed in the experimental model. Based on several epidemiological, in vivo and in vitro experiments, we focused on two clinical isolates showing contrasted severity in patients and BALB/c experimental mice model. We used DNA-seq as a high-throughput technology to facilitate the identification of genetic variants with discriminating potential between both isolates. Our results demonstrate that various levels of heterogeneity could be found between both L. major isolates in terms of chromosome or gene copy number variation (CNV), and that the intra-species divergence could surprisingly be related to single nucleotide polymorphisms (SNPs) and Insertion/Deletion (InDels) events. Interestingly, we particularly focused here on genes affected by both types of variants and correlated them with the observed gene CNV. Whether these differences are sufficient to explain the severity in patients is obviously still open to debate, but we do believe that additional layers of -omic information is needed to complement the genomic screen in order to draw a more complete map of severity determinants. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Expression of Foxp3, TGF-β and IL-10 in American cutaneous leishmaniasis lesions.

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    Rodrigues, F M D; Coelho Neto, G T; Menezes, J G P B; Gama, M E A; Gonçalves, E G; Silva, A R; Laurenti, M D; Corbett, C E P; Silveira, F T; Gomes, C M C

    2014-03-01

    Regulatory T cells (Tregs) are a unique population of CD25+CD4+ T cells that regulate innate and adaptive immune responses and have the ability to control the excessive or misdirected effects of the immune system. This modulation involves different mechanisms, such as the suppression of T cell proliferation and cytokine production, the secretion of suppressive cytokines (IL-10 and TGF-β) and the induction of effector T cell apoptosis in humans with infectious diseases such as Leishmania infections. The aim of this study was to evaluate the expression of Foxp3, IL-10 and TGF-β through immunohistochemistry in 22 skin biopsies of patients with localized cutaneous leishmaniasis (LCL) caused by Leishmania (Viannia) spp. from an endemic area in pre-Amazonian area of Maranhão State, Brazil. The density of these markers was also analyzed according to the species of parasite and the progression of the disease. The cellular density was 234 cells/mm(2) for Foxp3+ cells, 357 cells/mm(2) for TGF-β+ cells and 648 cells/mm(2) for IL-10+ cells in the studied skin lesions. The analysis of the cellular density of these immunological markers in relation to the species of Leishmania demonstrated that lesions caused by L. (V.) braziliensis had a lower density of Foxp3+ cells than lesions caused by L. (Viannia) spp. The expression of IL-10 was also lower in lesions caused by L. (V.) braziliensis. There were no significant differences in TGF-β expression between the two groups. The evaluation of these markers according to the progression of the disease did not reveal any significant differences. These findings suggest that Treg Foxp3+ cells, IL-10, and TGF-β play important roles in the immunopathogenesis of LCL and that these roles differ depending on the causal Leishmania species.

  13. Rearing and Biology ofPhlebotomus sergenti, the Main Vector of Anthroponotic Cutaneous Leishmaniasis in Iran.

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    Veysi, Arshad; Yaghoobi-Ershadi, Mohamad Reza; Rassi, Yavar; Hosseini-Vasoukolaei, Nasibeh; Jeddi-Tehrani, Mahmood; Rezaee-Node, Aref; Gholampour, Fatemeh; Saeidi, Zahra; Fatemi, Mahboubeh; Arandian, Mohamad Hossein; Khamesipour, Ali; Akhavan, Amir Ahmad

    2017-12-01

    Establishment of sand flies laboratory colonies is essential to understand various biological aspects of Phlebotominae sand flies. The aims of the current study were to establish the colony of Phlebotomus sergenti Parrot (1917), the main vector of anthroponotic cutaneous leishmaniasis in old world, and to study biological parameters of this species. The sand flies were reared at 26-28 °C temperature, 14:10 (light: dark) photoperiod and 70-80% relative humidity. Larval diet was a composted mixture of rabbit faces and rabbit pellets which is prepared through a special process. First to fifth generations of P. sergenti were used to define biological parameters. Results showed that, P. sergenti blood feeding percentage were 42% on chicken, 21% on BALB/c and 37% on golden hamster. Average time of blood digestion, egg incubation, 1 st instar larva, pupa and adult emerging was recorded at 3.4, 8.7, 15, 33.3 and 41.2 days after blood feeding, respectively. Mean number of laid eggs was 55.1 and retained eggs were 35 per a female. Fecundity and production rate were 61.6%, and 42.2% respectively. Average longevity recorded at 15.2 days for females and 14.8 days for males. Colony of P . sergenti has been established for the first time in Iran. Average interval time from egg to adult of this species was 32.5 days. Chicken and golden hamster were recommended as a blood source for colony initiation and routine blood feeding, respectively.

  14. Fluconazole in the Treatment of Cutaneous Leishmaniasis Caused by Leishmania braziliensis: A Randomized Controlled Trial.

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    Prates, Fernanda V de O; Dourado, Mayra E F; Silva, Silvana C; Schriefer, Albert; Guimarães, Luiz H; Brito, Maria das Graças O; Almeida, Juliana; Carvalho, Edgar M; Machado, Paulo R L

    2017-01-01

     The treatment of cutaneous leishmaniasis (CL) caused by Leishmania braziliensis in Brazil with pentavalent antimony (Sb v ) is associated with a high rate of failure, up to 45% of cases. In addition, Sb v can only administered parenterally and has important toxic effect. An effective, safe, and oral treatment for CL is required.  A randomized controlled clinical trial was conducted to compare the efficacy and safety of high-dosage oral fluconazole (6.5-8.0 mg/kg/d for 28 days) versus a standard Sb v protocol (20 mg/kg/d for 20 days) for the treatment of CL in Bahia, Brazil.  A total of 53 subjects were included in the trial; 26 were treated with Sb v , and 27 with fluconazole. Intention-to-treat analysis showed initial cure rates (2 months after treatment) of 22.2% (6 of 27) in the fluconazole and 53.8% (14 of 26) in the Sb v group (P = .04). Six months after treatment, the final cure rate remained the same in both groups, without any relapses. The frequencies of adverse effects in the Sb v and fluconazole groups were similar, 34.6% versus 37% respectively. One patient treated with fluconazole discontinued treatment owing to malaise, headache, and moderate dizziness (Common Terminology Criteria for Adverse Events grade 2).  Oral fluconazole at a dosage of 6.5-8 mg/kg/d for 28 days should not be considered an effective treatment for CL caused by L. braziliensisClinical Trials Registration. NCT01953744. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  15. Spatial Distribution of Sand Fly Vectors and Eco-Epidemiology of Cutaneous Leishmaniasis Transmission in Colombia.

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    Ferro, Cristina; López, Marla; Fuya, Patricia; Lugo, Ligia; Cordovez, Juan Manuel; González, Camila

    2015-01-01

    Leishmania is transmitted by Phlebotominae insects that maintain the enzootic cycle by circulating between sylvatic and domestic mammals; humans enter the cycles as accidental hosts due to the vector's search for blood source. In Colombia, leishmaniasis is an endemic disease and 95% of all cases are cutaneous (CL), these cases have been reported in several regions of the country where the intervention of sylvatic areas by the introduction of agriculture seem to have an impact on the rearrangement of new transmission cycles. Our study aimed to update vector species distribution in the country and to analyze the relationship between vectors' distribution, climate, land use and CL prevalence. A database with geographic information was assembled, and ecological niche modeling was performed to explore the potential distribution of each of the 21 species of medical importance in Colombia, using thirteen bioclimatic variables, three topographic and three principal components derived from NDVI. Binary models for each species were obtained and related to both land use coverage, and a CL prevalence map with available epidemiological data. Finally, maps of species potential distribution were summed to define potential species richness in the country. In total, 673 single records were obtained with Lutzomyia gomezi, Lutzomyia longipalpis, Psychodopygus panamensis, Psathyromyia shannoni and Pintomyia evansi the species with the highest number of records. Eighteen species had significant models, considering the area under the curve and the jackknife results: L. gomezi and P. panamensis had the widest potential distribution. All sand fly species except for Nyssomyia antunesi are mainly distributed in regions with rates of prevalence between 0.33 to 101.35 cases per 100,000 inhabitants and 76% of collection data points fall into transformed ecosystems. Distribution ranges of sand flies with medical importance in Colombia correspond predominantly to disturbed areas, where the

  16. First detection of Leishmania major DNA in Sergentomyia (Spelaeomyia darlingi from cutaneous leishmaniasis foci in Mali.

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    Zohra Berdjane-Brouk

    Full Text Available BACKGROUND: Leishmania major complex is the main causative agent of zoonotic cutaneous leishmaniasis (ZCL in the Old World. Phlebotomus papatasi and Phlebotomus duboscqi are recognized vectors of L. major complex in Northern and Southern Sahara, respectively. In Mali, ZCL due to L. major is an emerging public health problem, with several cases reported from different parts of the country. The main objective of the present study was to identify the vectors of Leishmania major in the Bandiagara area, in Mali. METHODOLOGY/PRINCIPAL FINDINGS: An entomological survey was carried out in the ZCL foci of Bandiagara area. Sandflies were collected using CDC miniature light traps and sticky papers. In the field, live female Phlebotomine sandflies were identified and examined for the presence of promastigotes. The remaining sandflies were identified morphologically and tested for Leishmania by PCR in the ITS2 gene. The source of blood meal of the engorged females was determined using the cyt-b sequence. Out of the 3,259 collected sandflies, 1,324 were identified morphologically, and consisted of 20 species, of which four belonged to the genus Phlebotomus and 16 to the genus Sergentomyia. Leishmania major DNA was detected by PCR in 7 of the 446 females (1.6%, specifically 2 out of 115 Phlebotomus duboscqi specimens, and 5 from 198 Sergentomyia darlingi specimens. Human DNA was detected in one blood-fed female S. darlingi positive for L. major DNA. CONCLUSION: Our data suggest the possible involvement of P. duboscqi and potentially S. darlingi in the transmission of ZCL in Mali.

  17. Trend of cutaneous leishmaniasis in kermanshah province, west of iran from 1990 to 2012.

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    Hamzavi, Yazdan; Khademi, Nahid

    2015-01-01

    This study was conducted to explain the trend of Cutaneous Leishmaniasis (CL) in Kermanshah Province, western Iran from 1991-2012. In this analytical-descriptive study, all of the patients suspected to CL in Kermanshah Province were studied. Smears were prepared from most of them, stained with Giemsa, and examined microscopically for Leishman bodies. A few of the patients were diagnosed according to physician diagnosis and response to glucantime. Questionnaires were completed for all of them. Collected data were analyzed using SPSS-21 and Spearman and Kendall tests. From 1991 to 2012, 1684 cases of CL were recorded. In the years 2011-12 the frequency of CL in the province reached to 7.4/100,000, which showed a remarkable increase in the frequency of new cases CL in the province. In the years 2011-12 about 47% of total cases of CL in the province, was seen in Ghasr-e-Shirin district,which the frequency of CL in this district reached to 264.5/100,000. Frequency of CL in males and females was 57% and 43% respectively. The most cases of CL were seen in housewives (32.1%) and age groups of 20 to 29 years old (19.9%). In addition, the most cases of disease were seen in winter (41.8%) and fall (28.9%). CL is increasing remarkably in warm climates of the province, and Ghasr-e-Shirin must be of particular interest, as the most infected district in the province.

  18. Nuancing stigma through ethnography: the case of cutaneous leishmaniasis in Suriname.

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    Ramdas, Sahienshadebie; van der Geest, Sjaak; Schallig, Henk D F H

    2016-02-01

    Health-related stigma and its dramatic consequences for those stigmatized have long been a crucial concern for public health authorities globally. However, before concluding that stigma spoils the lives of people with a particular disease or disability and is a major obstacle to obtaining/providing adequate health care, it is necessary to first determine whether there is actual stigmatization related to the condition concerned. The purpose of this article is to nuance the concept of stigma through a detailed ethnographic exploration of the experiences and views of patients and others affected by the parasitic skin disease cutaneous leishmaniasis (CL) in Suriname, South America. Qualitative data on the perceptions, treatment and illness experiences of CL in Suriname was collected in 2009 and 2010 among 205 CL patients at the Dermatology Service in the capital city Paramaribo, and among 321 people in different rural hinterland villages. The exploration reveals the complex and sometimes confusing statements of patients and observers of social reactions to the disease. The authors conclude that--in contrast to other societies--CL is not generally a stigmatized disease in Suriname (though this is not to deny that stigmatization may occur occasionally). Over the past decades, the concepts of stigma and stigmatization have been abundantly theorized. But when theory drifts away from ethnographic evidence, it may turn into imprecise popular speech. In this article, we warn against inflation of the term stigma and show, through an in-depth qualitative description of reactions to symptoms of CL in Suriname, why negative reactions may not necessarily entail stigma. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Epidemiological Study on Cutaneous Leishmaniasis in an Endemic Area, of Qom Province, Central Iran

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    Abedin Saghafipour

    2017-10-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is one of the most important health problems in many areas of Iran. There are two forms of the disease in Iran, anthroponotic and zoonotic CL. This study conducted to assess the epi­demiological situation of CL in an endemic area of Qom Province, central Iran from Apr to Nov 2015.Methods: The sticky paper traps and aspirating tubes were used for collecting adult sand flies. Sherman traps and small insect nets were used to capture rodents and small mammals. Giemsa staining was used for preparing the ex­panded smear and followed by PCR for identifying the causative agent in human, vectors, and reservoirs. In this study, relative frequency of CL was also calculated.Results: Fourteen species of Phlebotomine sand flies were collected. Phlebotomus papatasi (61.74% was the pre­dominant species through the period of activity. Overall, 62 Meriones libycus, 8 Nesokia indica, 4 Mus musculus, 16 Allactaga elater and 2 Hemiechinus auritis were caught. PCR technique showed 6 out of 150 P. papatasi (2%, two out of 62 M. libycus (3.23% and all of suspected human's skin tissue samples (100% were infected with Leishmania major. The relative frequency of CL was 0.30%. Conclusion: This is the first detection of L. major within P. papatasi, M. libycus and human in Kahak District in Qom Province of Iran. Zoonotic cycle of CL exists in this area, L. major is the causative agent, P. papatasi is the main vector and M. libycus is the main reservoir of the disease. 

  20. Disseminated Autochthonous Dermal Leishmaniasis Caused byLeishmania siamensis(PCM2 Trang) in a Patient from Central Thailand Infected with Human Immunodeficiency Virus.

    Science.gov (United States)

    Supsrisunjai, Chavalit; Kootiratrakarn, Tanawatt; Puangpet, Pailin; Bunnag, Thareena; Chaowalit, Prapaipit; Wessagowit, Vesarat

    2017-05-01

    AbstractSeveral case reports of autochthonous leishmaniasis in Thailand have been published since 1996. Most of the previous cases presented with visceral leishmaniasis (VL) and were mostly reported in southern part of Thailand. Recently, it has been evident that Leishmania martiniquensis is the main cause of Leishmania infection in Thailand. However, Leishmania siamensis (PCM2 Trang isolate) was found to be of a separate lineage with restricted distribution in southern Thailand and also a cause of disseminated dermal and visceral leishmaniasis in one published case. Here we report the first patient from central Thailand with human immunodeficiency virus infection presenting with disseminated dermal leishmaniasis. Polymerase chain reaction and DNA sequencing analysis (large subunit of RNA polymerase II and 18S ribosomal RNA internal transcribed spacer 1) from the tissue biopsy sample revealed the pathogen sequences to be highly homologous to PCM2 Trang strain previously reported from southern Thailand.

  1. Leishmaniasis FAQs

    Science.gov (United States)

    ... countries. The cases of leishmaniasis evaluated in the United States reflect travel and immigration patterns. For example, many of the cases of cutaneous leishmaniasis in U.S. civilian travelers have been acquired in common tourist ... found in the United States? Not usually. Almost all of the cases of ...

  2. Cutaneous Disseminated and Extracutaneous Sporotrichosis: Current Status of a Complex Disease

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    Alexandro Bonifaz

    2017-02-01

    Full Text Available Sporotrichosis is an implantation or inoculation mycosis caused by species of Sporothrix schenckii complex; its main manifestations are limited to skin; however, cutaneous-disseminated, disseminated (visceral and extracutaneous variants of sporotrichosis can be associated with immunosuppression, including HIV-AIDS, chronic alcoholism or more virulent strains. The most common extracutaneous form of sporotrichosis includes pulmonary, osteoarticular and meningeal. The laboratory diagnosis requires observing yeast forms and isolating the fungus; the two main causative agents are Sporothrix schenckii (ss and Sporothrix brasiliensis. Antibody levels and species recognition by Polimerase Chain Reaction using biological samples or cultures are also useful. The treatment of choice for most cases is amphotericin B and subsequent itraconazole for maintenance therapy.

  3. Molecular detection and identification of Leishmania infection in naturally infected sand flies in a focus of cutaneous leishmaniasis in northern Morocco.

    Science.gov (United States)

    Es-Sette, Nargys; Ajaoud, Malika; Laamrani-Idrissi, Abderrahman; Mellouki, Fouad; Lemrani, Meryem

    2014-07-02

    Cutaneous leishmaniasis is an infectious disease caused by various species of the flagellate protozoan Leishmania. During the past 20 years, cutaneous leishmaniasis has emerged as a major public health threat in Morocco. The main objective of this study was to study the occurrence of Leishmania infection in vectors and to identify sand fly blood meal sources in an endemic locality of cutaneous leishmaniasis within Sefrou province, where the vectors of leishmaniasis were still unknown. 2650 sand flies were collected using CDC miniature light traps and identified morphologically. The identified sand flies were tested for Leishmania infection by nested PCR. The source of blood meal of 10 freshly engorged females: 6 Phlebotomus longicuspis and 4 Phlebotomus sergenti, was determined using the Cyt b sequence. The collected sand flies consisted of 10 species, seven of which belonged to the genus Phlebotomus and three to the genus Sergentomyia. The most abundant species was P. longicuspis, accounting for 72% of the total sand flies collected. In females of three P. longicuspis and four P. sergenti, Leishmania infantum and Leishmania tropica DNA was detected, respectively.The source of blood meal of engorged females showed that all sand flies tested fed on humans. We report for the first time the natural infection of P. longicuspis with L. infantum in Morocco. The high frequency of this species in this region, in addition to its anthropophilic character make P. longicuspis the putative vector of L. infantum in this cutaneous leishmaniasis focus where L. tropica is confirmed as the causative agent of the disease and P. sergenti as its vector. The presence of L. infantum, and its presumed vector in this area, makes this a site of high risk of visceral leishmaniasis, mostly because of the proximity of a focus of human and canine visceral leishmaniasis.

  4. Presence of American cutaneous leishmaniasis vectors surrounding the city of Medellín, Colombia

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    Agudelo Luz A

    2002-01-01

    Full Text Available The presence of Lutzomyia (Helcocyrtomyia hartmanni, as a vector of Leishmania colombiensis and L. columbiana (Verrucarum group, recently incriminated in the transmission of leishmaniasis, and L. pia (Verrucarum group are reported for the first time in a periurban area of Medellín city. There is thus a risk of leishmaniasis transmission in this town.

  5. The efficacy of hydro alcoholic extract of Seidlitzia rosmarinus on experimental zoonotic cutaneous leishmaniasis lesions in murine model

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    Maryam Ahmadi

    2014-11-01

    Full Text Available Objective: Leishmaniasis is one of the most important parasitic infectious diseases in the world. Since last century, many efforts have been made to control and treat the disease, but appropriate vaccines, pesticides and medicines are not available or even eligible. The purpose of this study was to evaluate the effect of hydro-alcoholic extract of Seidlitzia rosmarinus on the lesions of experimental Cutaneous Leishmaniasis (CL in Balb/c mice. Materials and Methods: The population study was 60 Ballb/c mice which divided to 6 groups, all infected with Leishmania major [MRHO/75/IR]. Soon after the ulcer started to appear in the early stage, a dose of provided herbal extract with 5, 10 and 15% concentration applied on each lesion. The surface area of the lesions measured during an interval of 10 days. Direct Giemsa stained smears prepared two and four weeks after treatment. Results: Increasing the mean size of the lesions was statistically significant compared to those in control group (p>0.001. Visceral Leishmaniasis (VL developed in all of the mice including the control group that received Eucerine alone. Survival rate in group receiving 15% S. rosmarinus extracts showed significantly higher  compared to mice in control group (p

  6. Development of an acquisition protocol and a segmentation algortihm for wounds of cutaneous Leishmaniasis in digital images

    Science.gov (United States)

    Diaz, Kristians; Castañeda, Benjamín; Miranda, César; Lavarello, Roberto; Llanos, Alejandro

    2010-03-01

    We developed a protocol for the acquisition of digital images and an algorithm for a color-based automatic segmentation of cutaneous lesions of Leishmaniasis. The protocol for image acquisition provides control over the working environment to manipulate brightness, lighting and undesirable shadows on the injury using indirect lighting. Also, this protocol was used to accurately calculate the area of the lesion expressed in mm2 even in curved surfaces by combining the information from two consecutive images. Different color spaces were analyzed and compared using ROC curves in order to determine the color layer with the highest contrast between the background and the wound. The proposed algorithm is composed of three stages: (1) Location of the wound determined by threshold and mathematical morphology techniques to the H layer of the HSV color space, (2) Determination of the boundaries of the wound by analyzing the color characteristics in the YIQ space based on masks (for the wound and the background) estimated from the first stage, and (3) Refinement of the calculations obtained on the previous stages by using the discrete dynamic contours algorithm. The segmented regions obtained with the algorithm were compared with manual segmentations made by a medical specialist. Broadly speaking, our results support that color provides useful information during segmentation and measurement of wounds of cutaneous Leishmaniasis. Results from ten images showed 99% specificity, 89% sensitivity, and 98% accuracy.

  7. Clinical and Demographic Stratification of Test Performance: A Pooled Analysis of Five Laboratory Diagnostic Methods for American Cutaneous Leishmaniasis

    Science.gov (United States)

    Boggild, Andrea K.; Ramos, Ana P.; Espinosa, Diego; Valencia, Braulio M.; Veland, Nicolas; Miranda-Verastegui, Cesar; Arevalo, Jorge; Low, Donald E.; Llanos-Cuentas, Alejandro

    2010-01-01

    We evaluated performance characteristics of five diagnostic methods for cutaneous leishmaniasis. Patients who came to the Leishmania Clinic of Hospital Nacional Cayetano Heredia in Lima, Peru, were enrolled in the study. Lesion smears, culture, microculture, polymerase chain reaction (PCR), and leishmanin skin test (LST) were performed. A total of 145 patients with 202 lesions were enrolled: 114 patients with 161 lesions fulfilled criteria for cutaneous leishmaniasis. Sensitivity and specificity were 57.8% (95% confidence interval [CI] = 50.2–65.4%) and 100.0% for culture, 78.3% (95% CI = 71.9–84.7%) and 100.0% for microculture, 71.4% (95% CI = 64.4–78.4%) and 100.0% for smears, 78.2% (95% CI = 70.6–85.8%) and 77.4% (95% CI = 62.7–92.1%) for LST, and 96.9% (95% CI = 94.2–99.6%) and 65.9% (95% CI = 51.4–80.4%) for PCR. PCR was more sensitive than the other assays (P < 0.001). Sensitivities of culture, smears, and LST varied by lesion duration and appearance. PCR offers performance advantages over other assays, irrespective of patient age, sex, lesion duration, or appearance. That clinical factors influence performance of non-molecular assays offers clinicians a patient-focused approach to diagnostic test selection. PMID:20682880

  8. Mast cells have no impact on cutaneous leishmaniasis severity and related Th2 differentiation in resistant and susceptible mice.

    Science.gov (United States)

    Paul, Christoph; Wolff, Svenja; Zapf, Thea; Raifer, Hartmann; Feyerabend, Thorsten B; Bollig, Nadine; Camara, Bärbel; Trier, Claudia; Schleicher, Ulrike; Rodewald, Hans-Reimer; Lohoff, Michael

    2016-01-01

    The genus leishmania comprises different protozoan parasites which are causative agents of muco-cutaneous and systemic, potentially lethal diseases. After infection with the species Leishmania major, resistant mice expand Th1 cells which stimulate macrophages for Leishmania destruction. In contrast, susceptible mice generate Th2 cells which deactivate macrophages, leading to systemic spread of the pathogens. Th-cell differentiation is determined within the first days, and Th2 cell differentiation requires IL-4, whereby the initial IL-4 source is often unknown. Mast cells are potential sources of IL-4, and hence their role in murine leishmaniasis has previously been studied in mast cell-deficient Kit mutant mice, although these mice display immunological phenotypes beyond mast cell deficiency. We therefore readdressed this question by infecting Kit-independent mast cell-deficient mice that are Th1 (C57BL/6 Cpa(Cre) ) or Th2 (BALB/c Cpa(Cre) ) prone with L. major. Using different parasite doses and intra- or subcutaneous infection routes, the results demonstrate no role of mast cells on lesion size development, parasite load, immune cell phenotypes expanding in draining lymph nodes, and cytokine production during murine cutaneous leishmaniasis. Thus, other cell types such as ILCs or T cells have to be considered as primary source of Th2-driving IL-4. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Distribution pattern of anthroponotic cutaneous leishmaniasis caused by Leishmania tropica in Western Afghanistan during 2013-2014.

    Science.gov (United States)

    Fakhar, Mahdi; Karamian, Mehdi; Ghatee, Mohammad Amin; Taylor, Walter Robert; Pazoki Ghohe, Hossein; Rasooli, Sayed Abobakar

    2017-12-01

    Anthroponotic cutaneous leishmaniasis (ACL), caused by Leishmania tropica, is the main cause of cutaneous leishmaniasis (CL) in the Herat province, Western Afghanistan. We investigated the role of environmental factors on ACL distribution in Herat. Epidemiological data from 2457 patients were retrieved from the local WHO sub-office. Shapefile layers of districts, cities, villages, land cover, soil type and digital elevation model (DEM) of the Herat province were used to assess, by logistic regression modelling, the effects of land cover, soil types, elevation, and proximity to the Harirud river on the distribution of ACL. The key determinants of distribution were: (i) close proximity to the Harirud river, (ii) elevation between 700 and 1200m, (iii) intensive and intermittent irrigated cultivated land, and (iv) Haplocalcids with Torriorthents and Torrifluvents soil types. No ACL cases were found below 700m, and a few cases were present at >1200m in irrigated areas around the Harirud river. These findings suggest that moist soil and the humidity from irrigated areas found between 700 and 1200m provide suitable breeding sites of Phlebotomus sergenti, the main sandfly vector of L. tropica in Afghanistan. The effect of elevation also explains the predominance of ACL over ZCL in this region. The present study showed that distribution of ACL is strongly associated with environmental factors in West Afghanistan where the political and socio-economic conditions may also affect the epidemiology of CL. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. A survey of reservoir hosts in two foci of cutaneous leishmaniasis in Kerman province, southeast of Iran.

    Science.gov (United States)

    Ghaffari, Daryoush; Hakimi Parizi, Maryam; Yaghoobi Ershadi, Mohammad Reza; Sharifi, Iraj; Akhavan, Amir Ahmad

    2014-09-01

    In the Old World, cutaneous leishmaniasis (CL) is zoonoses and natural vertebrate hosts of CL parasites are mammals. This study was carried out on natural infection rates of Leishmania parasites in reservoir hosts in one new focus of zoonotic cutaneous leishmaniasis (ZCL) and in suspected reservoir in an old focus of ACL in Iran. The sampling of rodents using Sherman traps was carried out and PCR technique was used for detection and identification of Leishmania species in Bahreman district, Kerman province, southeast of Iran. In addition, the smears were taken from suspicious lesions in stray dogs in the city of Kerman, the center of Kerman province. Simultaneously, pieces of lesion (1 × 1×1 cm) were taken for further histopathological examination. Overall, 25 rodents were collected and identified, including Meriones libycus and Rhombomys opimus. Amastigotes were observed in 33 % of the R. opimus by microscopic examination and indentified as Leishmania major by PCR technique. Four suspicious dogs out of 391 stray dogs showed no Leishmania species. To the best of our knowledge, this is the first isolation and identification of L. major from R. opimus in Kerman province, where ZCL has been present in recent years. Therefore, R. opimus is considered as the main animal reservoir host in Bahreman ZCL focus. In ACL focus such as the city of Kerman, dogs had no role in CL infection as reservoir host.

  11. Clinicoepidemiologic pattern of cutaneous leishmaniasis and molecular characterization of its causative agent in Hajjah governorate, northwest of Yemen.

    Science.gov (United States)

    Mogalli, Nabil M; El Hossary, Shabaan S; Khatri, Mishri Lal; Mukred, Abdualdaim M; Kassem, Hala A; El Sawaf, Bahira M; Ramadan, Nadia F

    2016-11-01

    The clinicoepidemiologic profile of 143 cases (93 males and 50 females) with cutaneous leishmaniasis from 18 villages of Hajjah governorate, Yemen was studied. Dry-type lesions were seen in 98.6% and wet-type lesions in 1.4% of patients. Lesions were localized in all cases with different morphological patterns. Microscopic examination of Giemsa-stained slit smears revealed amastigotes in 74.1% of patients with dry-type lesions and 0% in patients with wet-type lesions. The burden of the parasites in the lesions was high indicating active transmission of the disease. Most cases were from villages with moderate altitude range (8001-1600m). All age groups were affected, but most cases were seen in ages from 5 to 15 years. Leishmania species identification was done for all cases by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The biopsic material was scraped from both Giemsa-stained and methanol-fixed smears. The molecular characterization of Leishmania species revealed Leishmania tropica as the causative agent of cutaneous leishmaniasis in Hajjah, Yemen. The risk factors associated with the transmission of the disease and recommendations for improving case detection were discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Analysis of salivary gland transcripts of the sand fly Lutzomyia ayacuchensis, a vector of Andean-type cutaneous leishmaniasis

    Science.gov (United States)

    Kato, Hirotomo; Jochim, Ryan C.; Gomez, Eduardo A.; Uezato, Hiroshi; Mimori, Tatsuyuki; Korenaga, Masataka; Sakurai, Tatsuya; Katakura, Ken; Valenzuela, Jesus G.; Hashiguchi, Yoshihisa

    2013-01-01

    The saliva of blood sucking insects contains potent pharmacologically active components that assist them in counteracting the host hemostatic and inflammatory systems during blood feeding. In addition, sand fly salivary proteins affect host immunity and have the potential to be a vaccine against Leishmania infection. In the present study, the salivary gland transcripts of Lutzomyia ayacuchensis, a vector of cutaneous leishmaniasis in Ecuadorian and Peruvian Andes, were analyzed by sequencing randomly selected clones of the salivary gland cDNA library of this sand fly. This resulted in the identification of the most abundant transcripts coding for secreted proteins. These proteins were homologous to the salivary molecules present in other sand flies including the RGD-containing peptide, PpSP15/SL1 family protein, yellow-related protein, putative apyrase, antigen 5-related protein, D7 family protein, and 27 kDa salivary protein. Of note, homologues of maxadilan, an active vasodilator abundantly present in saliva of Lutzomyia longipalpis, were not identified. This analysis is the first description of salivary proteins from a sand fly of the subgenus Helcocyrtomyia and from vector of cutaneous leishmaniasis in the New World. The present analysis will provide further insights into the evolution of salivary components in blood sucking arthropods. PMID:23000112

  13. Comparison of Thymus vulgaris (Thyme), Achillea millefolium (Yarrow) and propolis hydroalcoholic extracts versus systemic glucantime in the treatment of cutaneous leishmaniasis in balb/c mice.

    Science.gov (United States)

    Nilforoushzadeh, M A; Shirani-Bidabadi, L; Zolfaghari-Baghbaderani, A; Saberi, S; Siadat, A H; Mahmoudi, M

    2008-12-01

    Leishmaniasis is a parasitic disease transmitted by sand flies. Many investigations are performed to find an effective and safe treatment for leishmaniasis. In this study, we evaluated the efficacy of herbal extracts of Thymus vulgaris (Thyme) and Achillea millefolium (Yarrow), propolis hydroalcoholic extract and systemic glucantime against cutaneous leishmaniasis in Balb/c mice. A total of 45 mice were randomised into five groups each including nine mice. They were treated with pure ethanol 70 degrees, systemic glucantime, Achillea millefolium hydroalcoholic extract, Thymus vulgaris hydroalcoholic extract and propolis hydroalcoholic extract for six weeks. The statistical tests including student t-test were used for analysis. Data were analyzed by SPSS software, ver 13.00. Mean of ulcer size reduction were -17.66, -22.57, 43.29, 36.09 and 43.77% for the alcohol, glucantime, yarrow, thyme and propolis groups, respectively. The results were suggestive that Thymus vulgaris, Achillea millefolium and propolis hydroalcoholic extracts were significantly more effective in reduction of ulcer size as compared with glucantime (p = 0.006, 0.002 and 0.008, respectively). Our results are suggestive that Thymus vulgaris, Achillea millefolium and propolis extracts are effective for treatment of cutaneous leishmaniasis in mice. Regarding these results, we suggest that efficacy of these extracts alone or in combination are evaluated against human cutaneous leishmaniasis as a randomized clinical trial.

  14. Monitoring the response of patients with cutaneous leishmaniasis to treatment with pentamidine isethionate by quantitative real-time PCR, and identification of Leishmania parasites not responding to therapy

    NARCIS (Netherlands)

    Mans, D. R. A.; Kent, A. D.; Hu, R. V.; Lai A Fat, E. J.; Schoone, G. J.; Adams, E. R.; Rood, E. J.; Alba, S.; Sabajo, L. O. A.; Lai A Fat, R. F.; de Vries, H. J. C.; Schallig, H. D. F. H.

    2016-01-01

    Leishmania (Viannia) guyanensis is believed to be the principal cause of cutaneous leishmaniasis (CL) in Suriname. This disease is treated with pentamidine isethionate (PI), but treatment failure has increasingly been reported. To evaluate PI for its clinical efficacy, to compare parasite load, and

  15. A Comparison between the Effects of Glucantime, Topical Trichloroacetic Acid 50% plus Glucantime, and Fractional Carbon Dioxide Laser plus Glucantime on Cutaneous Leishmaniasis Lesions

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    Fariba Jaffary

    2016-01-01

    Full Text Available Background. Cutaneous leishmaniasis is an endemic disease in Iran. Pentavalent antimonial drugs have been the first line of therapy in cutaneous leishmaniasis for many years. However, the cure rate of these agents is still not favorable. This study was carried out to compare the efficacies of intralesional glucantime with topical trichloroacetic acid 50% (TCA 50% + glucantime and fractional carbon dioxide laser + glucantime in the treatment of cutaneous leishmaniasis. Methods. A total of 90 patients were randomly divided into three groups of 30 to be treated with intralesional injection of glucantime, a combination of topical TCA 50% and glucantime, or a combination of fractional laser and glucantime. The overall clinical improvement and changes in sizes of lesions and scars were assessed and compared among three groups. Results. The mean duration of treatment was 6.1±2.1 weeks in all patients (range: 2–12 weeks and 6.8±1.7, 5.2±1.0, and 6.3±3.0 weeks in glucantime, topical TCA plus glucantime, and fractional laser plus glucantime groups, respectively (P=0.011. Complete improvement was observed in 10 (38.5%, 27 (90%, and 20 (87% patients of glucantime, glucantime + TCA, and glucantime + laser groups, respectively (P<0.001. Conclusion. Compared to glucantime alone, the combination of intralesional glucantime and TCA 50% or fractional CO2 laser had significantly higher and faster cure rate in patients with cutaneous leishmaniasis.

  16. Dichotomy of the human T cell response to Leishmania antigens. I. Th1-like response to Leishmania major promastigote antigens in individuals recovered from cutaneous leishmaniasis

    DEFF Research Database (Denmark)

    Kemp, M; Hey, A S; Kurtzhals, J A

    1994-01-01

    The T cell response to antigens from Leishmania major promastigotes was investigated in peripheral blood mononuclear cells from Sudanese individuals with a history of cutaneous leishmaniasis (CL), Sudanese individuals with positive DTH reaction in the leishmanin skin test but with no history of s...... or subclinical L. major infection is an IFN-gamma-producing Th1-like response....

  17. Dichotomy of the T cell response to Leishmania antigens in patients suffering from cutaneous leishmaniasis; absence or scarcity of Th1 activity is associated with severe infections

    DEFF Research Database (Denmark)

    Gaafar, A; Kharazmi, A; Ismail, A

    1995-01-01

    The T cell response was studied in 25 patients suffering from cutaneous leishmaniasis caused by Leishmania major with severe (n = 10) and mild (n = 15) disease manifestations. Peripheral blood mononuclear cells (PBMC) from the patients were activated by sonicates of Leishmania promastigotes (LMP...

  18. Dichotomy of the human T cell response to Leishmania antigens. I. Th1-like response to Leishmania major promastigote antigens in individuals recovered from cutaneous leishmaniasis

    DEFF Research Database (Denmark)

    Kemp, M; Hey, A S; Kurtzhals, J A

    1994-01-01

    The T cell response to antigens from Leishmania major promastigotes was investigated in peripheral blood mononuclear cells from Sudanese individuals with a history of cutaneous leishmaniasis (CL), Sudanese individuals with positive DTH reaction in the leishmanin skin test but with no history...

  19. Comparison of the immune profile of nonhealing cutaneous Leishmaniasis patients with those with active lesions and those who have recovered from infection

    DEFF Research Database (Denmark)

    Ajdary, S; Alimohammadian, M H; Eslami, M B

    2000-01-01

    Th1-type cellular immune responses play a critical role in protection against infection with Leishmania parasites, whereas activation of Th2-type cells results in progressive disease. Cutaneous leishmaniasis caused by Leishmania major is often a self-healing disease; however, persistent nonhealing...

  20. Disseminated cutaneous histoplasmosis with laryngeal involvement in a setting of immune reconstitution inflammatory syndrome.

    Science.gov (United States)

    Sacoor, Mohamed F

    2017-01-01

    Histoplasmosis is a systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum . We report a case of disseminated cutaneous histoplasmosis with mucocutaneous involvement in an AIDS patient paradigmatic of the multifaceted nature of the disease, which is an expression of the immune reconstitution inflammatory syndrome (IRIS). A 39-year-old man presented with a three month history of asymptomatic papules and nodules with necrotic centres involving the centrofacial region. The patient was diagnosed as being HIV-positive a month earlier and was commenced on antiretroviral treatment. Two weeks after the development of skin lesions, the patient complained of a sore throat and hoarseness of his voice. A fibre-optic laryngoscopy and biopsies of the skin, larynx and liver were performed. The CD4 counts increased from 2 cells/µL to 124 cells/µL, whereas the viral load decreased from one million to less than 20 copies/mL. A fibre-optic laryngoscopy revealed a supraglottitis with ulceration on the epiglottis. Histology of the liver, larynx and sections of the skin demonstrated pandermal necrotising granulomatous inflammation. Grocott-Gomori methenamine silver and Periodic acid-Schiff (PAS) stains revealed a relative paucity of intracellular, narrow-neck budding fungal organisms. Culture findings confirmed the diagnosis of histoplasmosis. The patient was treated with intravenous amphotericin B for two weeks followed by oral itraconazole 100 mg twice a day, with an excellent response to treatment. We present this case to remind clinicians that disseminated histoplasmosis in AIDS patients may occur as an expression of IRIS. A sudden onset of hoarseness with cutaneous lesions in a patient with disseminated disease should alert one to possible laryngeal histoplasmosis. Prompt recognition and treatment will avert the potential fatal complications of this disease.

  1. Zoonotic cutaneous leishmaniasis in Shiraz, Southern Iran: A molecular, isoenzyme and morphologic approach

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    Qasem Asgari

    2007-05-01

    Full Text Available

    BACKGROUND: Cutaneous leishmaniasis (CL with diverse clinical manifestations is prevalent and remains a major public health problem in Iran and its incidence has been doubled over the last decade. The present study is about the potential role of rodents in the epidemiology of CL in Kharameh district in Shiraz, Southern Iran.

    METHODS: From April 2004 to April 2005, a total of sixteen rodents were collected in live traps from the endemic area of CL in Kharameh district in Shiraz. Evans medium was used for culture. Specific polymerase chain reaction and isoenzyme electrophoresis methods were performed to characterize the parasite.

    RESULTS: The rodent species were Tatera indica. Three samples from Tatera indica were found positive (2 males and 1 female in Kafdehak and Sejel-Abad villages for L. major. Macrophages in the bone marrow of femoral bone were infected with the amastigote form of the parasite.

    CONCLUSIONS: It seems that T. indica is the reservoir host for CL in Kharameh (a district in Shiraz, Southern Iran. It was shown that the bone marrow of the rodents is the tissue of choice for light and ultrastructural studies of

  2. Comparative immune study on cutaneous leishmaniasis patients with single and multiple sores.

    Science.gov (United States)

    Al-Qadhi, Ban Noori; Musa, Israa Salim; Al-Mulla Hummadi, Yassir Mustafa Kamal

    2015-09-01

    Ninety-five Iraqi patients with cutaneous leishmaniasis (CL) caused by Leishmania tropica at AL-Karama Hospital in Baghdad were included in this study. Sixty patients were with single sore and the remaining with multiple sores. The study also included 10 atopic patients and 30 healthy individuals as a control group. Cellular and humoral immune response at different stages of the disease activity (early and late) were evaluated by estimation of serum IFN-γ, IL-4 and total IgE antibodies using ELISA kits while, the detection of specific anti leishmanial IgE antibodies was done manually. Specific IgE antibodies were only detected in early CL (<2 months) patients 68 (71.57 %) while, were not detected in late CL, atopic and healthy controls 30 (100 %). The results also showed a positive relationship between this antibody and the number of sores. Th-2 predominates during the early stage of the disease then shifts to Th-1 that proceed in the late stage, but both cytokines increased in CL patients in comparison to control group. The immune response of CL infection is possibly regulated by both Th-1 and Th-2. Multiple sores patients showed an increase of anti leishmanial IgE (0.120 ± 0.014), total IgE (120.7 ± 39.58 IU/ml), IFN-γ (87.4 ± 30.52 pg/ml) and IL-4 (63.70 ± 20.32 pg/ml) levels than single sore patients with mean value of 0.108 ± 0.14, 92.3 ± 35.23 IU/ml, 47.2 ± 27.80 pg/ml and 51.04 ± 15.0 pg/ml respectively. It can be presented also as ratio of INF-γ/IL-4 = 1.37 which is greater than those for single sore 0.9. These results indicated that the immune response of multiple sores patient's is higher than that with single sores.

  3. Spatial Distribution of Sand Fly Vectors and Eco-Epidemiology of Cutaneous Leishmaniasis Transmission in Colombia.

    Directory of Open Access Journals (Sweden)

    Cristina Ferro

    Full Text Available Leishmania is transmitted by Phlebotominae insects that maintain the enzootic cycle by circulating between sylvatic and domestic mammals; humans enter the cycles as accidental hosts due to the vector's search for blood source. In Colombia, leishmaniasis is an endemic disease and 95% of all cases are cutaneous (CL, these cases have been reported in several regions of the country where the intervention of sylvatic areas by the introduction of agriculture seem to have an impact on the rearrangement of new transmission cycles. Our study aimed to update vector species distribution in the country and to analyze the relationship between vectors' distribution, climate, land use and CL prevalence.A database with geographic information was assembled, and ecological niche modeling was performed to explore the potential distribution of each of the 21 species of medical importance in Colombia, using thirteen bioclimatic variables, three topographic and three principal components derived from NDVI. Binary models for each species were obtained and related to both land use coverage, and a CL prevalence map with available epidemiological data. Finally, maps of species potential distribution were summed to define potential species richness in the country.In total, 673 single records were obtained with Lutzomyia gomezi, Lutzomyia longipalpis, Psychodopygus panamensis, Psathyromyia shannoni and Pintomyia evansi the species with the highest number of records. Eighteen species had significant models, considering the area under the curve and the jackknife results: L. gomezi and P. panamensis had the widest potential distribution. All sand fly species except for Nyssomyia antunesi are mainly distributed in regions with rates of prevalence between 0.33 to 101.35 cases per 100,000 inhabitants and 76% of collection data points fall into transformed ecosystems.Distribution ranges of sand flies with medical importance in Colombia correspond predominantly to disturbed areas

  4. [An alternative biphasic nutrient medium for the diagnosis of cutaneous leishmaniasis].

    Science.gov (United States)

    Aksoy Gökmen, Ayşegül; Öncel, Koray; Özdemir, Oğuz Alp; Pektaş, Bayram; Çavuş, İbrahim; Güngör, Serdar; Uzun, Berrin; Kaya, Selçuk; Karaca, Şemsettin; Yula, Erkan; Demirci, Mustafa; Özbilgin, Ahmet

    2015-04-01

    Cutaneous leishmaniasis (CL) caused by the Leishmania spp. parasites, is a disease characterized by nodulo-ulcerative lesions in the skin. CL is transmitted to humans by infected sandflies during blood sucking, and is endemic in about 98 countries over the world. The demonstration of amastigotes via microscopic examination, and the growth of promastigotes in NNN (Novy-MacNeal-Nicolle) medium are gold standard methods for laboratory diagnosis. The aim of this study was to compare the biphasic NNN medium that is frequently used in routine laboratories with the biphasic nutrient medium that can be prepared easily in microbiology laboratories, for the growth of promastigotes. In the study, the aspiration fluid sample was used as clinical sample which was obtained from the skin lesion of a 47-year-old female patient admitted to İzmir Katip Celebi Ataturk Education and Research Hospital dermatology outpatient clinic and pre-diagnosed as CL. The aspirate sample taken from the lesion was evaluated with microscopy, cultivation in two different media and real-time polymerase chain reaction (Rt-PCR) methods. In microscopic examination Leishmania amastigotes were observed in Giemsa-stained smears prepared from the aspiration fluid. In Rt-PCR performed by using specific primers and probes targeting ITS1 region of Leishmania parasite, a melting-curve compatible with L.tropica was detected. For cultivation, triple inoculations of the aspirate sample into NNN (NNN + RPMI 1640 + 10% fetal calf serum) and nutrient media (nutrient agar + nutrient broth + 10% fetal calf serum) were used. The cultures were incubated at 27°C for 10 days, and the number of propagated promastigotes were counted on the third, seventh and tenth days. The growth of Leishmania promastigotes was detected in both media on the third day. The number of promastigotes grown in NNN medium on the third, seventh and tenth days were 105/ml, 106/ml and 108/ml, respectively. Those values in nutrient medium were 106/ml

  5. Leishmaniasis in Northern and Western Africa: A Review

    African Journals Online (AJOL)

    Albert Kimutai

    and disseminated lesions. Phlebotomus papatasi (sandfly) is the proven vector of L. major, and rodents. Psammomys obesus and Meriones spp. serve as animal reservoir hosts. Some countries of the region have endemic foci of zoonotic and anthroponotic cutaneous leishmaniasis, which could cause epidemics among.

  6. Unexpected co-detection of promastigote and amastigote Leishmania forms in a human cutaneous lesion: implications for leishmaniasis physiopathology and treatment.

    Science.gov (United States)

    Haouas, Najoua; Remadi, Latifa; Chaara, Dhekra; Chargui, Najla; Dabghi, Radhia; Jbeniani, Henda; Babba, Hamouda; Ravel, Christophe

    2015-01-01

    Cutaneous leishmaniasis pathogenicity depends on the survival and replication of the parasitic protozoa in the form of non-motile amastigotes inside macrophages. Here, we report the unprecedented observation of both Leishmania major amastigote and promastigote forms (the latter is normally detected only in the mid gut of the insect vector or in vitro culture) in a cutaneous lesion of a 6-year-old boy. This finding suggests that modifications of the skin lesion environment, such as maceration and changes in pH or temperature, could promote the in situ transformation of Leishmania amastigotes into promastigotes. This observation raises questions about the physiopathology of cutaneous leishmaniasis and the influence of micro-environmental changes on the efficiency of topical treatments. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. [Transmission of cutaneous leishmaniasis associated with cacao (Theobroma cacao) plantations in Tabasco].

    Science.gov (United States)

    Carrada Figueroa, Georgina Del Carmen; Leal Ascencio, Víctor Javier; Jiménez Sastré, Alejandro; López Álvarez, Jorge

    2014-01-01

    Tabasco is the Mexican state that reported the highest number (37.4%) of patients with leishmaniasis during 1990-2011. Close to 90% of these patients lived in Chontalpa, where the municipality of Cunduacán accounted for the majority of the cases. One of the characteristics of this region is that houses are located within cacao plantations. To determine if cacao plantations are a risk factor for leishmaniasis transmission in locations of Cunduacán, Tabasco. We performed an analytical and retrospective study of 115 locations in Cunduacán, analyzing the number of localities with or without patients with leishmaniasis registered between 2000-2011 and, additionally, if they had cacao plantations, using a map where different crops were georeferenced. We measured the magnitude of the association (odds ratio, 95% CI). During the period 2000-2011, cases of leishmaniasis were reported in 77 (67.0%) Cunduacán locations, of these, 55 (71.4%) had cocoa plantations, five (6.5%) of banana, five (6.5%) of cane, and 12 (15.6%) had no crops georeferenced. We found that cocoa crops are a risk factor for the transmission of leishmaniasis (OR: 3.438; 95% CI: 1,526-7,742). The probability of transmission of leishmaniasis in areas with cocoa crops is greater than in communities without this crop.

  8. Immunotherapy, immunochemotherapy and chemotherapy for American cutaneous leishmaniasis treatment Imunoterapia, imunoquimioterapia e quimioterapia no tratamento da leishmaniose tegumentar americana

    Directory of Open Access Journals (Sweden)

    Wilson Mayrink

    2006-02-01

    Full Text Available The first choice of treatment for American cutaneous leishmaniasis is the pentavalent antimonial drug. Although it has been shown that this treatment is mostly effective and indicated, some disadvantages should be taken into account such as side effects, long term treatment inconveniences and counter-indication for patients suffering from cardiopathy, nephropathy; yet, aging, pregnancy and other conditions. With the advent of the vaccine anti-American cutaneous leishmaniasis as a prophylactic measure, studies on therapy using the vaccine associated or not with other drugs have been performed by many investigators and it is currently among the alternative treatments and prevention measures for American cutaneous leishmaniasis. In conclusion, the association between antimony and vaccine (immunochemotherapy showed the same cure rate when compared with the standard treatment (100% and it was also able to reduce the salt volume in 17.9% and treatment length from 87 to 62 days, decreasing side effects.O tratamento de primeira escolha para leishmaniose tegumentar americana é o antimonial pentavalente. Embora este tratamento seja na maioria das vezes efetivo e indicado, devem ser consideradas as desvantagens tais como efeitos colaterais, longa duração do tratamento e contra-indicação para cardiopatas, nefropatas, idosos, grávidas e outras condições. Com o advento da vacina antileishmaniose tegumentar americana para fins profiláticos e terapêuticos, associando-a ou não a outros fármacos, muitas pesquisas têm sido desenvolvidas, sendo a vacina a principal entre os atuais recursos no tratamento e prevenção da leishmaniose tegumentar americana. Em conclusão, a associação do antimônio com a vacina (imunoquimioterapia apresentou o mesmo índice de cura em relação ao tratamento padrão (100%, e ainda reduziu o volume do sal em 17,9% e o tempo de cura significativamente, de 87 para 62 dias; conseqüentemente, reduzindo os efeitos colaterais.

  9. Cutaneous leishmaniasis in the central provinces of Hama and Edlib in Syria: Vector identification and parasite typing.

    Science.gov (United States)

    Haddad, Nabil; Saliba, Hanadi; Altawil, Atef; Villinsky, Jeffrey; Al-Nahhas, Samar

    2015-10-12

    Cutaneous leishmaniasis is a disease transmitted by sand fly bites. This disease is highly prevalent in Syria where Leishmania major and Leishmania tropica are the known aetiological agents. In 2011, more than 58,000 cases were reported in the country by the Ministry of Health. The central region of the country harbors 20 % of the reported cases. However, the epidemiology of the disease in this area is not well understood. An epidemiological survey was conducted in 2010 to identity the circulating parasite and the sand fly vector in the central provinces of Edlib and Hama. Sand fly specimens were collected using CDC light traps and identified morphologically. Total DNA was extracted from the abdomens of female specimens and from Giemsa-stained skin lesion smears of 80 patients. Leishmania parasites were first identified by sequencing the ITS1 gene amplicons. Then polymorphism analysis was performed using the RFLP technique. A total of 2142 sand flies were collected. They belonged to eight species, among which Phlebotomus sergenti and Phlebotomus papatasi were the most predominant. L. tropica ITS1 gene was amplified from two pools of P. sergenti specimens and from skin smears of cutaneous leishmaniasis patients. This suggests that P. sergenti is the potential vector species in the study area. The digestion profiles of the obtained amplicons by TaqI restriction enzyme were identical for all analysed L. tropica parasites. Moreover, L. infantum ITS1 gene was amplified from two pools of Phlebotomus tobbi in the relatively humid zone of Edlib. L. tropica is confirmed to be the aetiological agent of cutaneous leishmaniasis cases in the central provinces. RFLP technique failed to show any genetic heterogeneity in the ITS1 gene among the tested parasites. The molecular detection of this parasite in human skin smears and in P. sergenti supports the vector status of this species in the study area. The detection of L. infantum in P. tobbi specimens indicates a potential

  10. Effect of Polyvinyl Alcohol (PVA) Containing Artemether in Treatment of Cutaneous Leishmaniasis Caused by Leishmania major in BALB/c Mice.

    Science.gov (United States)

    Ebrahimisadr, Parisa; Ghaffarifar, Fatemeh; Hassan, Zuhir Mohammad; Sirousazar, Mohammad; Mohammadnejad, Fatemeh

    2014-05-01

    Polyvinyl alcohol (PVA) is one of the well-known polymers, which has been used in numerous biomedical applications because of its good biocompatibility. Due to problems made by the therapeutics already used for leishmaniasis, the aim of this study was to evaluate the effect of PVA containing artemether in treating cutaneous leishmaniasis in BALB/c mice. Aqueous solution of PVA was prepared by mixing with Double Distilled Water. After preparation of PVA, 4.33 mg of each drug (main drug artemether and control drug 14% glucantime) was added to 100 g of prepared PVA-honey solution. The solution was incubated at 37°C and the release of artemether was evaluated by measuring absorbance at 260 nm wave length. In this study for treatment of mice lesion, we used PVA containing artemether and glucantime and this method was compared with ointment treatment. Mean diameters of lesions in mice treated with artemether were smaller than the control group and the differences were significant (P PVA containing artemether in comparison with the group treated with ointment of artemether were smaller and the differences were significant (P PVA containing artemether is a new method for treatment of cutaneous leishmaniasis and according to the obtained results, artemether is an appropriate and effective drug, especially when used with PVA as a lesion dressing; thus we suggest that this method can be applied for the treatment of cutaneous leishmaniasis.

  11. Integrated Tools for American Cutaneous Leishmaniasis Surveillance and Control: Intervention in an Endemic Area in Rio de Janeiro, RJ, Brazil

    Directory of Open Access Journals (Sweden)

    Cheryl Gouveia

    2012-01-01

    Full Text Available American cutaneous leishmaniasis (ACL is a focal disease whose surveillance and control require complex actions. The present study aimed to apply integrated tools related to entomological surveillance, environmental management, and health education practices in an ACL-endemic area in Rio de Janeiro city, RJ, Brazil. The distribution of the disease, the particular characteristics of the localities, and entomological data were used as additional information about ACL determinants. Environmental management actions were evaluated after health education practices. The frequency of ACL vectors Lutzomyia (N. intermedia and L. migonei inside and outside houses varied according to environment characteristics, probably influenced by the way of life of the popular groups. In this kind of situation environmental management and community mobilization become essential, as they help both specialists and residents create strategies that can interfere in the dynamics of vector’s population and the contact between man and vectors.

  12. [Spatial and/or olfactory memory in sandflies in an endemic area for American cutaneous leishmaniasis, southern Brazil].

    Science.gov (United States)

    Freitas, Janaína Sales de; Reinhold-Castro, Kárin Rosi; Casanova, Cláudio; Silva, Joseane Padilha da; Previdelli, Isolde; Teodoro, Ueslei

    2009-01-01

    The results from an investigation on the possibility that sandflies in an endemic area for American cutaneous leishmaniasis, in the state of Paraná, may have memory are reported. Sandflies were caught in Recanto Marista, Doutor Camargo, State of Paraná, Brazil, using Falcão traps in two chicken sheds (G1 and G2), between November 15 and 26, 2007. A total of 2,080 sandflies were caught (1,000 in G1 and 1,080 in G2) and these were marked and released. Nyssomyia neivai was the most (90.5%) frequent species. Out of the total released, 168 sandflies (8%) were recaptured and the recapture rate in G2 was significant. The results show that it is possible that spatial or olfactory memory and/or host loyalty exists, and that this will guide the sandflies in recognizing the places where sources of blood are available.

  13. Hourly activity of Lutzomyia neivai in the endemic zone of cutaneous leishmaniasis in Tucumán, Argentina: preliminary results

    Directory of Open Access Journals (Sweden)

    Ana Denise Fuenzalida

    2011-08-01

    Full Text Available In the present work, the hourly activity of Lutzomyia neivai was studied in the southern part of the province of Tucumán, Argentina, in an area of transmission of cutaneous leishmaniasis during two months of higher activity. In addition, the variables that influenced the abundance of Lu. neivai were evaluated. A total of 1,146 individuals belonging to Lu. neivai (97% and Lutzomyia migonei (3% were captured. The hourly activity of Lu. neivai was mainly nocturnal, with a bimodal pattern in both months. In January, the variable that most influenced the abundance of Lu. neivai was the temperature, whereas in April, that variable was humidity. These results may contribute to the design of anti-vectorial control measures at a micro-focal scale.

  14. American cutaneous leishmaniasis in dogs from an endemic urban area in Cianorte municipality, Paraná State, Brazil

    Directory of Open Access Journals (Sweden)

    DA Cerino

    2010-01-01

    Full Text Available American cutaneous leishmaniasis (ACL was investigated in dogs from an urban endemic area in Cianorte, Paraná state, Brazil. Of 169 studied dogs, none presented suspected ACL lesions. Eleven animals (6.6% had anti-Leishmania braziliensis antibodies (titers > 40 detected by the immunofluorescent antibody test (IFAT while four (2.4% showed L. braziliensis-complex DNA by the polymerase chain reaction (PCR. Although no associations were found between IFAT or PCR results and age, sex, origin, free-roaming animals or length of residence at the address, the majority of IFAT- or PCR-positive dogs were from the urban area of the city and were allowed to roam freely beyond their neighborhood. The presence of anti-Leishmania braziliensis antibodies and L. braziliensis-complex DNA in dogs from this urban area near a native-forest park indicates the importance of following up on these dogs to confirm the ACL diagnosis.

  15. Integrated Tools for American Cutaneous Leishmaniasis Surveillance and Control: Intervention in an Endemic Area in Rio de Janeiro, RJ, Brazil

    Science.gov (United States)

    Gouveia, Cheryl; de Oliveira, Rosely Magalhães; Zwetsch, Adriana; Motta-Silva, Daniel; Carvalho, Bruno Moreira; de Santana, Antônio Ferreira; Rangel, Elizabeth Ferreira

    2012-01-01

    American cutaneous leishmaniasis (ACL) is a focal disease whose surveillance and control require complex actions. The present study aimed to apply integrated tools related to entomological surveillance, environmental management, and health education practices in an ACL-endemic area in Rio de Janeiro city, RJ, Brazil. The distribution of the disease, the particular characteristics of the localities, and entomological data were used as additional information about ACL determinants. Environmental management actions were evaluated after health education practices. The frequency of ACL vectors Lutzomyia (N.) intermedia and L. migonei inside and outside houses varied according to environment characteristics, probably influenced by the way of life of the popular groups. In this kind of situation environmental management and community mobilization become essential, as they help both specialists and residents create strategies that can interfere in the dynamics of vector's population and the contact between man and vectors. PMID:22988458

  16. In Vitro and In Vivo Evaluation of Essential Oil from Artemisia absinthium L. Formulated in Nanocochleates against Cutaneous Leishmaniasis.

    Science.gov (United States)

    Tamargo, Beatriz; Monzote, Lianet; Piñón, Abel; Machín, Laura; García, Marley; Scull, Ramón; Setzer, William N

    2017-06-09

    Background: Leishmaniasis is a zoonotic disease caused by protozoan parasites from Leishmania genus. Currently, there are no effective vaccines available and the available therapies are far from ideal. In particular, the development of new therapeutic strategies to reduce the infection caused by Leishmania amazonensis could be considered desirable. Different plant-derived products have demonstrated antileishmanial activity, including the essential oil (EO) from Artemisia absinthium L. (EO-Aa), Asteraceae. Methods: In the present study, the EO-Aa formulated in nanocochleates (EO-Aa-NC) was investigated in vitro against intracellular amastigotes of L. amazonensis and non-infected macrophages from BALB/c mice. In addition, the EO-Aa-NC was also evaluated in vivo against on experimental cutaneous leishmaniasis, which body weight, lesion progression, and parasite load were determined. Results: EO-Aa-NC displayed IC 50 values of 21.5 ± 2.5 μg/mL and 27.7 ± 5.6 μg/mL against intracellular amastigotes of L. amazonensis and non-infected peritoneal macrophage, respectively. In the animal model, the EO-Aa-NC (30 mg/kg/intralesional route/every 4 days 4 times) showed no deaths or weight loss greater than 10%. In parallel, the EO-Aa-NC suppressed the infection in the murine model by approximately 50%, which was statistically superior ( p 0.05) as administration of the reference drug. Conclusions: Encochleation of EO-Aa resulted in a stable, tolerable, and efficacious antileishmanial formulation, facilitating systemic delivery of EO, with increased activity compared to administration of the free EO-Aa. This new formulation shows promising potential to future studies aimed at a new therapeutic strategy to treat leishmaniasis.

  17. Genetic diversity of Leishmania donovani that causes cutaneous leishmaniasis in Sri Lanka: a cross sectional study with regional comparisons.

    Science.gov (United States)

    Kariyawasam, Udeshika Lakmini; Selvapandiyan, Angamuthu; Rai, Keshav; Wani, Tasaduq Hussain; Ahuja, Kavita; Beg, Mizra Adil; Premathilake, Hasitha Upendra; Bhattarai, Narayan Raj; Siriwardena, Yamuna Deepani; Zhong, Daibin; Zhou, Guofa; Rijal, Suman; Nakhasi, Hira; Karunaweera, Nadira D

    2017-12-22

    Leishmania donovani is the etiological agent of visceral leishmaniasis (VL) in the Indian subcontinent. However, it is also known to cause cutaneous leishmaniasis (CL) in Sri Lanka. Sri Lankan L. donovani differs from other L. donovani strains, both at the molecular and biochemical level. To investigate the different species or strain-specific differences of L. donovani in Sri Lanka we evaluated sequence variation of the kinetoplastid DNA (kDNA). Parasites isolated from skin lesions of 34 CL patients and bone marrow aspirates from 4 VL patients were genotyped using the kDNA minicircle PCR analysis. A total of 301 minicircle sequences that included sequences from Sri Lanka, India, Nepal and six reference species of Leishmania were analyzed. Haplotype diversity of Sri Lankan isolates were high (H d  = 0.757) with strong inter-geographical genetic differentiation (F ST  > 0.25). In this study, L. donovani isolates clustered according to their geographic origin, while Sri Lankan isolates formed a separate cluster and were clearly distinct from other Leishmania species. Within the Sri Lankan group, there were three distinct sub-clusters formed, from CL patients who responded to standard antimony therapy, CL patients who responded poorly to antimony therapy and from VL patients. There was no specific clustering of sequences based on geographical origin within Sri Lanka. This study reveals high levels of haplotype diversity of L. donovani in Sri Lanka with a distinct genetic association with clinically relevant phenotypic characteristics. The use of genetic tools to identify clinically relevant features of Leishmania parasites has important therapeutic implications for leishmaniasis.

  18. In Vitro and In Vivo Evaluation of Essential Oil from Artemisia absinthium L. Formulated in Nanocochleates against Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Beatriz Tamargo

    2017-06-01

    Full Text Available Background: Leishmaniasis is a zoonotic disease caused by protozoan parasites from Leishmania genus. Currently, there are no effective vaccines available and the available therapies are far from ideal. In particular, the development of new therapeutic strategies to reduce the infection caused by Leishmania amazonensis could be considered desirable. Different plant-derived products have demonstrated antileishmanial activity, including the essential oil (EO from Artemisia absinthium L. (EO-Aa, Asteraceae. Methods: In the present study, the EO-Aa formulated in nanocochleates (EO-Aa-NC was investigated in vitro against intracellular amastigotes of L. amazonensis and non-infected macrophages from BALB/c mice. In addition, the EO-Aa-NC was also evaluated in vivo against on experimental cutaneous leishmaniasis, which body weight, lesion progression, and parasite load were determined. Results: EO-Aa-NC displayed IC50 values of 21.5 ± 2.5 μg/mL and 27.7 ± 5.6 μg/mL against intracellular amastigotes of L. amazonensis and non-infected peritoneal macrophage, respectively. In the animal model, the EO-Aa-NC (30 mg/kg/intralesional route/every 4 days 4 times showed no deaths or weight loss greater than 10%. In parallel, the EO-Aa-NC suppressed the infection in the murine model by approximately 50%, which was statistically superior (p < 0.05 than controls and mice treated with EO-Aa. In comparison with Glucantime®, EO-Aa-NC inhibited the progression of infection as efficiently (p > 0.05 as administration of the reference drug. Conclusions: Encochleation of EO-Aa resulted in a stable, tolerable, and efficacious antileishmanial formulation, facilitating systemic delivery of EO, with increased activity compared to administration of the free EO-Aa. This new formulation shows promising potential to future studies aimed at a new therapeutic strategy to treat leishmaniasis.

  19. [Cutaneous leishmaniasis cases in Nizip, Turkey after the Syrian civil war].

    Science.gov (United States)

    Salman, Ismail Serkan; Vural, Ahmet; Unver, Ahmet; Saçar, Suzan

    2014-01-01

    Cutaneous leishmaniasis (CL), seen endemically in many countries, is a widespread protozoon disease all around the world. The neighboring countries of Turkey namely Iran, Iraq and Syria are highly endemic regions for CL, and more than 98% of the cases in Turkey are reported from South and Southeastern Anatolian regions. The aim of this study was to detect the prevalence of CL in Nizip, a district of Gaziantep province of southeastern Turkey, for three and half year period and to call attention to the dramatic increase of CL cases observed after the Syrian civil war. A total of 416 samples obtained from clinically suspected CL patients (of them 341 were Syrian refugees) who were admitted to Nizip State Hospital between January 1st 2010 and March 19th 2013 were included in the study. Lesion samples were collected according to the notice issued by Turkish Ministry of Health and Giemsa-stained smears were examined under the microscope (x1000). Samples from 77 patients (18.5%) yielded positive results with the observation of Leishmania amastigote forms. Fourty-seven (61%) of patients were female and 30 (39%) were male. Of the positive patients 52 (67.5%) belonged to 0-19 age group, 13 (16.9%) 20-39 and 12 (15.6%) 40-60 age groups. In the evaluation of the lesion characteristics, 33 (43%) patients had single and 44 (57%) had multiple lesions with a distribution mainly on face, arm and lower extremities, in a decreasing order. The period of time for the development of the lesions varied from 1.5 month to one year with the mean value of 3.4 months. There was no statistically significant relationship between the age and gender of patients, and the characteristics (quantity, distribution and time of occurence) of lesions (p> 0.05). The number of domestic and Syrian CL cases detected in Nizip in the years of 2010, 2011, 2012 and 2013 (the first three months) were as follows; 1 and 0, 2 and 0, 7 and 0, 5 and 62, respectively. So a total of 62 (80.5%) and 15 (19.5%) of CL

  20. PANCREATIC TOXICITY AS AN ADVERSE EFFECT INDUCED BY MEGLUMINE ANTIMONIATE THERAPY IN A CLINICAL TRIAL FOR CUTANEOUS LEISHMANIASIS

    Directory of Open Access Journals (Sweden)

    Marcelo Rosandiski LYRA

    Full Text Available SUMMARY American tegumentary leishmaniasis is an infectious disease caused by a protozoan of the genus Leishmania. Pentavalent antimonials are the first choice drugs for cutaneous leishmaniasis (CL, although doses are controversial. In a clinical trial for CL we investigated the occurrence of pancreatic toxicity with different schedules of treatment with meglumine antimoniate (MA. Seventy-two patients were allocated in two different therapeutic groups: 20 or 5 mg of pentavalent antimony (Sb5+/kg/day for 20 or 30 days, respectively. Looking for adverse effects, patients were asked about abdominal pain, nausea, vomiting or anorexia in each medical visit. We performed physical examinations and collected blood to evaluate serum amylase and lipase in the pre-treatment period, and every 10 days during treatment and one month post-treatment. Hyperlipasemia occurred in 54.8% and hyperamylasemia in 19.4% patients. Patients treated with MA 20 mg Sb5+ presented a higher risk of hyperlipasemia (p = 0.023. Besides, higher MA doses were associated with a 2.05 higher risk ratio (p = 0.003 of developing more serious (moderate to severe hyperlipasemia. The attributable fraction was 51% in this group. Thirty-six patients presented abdominal pain, nausea, vomiting or anorexia but only 47.2% of those had hyperlipasemia and/ or hyperamylasemia. These findings suggest the importance of the search for less toxic therapeutic regimens for the treatment of CL.

  1. Epidemiological aspects of American cutaneous leishmaniasis (ACL) in an endemic area of forest extractivist culture in western Brazilian Amazonia.

    Science.gov (United States)

    Brilhante, Andreia Fernandes; Melchior, Leonardo Augusto Kohatsu; Nunes, Vânia Lúcia Brandão; Cardoso, Cristiane de Oliveira; Galati, Eunice Aparecida Bianchi

    2017-04-13

    The study sought to analyze clinical and epidemiological aspects of cutaneous leishmaniasis (CL) in Xapuri, Acre, Brazil. Data from 2008 to 2014 registered in the notification records of the disease of the Information System of the Complaints of Notification (SINAN), and the data of the Information Department of the Unified Health System (DATASUS) available from 2007 to 2013 were used and analyzed in the light of the statistics of the temporal series by the Prais-Winsten method and chi-squared test. A total of 906 cases were registered with 60.2% occurring in men and 39.7% in women. The groups from 0 to 4 years of age (48.0%) and from 5 to 19 years of age (23.3%) were the most affected. Regarding the clinical forms, 77.7% presented CL and 22.3% mucocutaneous leishmaniasis (MCL). Among the 896 cases with information on the diagnostic methods used, Montenegro's skin test predominated (66.4%), with a positive result of 95.8% for CL and 99.3% for MCL. Treatment with N-methylglucamine antimony was performed in 99.4% of the cases, but discontinuously used in the majority of patients. This study presents information which may be used as a tool for the epidemiological surveillance and control of the disease in Xapuri, a region which depends essentially on forest resources and ecological tourism.

  2. Epidemiological aspects of American cutaneous leishmaniasis (ACL in an endemic area of forest extractivist culture in western Brazilian Amazonia

    Directory of Open Access Journals (Sweden)

    Andreia Fernandes Brilhante

    Full Text Available ABSTRACT The study sought to analyze clinical and epidemiological aspects of cutaneous leishmaniasis (CL in Xapuri, Acre, Brazil. Data from 2008 to 2014 registered in the notification records of the disease of the Information System of the Complaints of Notification (SINAN, and the data of the Information Department of the Unified Health System (DATASUS available from 2007 to 2013 were used and analyzed in the light of the statistics of the temporal series by the Prais-Winsten method and chi-squared test. A total of 906 cases were registered with 60.2% occurring in men and 39.7% in women. The groups from 0 to 4 years of age (48.0% and from 5 to 19 years of age (23.3% were the most affected. Regarding the clinical forms, 77.7% presented CL and 22.3% mucocutaneous leishmaniasis (MCL. Among the 896 cases with information on the diagnostic methods used, Montenegro’s skin test predominated (66.4%, with a positive result of 95.8% for CL and 99.3% for MCL. Treatment with N-methylglucamine antimony was performed in 99.4% of the cases, but discontinuously used in the majority of patients. This study presents information which may be used as a tool for the epidemiological surveillance and control of the disease in Xapuri, a region which depends essentially on forest resources and ecological tourism.

  3. Anthropogenic influence on the distribution, abundance and diversity of sandfly species (Diptera: Phlebotominae: Psychodidae, vectors of cutaneous leishmaniasis in Panama

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    Anayansi Valderrama

    2011-12-01

    Full Text Available In Panama, species of the genus Lutzomyia are vectors of American cutaneous leishmaniasis (ACL. There is no recent ecological information that may be used to develop tools for the control of this disease. Thus, the goal of this study was to determine the composition, distribution and diversity of Lutzomyia species that serve as vectors of ACL. Sandfly sampling was conducted in forests, fragmented forests and rural environments, in locations with records of ACL. Lutzomyia gomezi, Lutzomyia panamensis and Lutzomyia trapidoi were the most widely distributed and prevalent species. Analysis of each sampling point showed that the species abundance and diversity were greatest at points located in the fragmented forest landscape. However, when the samples were grouped according to the landscape characteristics of the locations, there was a greater diversity of species in the rural environment locations. The Kruskal Wallis analysis of species abundance found that Lu. gomezi and Lu. trapidoi were associated with fragmented environments, while Lu. panamensis, Lutzomyia olmeca bicolor and Lutzomyia ylephiletor were associated with forested environments. Therefore, we suggest that human activity influences the distribution, composition and diversity of the vector species responsible for leishmaniasis in Panama.

  4. Polymorphisms in the TOLLIP Gene Influence Susceptibility to Cutaneous Leishmaniasis Caused by Leishmania guyanensis in the Amazonas State of Brazil.

    Science.gov (United States)

    de Araujo, Felipe Jules; da Silva, Luan Diego Oliveira; Mesquita, Tirza Gabrielle; Pinheiro, Suzana Kanawati; Vital, Wonei de Seixas; Chrusciak-Talhari, Anette; Guerra, Jorge Augusto de Oliveira; Talhari, Sinésio; Ramasawmy, Rajendranath

    2015-01-01

    The clinical outcome to Leishmania-infection is determined by the individual adaptive immune T helper cell responses and their interactions with parasitized host cells. An early development of a proinflammatory immune response (Th1 response) is necessary for Leishmania-infection resolution. The Toll-interacting protein (TOLLIP) regulates human Toll-like receptors signaling pathways by down regulating the proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) and inducing the ant-inflammatory cytokine interleukin-10 (IL-10). Polymorphisms in the TOLLIP gene are associated with infectious diseases. The polymorphisms rs5743899 and rs3750920 in the TOLLIP gene were genotyped by polymerase chain reaction and restriction fragment length polymorphism (RFLP) analysis in 631 patients with cutaneous leishmaniasis (CL) caused by L. guyanensis and 530 individuals with no history of leishmaniasis. The G and T alleles of the rs5743899 and rs3750920 were more common in patients with CL than in healthy individuals (P = 2.6 x10(-8) ; odds ratio [OR], 1.7 [ 95% confidence interval (CI) 1.4-2.0] and P = 1.9 x10(-8) ; OR, 1.6 [95% CI 1.4-1.9] respectively). The r2 and D' linkage disequilibrium between the two polymorphisms are 0.05 and 0.473 with a confidence bounds of 0.37 to 0.57 respectively. The two polymorphisms are independently associated with an increased risk of developing CL.

  5. Control of Cutaneous Leishmaniasis Using Deltamethrin Treated Nets in Comparison to Indoors Residual Spraying in a Rural Area of Iran.

    Science.gov (United States)

    Kayedi, Mohammad Hassan; Rassi, Yavar; Chegeni-Sharafi, Ali; Rostami, Reza; Rafizadeh, Sayena; Abdali, Nargess

    2017-06-01

    Cutaneous leishmaniasis (CL) is an important vector-borne disease in Iran. The present study aimed to evaluate the efficacy of Deltamethrin treated nets in comparison to Indoors Residual Spraying (IRS) for the control of leishmaniasis in a new focal area of Iran. The study was carried out in 5 villages in the west of Iran during 2012-2013. One village was selected to the application of Insecticide Treated Nets (ITNs, 25 mg/m 2 deltamethrin) among residents. Four other villages were considered for IRS using deltamethrin emulsion, 2.5% EG and Aicon 10WP. Spraying was repeated after 3 month. Other control methods e.g. environmental managements, and treatment of positive cases were carried out in all villages. After 1 yr of trial, the cases of disease reduced from 50 to 2 and 128 to 5 for ITNs distributed nets and use of IRS in the villages, respectively. Reduction of CL cases in both methods were significant ( P <0.001).

  6. Anthropogenic influence on the distribution, abundance and diversity of sandfly species (Diptera: Phlebotominae: Psychodidae), vectors of cutaneous leishmaniasis in Panama.

    Science.gov (United States)

    Valderrama, Anayansi; Tavares, Mara Garcia; Andrade Filho, José Dilermando

    2011-12-01

    In Panama, species of the genus Lutzomyia are vectors of American cutaneous leishmaniasis (ACL). There is no recent ecological information that may be used to develop tools for the control of this disease. Thus, the goal of this study was to determine the composition, distribution and diversity of Lutzomyia species that serve as vectors of ACL. Sandfly sampling was conducted in forests, fragmented forests and rural environments, in locations with records of ACL. Lutzomyia gomezi, Lutzomyia panamensis and Lutzomyia trapidoi were the most widely distributed and prevalent species. Analysis of each sampling point showed that the species abundance and diversity were greatest at points located in the fragmented forest landscape. However, when the samples were grouped according to the landscape characteristics of the locations, there was a greater diversity of species in the rural environment locations. The Kruskal Wallis analysis of species abundance found that Lu. gomezi and Lu. trapidoi were associated with fragmented environments, while Lu. panamensis, Lutzomyia olmeca bicolor and Lutzomyia ylephiletor were associated with forested environments. Therefore, we suggest that human activity influences the distribution, composition and diversity of the vector species responsible for leishmaniasis in Panama.

  7. Development, Characterization, and In Vitro Biological Performance of Fluconazole-Loaded Microemulsions for the Topical Treatment of Cutaneous Leishmaniasis

    Science.gov (United States)

    Graminha, Márcia; Cerecetto, Hugo; González, Mercedes

    2015-01-01

    Cutaneous leishmaniasis (CL) is a resistant form of leishmaniasis that is caused by a parasite belonging to the genus Leishmania. FLU-loaded microemulsions (MEs) were developed by phase diagram for topical administration of fluconazole (FLU) as prominent alternative to combat CL. Three MEs called F1, F2, and F3 (F1—60% 50 M phosphate buffer at pH 7.4 (PB) as aqueous phase, 10% cholesterol (CHO) as oil phase, and 30% soy phosphatidylcholine/oil polyoxyl-60 hydrogenated castor oil/sodium oleate (3/8/6) (S) as surfactant; F2—50% PB, 10% CHO, and 40% S; F3—40% PB, 10% CHO, and 50 % S) were characterized by droplet size analysis, zeta potential analysis, X-ray diffraction, continuous flow, texture profile analysis, and in vitro bioadhesion. MEs presented pseudoplastic flow and thixotropy was dependent on surfactant concentration. Droplet size was not affected by FLU. FLU-loaded MEs improved the FLU safety profile that was evaluated using red cell haemolysis and in vitro cytotoxicity assays with J-774 mouse macrophages. FLU-unloaded MEs did not exhibit leishmanicidal activity that was performed using MTT colourimetric assays; however, FLU-loaded MEs exhibited activity. Therefore, these MEs have potential to modulate FLU action, being a promising platform for drug delivery systems to treat CL. PMID:25650054

  8. Morphological and immunohistochemical clues for the diagnosis of cutaneous leishmaniasis and the interpretation of CD1a status.

    Science.gov (United States)

    Fernandez-Flores, Angel; Rodriguez-Peralto, José Luis

    2016-03-01

    CD1a immunoexpression by amastigotes of Leishmania major and L tropica has been demonstrated. We studied the CD1a and the langerin status of amastigotes in cases of L infantum. We investigated 19 cases of cutaneous leishmaniasis. All cases were immunostained with CD1a, langerin, and CD68. We also studied 4 cases of visceral leishmaniasis. We found expression of CD1a by amastigotes in all of these 19 cases. CD1a(-) amastigotes are found in reticular areas of the dermis. The pattern of CD1a immunostaining of amastigotes is characteristic, with peripheral positivity, a negative nucleus in the center, and reinforcement of the kinetoplast in 1 pole. Leishmania amastigotes were langerin-negative. Visceral Leishmania amastigotes also express CD1a. Our study was limited because it only included cases of infection by L infantum. (1) L infantum is CD1a(+), (2) the pattern of CD1a immunostaining of amastigotes is peculiar, (3) CD1a(-) amastigotes are found in reticular areas of the dermis, and (4) visceral Leishmania amastigotes also express CD1a. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  9. The Role of Histopathology and Immunohistochemistry in the Diagnosis of Cutaneous Leishmaniasis Without "Discernible" Leishman-Donovan Bodies.

    Science.gov (United States)

    Dias-Polak, David; Geffen, Yuval; Ben-Izhak, Ofer; Bergman, Reuven

    2017-12-01

    Histopathology plays an important role in the diagnosis of cutaneous leishmaniasis (CL) but Leishman-Donovan (LD) bodies may not always be discernible. Recently, anti-CD1a antibody (Ab), clone MTB1, was found to decorate LD bodies immunohistochemically. Can histopathology without discernible LD bodies be used to diagnose CL, and can immunohistochemistry using anti-CD1a Ab, clone MTB1, detect LD bodies in these cases. Suspected CL lesions were studied histopathologically and immunohistochemically, and the patients' clinical files were reviewed. Of the 196 patients with suspected CL, direct smear demonstrated LD bodies in 50 (25.5%). Of the remaining 146 patients, 118 underwent biopsy. In 56 (47.5%) patients, the hematoxylin-eosin-stained sections revealed LD bodies. In 47 (39.8%) patients, LD bodies were not discerned but the histopathology demonstrated histiocytic infiltrates with varying numbers of plasma cells along with other inflammatory cells, and negative Ziehl-Neelsen and periodic acid-Schiff stains. This pattern was termed "histopathology consistent with leishmaniasis." The history, clinical findings, and response to anti-leishmania therapy supported the diagnosis of CL in all of them, and immunostains for CD1a, clone MTB1, detected LD bodies in 11 (23.4%) of these 47 patients. "Histopathology consistent with CL" along with appropriate clinical findings supports the diagnosis of CL in an endemic area, and immunostains with CD1a Ab, clone MTB1, may help in the minority of the cases.

  10. The role of the P2X7 receptor in murine cutaneous leishmaniasis: aspects of inflammation and parasite control.

    Science.gov (United States)

    Figliuolo, Vanessa Ribeiro; Chaves, Suzana Passos; Savio, Luiz Eduardo Baggio; Thorstenberg, Maria Luiza Prates; Machado Salles, Érika; Takiya, Christina Maeda; D'Império-Lima, Maria Regina; de Matos Guedes, Herbert Leonel; Rossi-Bergmann, Bartira; Coutinho-Silva, Robson

    2017-06-01

    Leishmania amazonensis is the etiological agent of diffuse cutaneous leishmaniasis. The immunopathology of leishmaniasis caused by L. amazonensis infection is dependent on the pathogenic role of effector CD4 + T cells. Purinergic signalling has been implicated in resistance to infection by different intracellular parasites. In this study, we evaluated the role of the P2X7 receptor in modulating the immune response and susceptibility to infection by L. amazonensis. We found that P2X7-deficient mice are more susceptible to L. amazonensis infection than wild-type (WT) mice. P2X7 deletion resulted in increased lesion size and parasite load. Our histological analysis showed an increase in cell infiltration in infected footpads of P2X7-deficient mice. Analysis of the cytokine profile in footpad homogenates showed increased levels of IFN-γ and decreased TGF-β production in P2X7-deficient mice, suggesting an exaggerated pro-inflammatory response. In addition, we observed that CD4 + and CD8 + T cells from infected P2X7-deficient mice exhibit a higher proliferative capacity than infected WT mice. These data suggest that P2X7 receptor plays a key role in parasite control by regulating T effector cells and inflammation during L. amazonensis infection.

  11. Cutaneous leishmaniasis caused by Leishmania donovani in the tribal population of the Agasthyamala Biosphere Reserve forest, Western Ghats, Kerala, India.

    Science.gov (United States)

    Kumar, N Pradeep; Srinivasan, R; Anish, T S; Nandakumar, G; Jambulingam, P

    2015-02-01

    Cutaneous leishmaniasis (CL), a neglected tropical disease, is reported to be prevalent in tribal villages located in the Agasthyamala Biosphere Reserve forests of Western Ghats, Kerala state, India. We carried out an investigation to characterize the species of Leishmania parasites involved in these infections prevalent among one of the oldest human tribal populations in India. Skin aspirates collected from 13 clinically diagnosed cases were subjected to histopathological investigations, serological rapid tests using 'rk39' and molecular diagnostics. Clinical manifestations recorded among the patients were hypo-pigmented erythematous nodules/papules on limbs and other parts of the body. Histopathological investigations of these skin lesions among patients showed Leishman-Donovan bodies in macrophages. None of the patients were found to be positive for rk39 tests, which detect active visceral leishmaniasis. Using three different genetic markers [kinetoplast minicircle DNA, 3' UTR region of heat-shock protein 70 (Hsp70) and Hsp70 gene] we identified the parasite species involved in these infections to be Leishmania donovani. The 6-phosphogluconate (6-PGDH) gene sequences of the parasite isolates from Western Ghats indicated close genetic relatedness to L. donovani isolates reported from Sri Lanka, also causing CL. This could be cited as another instance of 'local endemism' of organisms in this single 'bio-geographic unit'. © 2015 The Authors.

  12. A two years study on vectors of cutaneous Leishmaniasis. Evidence for sylvatic transmission cycle in the state of Campeche, Mexico.

    Science.gov (United States)

    Rebollar-Téllez, E A; Ramírez-Fraire, A; Andrade-Narvaez, F J

    1996-01-01

    Vectors of cutaneous leishmaniasis in the State of Campeche were studied in relation to the transmission cycle of Leishmania (Le.) mexicana. To determine how transmission of leishmaniasis occurs, we collected phlebotomine sand flies for two years. In the first year (October 1990 to November 1991) the collections were made with CDC light traps, Shannon traps and direct captures at natural shelters around the village (La Libertad. In the second year (February 1993 to January 1994) the catches were performed at 8 km southeast of La Libertad in the forest. Female sand flies were examined for Leishmania. During the first year, 347 sand flies of nine species were collected, most of which were Lutzomyia deleoni (61.3%). When all nine species were considered, more females than males were captured. Low densities of anthropophillic species of sand flies around the village indicated that sylvatic transmission was taking place. For the second year. 1484 sand flies of 16 species were caught. The most common were L. olmeca olmeca (21.7%), L. cruciata (19.2%) and L. ovallesi (14.1%). Similarly, more females were caught than males. Thirty-five females of five species were found infected with flagellates believed to be Leishmania sp. The highest infection rate was found in L. olmeca olmeca (7.1%) followed by L. cruciata (4.5%) and L. ovallesi (1.1%). These data plus other evidence on the epidemiology of human cases and results from reservoir studies are discussed in relation to the sylvatic transmission cycle.

  13. Pomegranate (Punica granatum Juice Shows Antioxidant Activity against Cutaneous Leishmaniasis-Induced Oxidative Stress in Female BALB/c Mice

    Directory of Open Access Journals (Sweden)

    Badriah Alkathiri

    2017-12-01

    Full Text Available Leishmania species are parasites that multiply within phagocytes and cause several clinical diseases characterized by single or multiple ulcerations. One of the complications that can induce tissue damage and the resulting scars is caused by secondary bacterial infections. Studies to find new, effective, and safe oral drugs for treating leishmaniasis are being conducted since several decades, owing to the problems associated with the use of antimonials available. Previously, the antiparasitic and antioxidant properties of Punica granatum (pomegranate, P. granatum have been reported. Therefore, in the present study, we aimed to investigate the antileishmanial activity of pomegranate aqueous juice in vitro and in female BALB/c mice. A 3-(4.5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide (MTT assay in Leishmania major promastigotes and alterations in the antioxidant status, liver function, and skin histological changes in L. major-infected mice orally treated with pomegranate juice alone and in combination with the antibiotic ciprofloxacin, were used to investigate the in vitro and in vivo antileishmanial activity of pomegranate juice, respectively. Oral P. granatum juice treatment significantly reduced the average size of cutaneous leishmaniasis lesions compared with that of the untreated mice. This antileishmanial activity of P. granatum was associated with enhanced antioxidant enzyme activities. Histopathological evaluation proved the antileishmanial activity of P. granatum, but did not reveal changes in the treated animals, compared to the positive control. In conclusion, P. granatum shows high and fast antileishmanial activity probably by boosting the endogenous antioxidant activity.

  14. Pomegranate (Punica granatum) Juice Shows Antioxidant Activity against Cutaneous Leishmaniasis-Induced Oxidative Stress in Female BALB/c Mice.

    Science.gov (United States)

    Alkathiri, Badriah; El-Khadragy, Manal F; Metwally, Dina M; Al-Olayan, Ebtesam M; Bakhrebah, Muhammed A; Abdel Moneim, Ahmed E

    2017-12-18

    Leishmania species are parasites that multiply within phagocytes and cause several clinical diseases characterized by single or multiple ulcerations. One of the complications that can induce tissue damage and the resulting scars is caused by secondary bacterial infections. Studies to find new, effective, and safe oral drugs for treating leishmaniasis are being conducted since several decades, owing to the problems associated with the use of antimonials available. Previously, the antiparasitic and antioxidant properties of Punica granatum (pomegranate, P. granatum ) have been reported. Therefore, in the present study, we aimed to investigate the antileishmanial activity of pomegranate aqueous juice in vitro and in female BALB/c mice. A 3-(4.5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay in Leishmania major promastigotes and alterations in the antioxidant status, liver function, and skin histological changes in L. major -infected mice orally treated with pomegranate juice alone and in combination with the antibiotic ciprofloxacin, were used to investigate the in vitro and in vivo antileishmanial activity of pomegranate juice, respectively. Oral P. granatum juice treatment significantly reduced the average size of cutaneous leishmaniasis lesions compared with that of the untreated mice. This antileishmanial activity of P. granatum was associated with enhanced antioxidant enzyme activities. Histopathological evaluation proved the antileishmanial activity of P. granatum , but did not reveal changes in the treated animals, compared to the positive control. In conclusion, P. granatum shows high and fast antileishmanial activity probably by boosting the endogenous antioxidant activity.

  15. Development, Characterization, and In Vitro Biological Performance of Fluconazole-Loaded Microemulsions for the Topical Treatment of Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Marcela Brito Oliveira

    2015-01-01

    Full Text Available Cutaneous leishmaniasis (CL is a resistant form of leishmaniasis that is caused by a parasite belonging to the genus Leishmania. FLU-loaded microemulsions (MEs were developed by phase diagram for topical administration of fluconazole (FLU as prominent alternative to combat CL. Three MEs called F1, F2, and F3 (F1—60% 50 M phosphate buffer at pH 7.4 (PB as aqueous phase, 10% cholesterol (CHO as oil phase, and 30% soy phosphatidylcholine/oil polyoxyl-60 hydrogenated castor oil/sodium oleate (3/8/6 (S as surfactant; F2—50% PB, 10% CHO, and 40% S; F3—40% PB, 10% CHO, and 50 % S were characterized by droplet size analysis, zeta potential analysis, X-ray diffraction, continuous flow, texture profile analysis, and in vitro bioadhesion. MEs presented pseudoplastic flow and thixotropy was dependent on surfactant concentration. Droplet size was not affected by FLU. FLU-loaded MEs improved the FLU safety profile that was evaluated using red cell haemolysis and in vitro cytotoxicity assays with J-774 mouse macrophages. FLU-unloaded MEs did not exhibit leishmanicidal activity that was performed using MTT colourimetric assays; however, FLU-loaded MEs exhibited activity. Therefore, these MEs have potential to modulate FLU action, being a promising platform for drug delivery systems to treat CL.

  16. Fauna and Monthly Activity of Sand flies in The Focus of Cutaneous Leishmaniasis in Bushehr District (2007-2008

    Directory of Open Access Journals (Sweden)

    Abdolrasoul Forouzani

    2011-04-01

    Full Text Available Background: Cutaneous Leishmaniasis is one of the endemic diseases in Bushehr Province, which its prevalence has increased in some districts, as well as Bushehr district recently. This is essential to access minute information about epidemiology of diseases (Parasite, Vector, Reservior, in order to achieve effective control of disease. One of the basic information in respect of controlling measures, is the knowledge and information of fauna and monthly activities of vectors which is essential, because ignoring of different biological aspects of vectors, could cause failure to control strategies. Methods: This is a descriptive- cross sectional study, carried out in four villages of Bushehr district (2007-2008 which were affected by cutaneous Leishmaniasis. Sand flies were collected by standard sticky traps, and identified by electric microscope, using reliable identification keys. Results: Sixteen species. (six Phelebotomus and ten Sergentomyia were identified from a total of 15952 sand flies caught for this study, out of which eight species are reported for the first time in Bushehr district, namely: Phelobotomus mongolensis, P.caucasicus, P.ansari, Sergentomyia tiberiadis, S.clydei, S.antenata, S.iranica, S.palestiensis. Monthly activity of sand flies starts in mid March and ends by the end of December. The peack of sand flies monthly activities is in June, while the peack activity of P.papatasi is in the end of July. Conclusion: Considering nine months activity period of sand flies in Bushehr district, and their peack of activities, specially for P.paptasi, it is suggested that the controlling measures to be administrated in July.

  17. Treatment of cutaneous leishmaniasis with aminosidine (paromomycin) ointment: double-blind, randomized trial in the Islamic Republic of Iran.

    Science.gov (United States)

    Asilian, A.; Jalayer, T.; Nilforooshzadeh, M.; Ghassemi, R. L.; Peto, R.; Wayling, S.; Olliaro, P.; Modabber, F.

    2003-01-01

    OBJECTIVE: To compare the parasitological and clinical efficacy of four weeks versus two weeks of treatment with aminosidine (paromomycin) ointment in patients with cutaneous leishmaniasis caused by Leishmania major in the Islamic Republic of Iran. METHODS: Double-blind, randomized trial of four weeks of aminosidine ointment (n = 108) vs two weeks of aminosidine ointment and two weeks of placebo (n = 108). Patients were assessed on days 15, 29, 45, and 105 for clinical cures and clinical and parasitological cures. FINDINGS: Four weeks' treatment gave significantly better cure rates than two weeks' treatment: on day 29, there were 80/108 (74%) vs 64/108 (59%) clinical cures (P = 0.05) and 47 (44%) vs 26 (24%) clinical and parasitological cures (P = 0.005). By day 45, fewer patients who received four weeks' treatment had required rescue treatment with antimonials than those who received two weeks' treatment: 20 (19%) vs 36 (33%) (P = 0.02). On day 105, the results still favoured those who had been allocated four weeks of active treatment, but the differences were no longer as clearly significant. No side-effects were observed or reported. CONCLUSION: Approximately two-thirds of patients given ointment for four weeks were cured clinically. Although about half of those cured might have recovered spontaneously even without treatment, four weeks of aminosidine ointment could become the first-line treatment for uncomplicated cutaneous leishmaniasis due to L. major, with antimonials needed in only the one-third of patients not cured by the end of treatment with aminosidine. This would considerably reduce the costs and side-effects associated with antimonial drugs. PMID:12856053

  18. Isolated cutaneous leishmaniasis over face – A diagnostic dilemma

    African Journals Online (AJOL)

    Santosh K. Swain

    2016-01-08

    Jan 8, 2016 ... Leishmaniasis is a vector borne disease and caused by a kine- toplastid protozoan parasite. The parasite is transmitted from one patient to another through the bites of female sandfly, or occasionally through non-vector routes including congenital, blood transfusion, sexual, laboratory acquired and person-.

  19. Molecular epidemiological study of cutaneous leishmaniasis in the east north of Iran

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    Kazem Hassanpour

    2014-09-01

    Full Text Available Objective: To identify and study the epidemiology of Leishmania species isolated from patients with leishmaniasis by PCR method in Sabzevar, Khorasan Razavi Province, Iran. Methods: Aspirated samples from the lesions of 86 patients with confirmed leishmaniasis used for direct smear preparation. The samples are prepared and cultured in the Novy-MacNealNicolle and Roswell Park Memorial Institute-1640 culture mediums. After extraction of DNA by using phenol-chloroform, parasite kintoplast DNA gene amplification was done by using PCR. The electrophoresis pattern of each species was compared with standard species of Leishmania tropica (L. tropica and Leishmania major (L. major. Results: Results of PCR patterns of kintoplast DNA gene suggested that two types of L. tropica and L. major isolated from leishmaniasis patients in Sabzevar and their findings indicated that both species of parasites, L. tropica and L. major are prevalent in Sabzevar. Conclusions: According to this information, Sabzevar can be divided in two focal points of dry and dry-wet in terms of leishmaniasis, while it was previously known as the dry focal point. Likewise a significant relationship observed between Leishmania species to time distribution, type of lesion, amount of parasites and infection districts.

  20. Leishmaniasis and AIDS coinfection*

    Science.gov (United States)

    Hozannah, Adriana; Santos, Monica; Chrusciak-Talhari, Anette; Talhari, Carolina

    2013-01-01

    Cutaneous leishmaniasis and HIV coinfection has been reported in Brazil since the initial description of AIDS in the country. We report an HIV-positive patient under antiretroviral treatment who presented with cutaneous leishmaniasis which was successfully treated with meglumine antimoniate. PMID:24474115

  1. Tip of the iceberg: 18F-FDG PET/CT diagnoses extensively disseminated coccidioidomycosis with cutaneous lesions

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    Nia BB

    2017-07-01

    Full Text Available We present a case of an immunocompetent 27-year-old African American man who was initially diagnosed with diffuse pulmonary coccidioidomycosis and started on oral fluconazole. While his symptoms improved, he began to develop tender cutaneous lesions. Biopsies of the cutaneous lesions grew Coccidioides immitis. Subsequent 18F-FDG PET/CT revealed extensive multisystem involvement including the skin/subcutaneous fat, lungs, spleen, lymph nodes, and skeleton. This case demonstrates the utility of obtaining an 18F-FDG PET/CT to assess the disease extent and activity in patients with disseminated coccidioidomycosis who initially present with symptoms involving only the lungs.

  2. Demographic and spatio-temporal distribution of cutaneous leishmaniasis in the Souf oasis (Eastern South of Algeria): Results of 13 years.

    Science.gov (United States)

    Khezzani, Bachir; Bouchemal, Salah

    2017-02-01

    Cutaneous leishmaniasis is one of many dangerous parasitic diseases. It remains a serious public health problem not only in Souf oasis, but also in Algeria and all developing countries. The results of our thirteen-year study shows a recording of 4813 confirmed cases of cutaneous leishmaniasis and the details shows that this disease affects all municipalities and all age groups, from infants to elderly, but the most affected ones are teenagers aging (10-19) years with 1512 cases (31.41%) and infants less than 9 years old with 1237 cases (25.70%). In addition, males are more prone to this disease than females (65% and 35% respectively). Among the 18 municipalities in the Souf, the most affected were El-Oued with 1171 cases (24.33%) followed by Guemar with 997 cases (20.71%). Furthermore, more than 40.03% of all cases (1927 cases), were record just in one year in 2010. A parallel, this study shows that the original factors of the studied area, such as climatological, agricultural and environmental factors, was the reason do not apparition this epidemic for a long time, but the changes in these conditions, resulting from various human activities create new environmental conditions, which help with the emergence and spread of leishmaniasis disease. The effective fight against this disease should be based on the elimination of the vectors and reservoirs populations, by the overall improvement of sanitary conditions and hygiene, extensive research in epidemiology of leishmaniasis could also reduce the incidence of cutaneous leishmaniasis. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Evaluation of a direct immunofluorescent antibody (difma test using Leishmania genus - specific monoclonal antibody in the routine diagnosis of cutaneous leishmaniasis

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    Martha E. Chico

    1995-06-01

    Full Text Available A direct immunofluorescent antibody (DIFMA test using a Leishmania genus- specific monoclonal antibody was evaluated in the routine diagnosis of cutaneous leishmaniasis (CL in Ecuador. This test was compared with the standard diagnostic techniques of scrapings, culture and histology. Diagnostic samples were taken from a total of 90 active dermal ulcers from patients from areas of Ecuador known to be endemic for cutaneous leishmaniasis. DIFMA was positive in all lesions. It was shown to be significantly superior to standard diagnostic methods either alone or in combination. The sensitivity of DIFMA did not diminish with chronicity of lesions. This test proved to be extremely useful in the routine diagnosis of CL because it is highly sensitive, is easy to use and produces rapid results.

  4. Blood-meal identification in phlebotomine sand flies (Diptera: Psychodidae) from Valle Hermoso, a high prevalence zone for cutaneous leishmaniasis in Ecuador.

    Science.gov (United States)

    Anaguano, David F; Ponce, Patricio; Baldeón, Manuel E; Santander, Stephanie; Cevallos, Varsovia

    2015-12-01

    Cutaneous leishmaniasis is a neglected tropical disease transmitted by phlebotomine sand flies of the genus Lutzomyia. In South America, cutaneous leishmaniasis is endemic in the majority of countries. There are no previous reports of phlebotomine sand fly host feeding sources in Ecuador. We identified blood meal sources for phlebotomine sand fly species in Valle Hermoso, a hyper endemic area for leishmaniasis in Ecuador. Phlebotomine sand fly collections were carried out during the dry and rainy seasons. PCR and multiplex PCR were performed from DNA extracted from the abdomens of blood-fed females to specifically identify the avian and mammalian blood meal sources. Avian-blood (77%), mammalian-blood (16%) and mixed avian-mammalian blood (7%) were found in the samples. At the species level, blood from chickens (35.5%), humans (2.8%), cows (2.8%) and dogs (1.9%) was specifically detected. Nyssomyia trapidoi was the most common species of Lutzomyia found that fed on birds. The present results may aid the development of effective strategies to control leishmaniasis in Ecuador. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Cutaneous leishmaniasis in a mule (Equus caballus x Equus asinus) in a endemic area of the state of Rio de Janeiro

    OpenAIRE

    Aguilar, Cruz Manuel; Rangel, Elizabeth F.

    1986-01-01

    É relatado o encontro de infecção por parasitos do gênero Leishmania, em lesão cutânea de uma mula (Equus caballus x Equus asinus) procedente de uma localidade endêmica de leishmaniose tegumentar, no Estado do Rio de Janeiro.Leishmania parasites were found in a skin lesion of a mule (Equus caballus x Equus asinus) from a locality with endemic cutaneous leishmaniasis, in the state of Rio de Janeiro.

  6. Isolation and isoenzyme characterization of Leishmania (Viannia braziliensis from a case of human cutaneous leishmaniasis in northeast centre of the state of São Paulo

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    MC Pinto

    2005-11-01

    Full Text Available The diagnosis of human cutaneous leishmaniasis in small towns is sometimes made without the species identification of the Leishmania, even in areas without previous epidemiological surveys. Here we report the isolation of a Leishmania strain from a patient of Rincão, state of São Paulo, that was identified by isoenzyme characterization as L. (Viannia braziliensis. Sand fly collections were made in the area where the patient live in order to investigate the likely vector species.

  7. Inflammation in disseminated lesions: an analysis of CD4+, CD20+, CD68+, CD31+ and vW+ cells in non-ulcerated lesions of disseminated leishmaniasis

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    Dayana Santos Mendes

    2013-02-01

    Full Text Available Disseminated leishmaniasis (DL differs from other clinical forms of the disease due to the presence of many non-ulcerated lesions (papules and nodules in non-contiguous areas of the body. We describe the histopathology of DL non-ulcerated lesions and the presence of CD4-, CD20-, CD68-, CD31- and von Willebrand factor (vW-positive cells in the inflamed area. We analysed eighteen biopsies from non-ulcerated lesions and quantified the inflamed areas and the expression of CD4, CD20, CD68, CD31 and vW using Image-Pro software (Media Cybernetics. Diffuse lymphoplasmacytic perivascular infiltrates were found in dermal skin. Inflammation was observed in 3-73% of the total biopsy area and showed a significant linear correlation with the number of vW+ vessels. The most common cells were CD68+ macrophages, CD20+ B-cells and CD4+ T-cells. A significant linear correlation between CD4+ and CD20+ cells and the size of the inflamed area was also found. Our findings show chronic inflammation in all DL non-ulcerated lesions predominantly formed by macrophages, plasmacytes and T and B-cells. As the inflamed area expanded, the number of granulomas and extent of the vascular framework increased. Thus, we demonstrate that vessels may have an important role in the clinical evolution of DL lesions.

  8. Susceptibility Status of Phlebotomus Papatasi and P. Sergenti (Diptera: Psychodidae to DDT and Deltamethrin in a Focus of Cutaneous Leishmaniasis After Earthquake Strike in Bam, Iran

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    MA Oshaghi

    2011-12-01

    Full Text Available Background: The cutaneous leishmaniasis (CL has been occurred in Dehbakri County, located 46 km of Bam Dis­trict, Kerman Province since 2004–2005. Phlebotomus papatasi is an important vector of zoonotic cutaneous leishmanisis (ZCL as well as sand fly fever and P. sergenti is considered as main vector of anthroponotic cutaneous leishmaniasis (ACL in Iran. There are several measures for vector control with emphasizing on insecticides. The objective of this study was to determine the baseline susceptibility of leishmaniasis vectors to the DDT and del­tamethrin in an endemic focus of CL in southern Iran.Methods: Baseline susceptibility tests were carried out on field collected strains of P. papatasi and P. sergenti and tested with WHO impregnated papers with DDT 4.0% and deltamethrin 0.05% in the focus of disease in Dehbakri County during summer 2010. The values of LT50 and LT90 were determined using probit analysis and regression lines.Results: The LT50 value of DDT 4.0% and deltamethrin 0.05% against P. papatasi was 20.6 and 13.6 minutes re­spectively. The same data for P. sergenti were ranged between 21.8 and 17.7 minutes.Conclusion: The results of tests will provide a guideline for implementation of vector control using pesticides such as impregnated bed nets, indoor residual spraying and fogging.

  9. Primary cutaneous follicle center lymphoma associated with an extracutaneous dissemination: a cytogenetic finding of potential prognostic value.

    Science.gov (United States)

    Subramaniyam, Shivakumar; Magro, Cynthia M; Gogineni, Swarna; Tam, Wayne; Mathew, Susan

    2015-11-01

    Cytogenetic studies on cutaneous lymphomas are rare, and very little is known about their prognostic value. We present a rare case of primary cutaneous follicle center lymphoma (PCFCL) with a complex translocation presenting with cutaneous and extracutaneous dissemination in the lymph node. Morphologic, immunohistochemical, conventional cytogenetic, and fluorescence in situ hybridization (FISH) studies were performed on this patient. A combination of cytogenetic and FISH analysis identified a complex novel four-way t(2;14;9;3) (p11.2;q32;p13;q27) translocation involving rearrangements of BCL6, immunoglobulin light and heavy chain genes, and an unknown gene on 9p. Our report elaborates the morphologic and immunohistochemical features in combination with cytogenetic and molecular cytogenetic analysis of PCFCL, which provide additional insight into the clinical and biologic behavior of this lesion. Copyright© by the American Society for Clinical Pathology.

  10. Modeling zoonotic cutaneous leishmaniasis incidence in central Tunisia from 2009-2015: Forecasting models using climate variables as predictors.

    Science.gov (United States)

    Talmoudi, Khouloud; Bellali, Hedia; Ben-Alaya, Nissaf; Saez, Marc; Malouche, Dhafer; Chahed, Mohamed Kouni

    2017-08-01

    Transmission of zoonotic cutaneous leishmaniasis (ZCL) depends on the presence, density and distribution of Leishmania major rodent reservoir and the development of these rodents is known to have a significant dependence on environmental and climate factors. ZCL in Tunisia is one of the most common forms of leishmaniasis. The aim of this paper was to build a regression model of ZCL cases to identify the relationship between ZCL occurrence and possible risk factors, and to develop a predicting model for ZCL's control and prevention purposes. Monthly reported ZCL cases, environmental and bioclimatic data were collected over 6 years (2009-2015). Three rural areas in the governorate of Sidi Bouzid were selected as the study area. Cross-correlation analysis was used to identify the relevant lagged effects of possible risk factors, associated with ZCL cases. Non-parametric modeling techniques known as generalized additive model (GAM) and generalized additive mixed models (GAMM) were applied in this work. These techniques have the ability to approximate the relationship between the predictors (inputs) and the response variable (output), and express the relationship mathematically. The goodness-of-fit of the constructed model was determined by Generalized cross-validation (GCV) score and residual test. There were a total of 1019 notified ZCL cases from July 2009 to June 2015. The results showed seasonal distribution of reported ZCL cases from August to January. The model highlighted that rodent density, average temperature, cumulative rainfall and average relative humidity, with different time lags, all play role in sustaining and increasing the ZCL incidence. The GAMM model could be applied to predict the occurrence of ZCL in central Tunisia and could help for the establishment of an early warning system to control and prevent ZCL in central Tunisia.

  11. Interleukin 10-Dominant Immune Response and Increased Risk of Cutaneous Leishmaniasis After Natural Exposure to Lutzomyia intermedia Sand Flies.

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    Carvalho, Augusto M; Cristal, Juqueline R; Muniz, Aline C; Carvalho, Lucas P; Gomes, Regis; Miranda, José C; Barral, Aldina; Carvalho, Edgar M; de Oliveira, Camila I

    2015-07-01

    Leishmaniasis is caused by parasites transmitted to the vertebrate host by infected sand flies. During transmission, the vertebrate host is also inoculated with sand fly saliva, which exerts powerful immunomodulatory effects on the host's immune response. We conducted a prospective cohort analysis to characterize the human immune response to Lutzomyia intermedia saliva in 264 individuals, from an area for cutaneous leishmaniasis (CL) caused by Leishmania braziliensis. Antibodies were found in 150 individuals (56.8%); immunoglobulin G1 and G4 were the predominant subclasses. Recall responses to salivary gland sonicate showed elevated production of interleukin 10 (IL-10), interleukin 13, interferon γ, CXCL9, and CCL2 compared with controls. CD4(+)CD25(+) T cells, including Foxp3(+) cells, were the main source of IL-10. L. braziliensis replication was increased (P < .05) in macrophages cocultured with saliva-stimulated lymphocytes from exposed individuals and addition of anti-IL-10 reverted this effect. Positive correlation between antibody response to saliva and cellular response to Leishmania was not found. Importantly, individuals seropositive to saliva are 2.1 times more likely to develop CL (relative risk, 2.1; 95% confidence interval, 1.07-4.2; P < .05). Exposure to L. intermedia sand flies skews the human immune response, facilitating L. braziliensis survival in vitro, and increases the risk of developing CL. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  12. Modeling zoonotic cutaneous leishmaniasis incidence in central Tunisia from 2009-2015: Forecasting models using climate variables as predictors.

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    Khouloud Talmoudi

    2017-08-01

    Full Text Available Transmission of zoonotic cutaneous leishmaniasis (ZCL depends on the presence, density and distribution of Leishmania major rodent reservoir and the development of these rodents is known to have a significant dependence on environmental and climate factors. ZCL in Tunisia is one of the most common forms of leishmaniasis. The aim of this paper was to build a regression model of ZCL cases to identify the relationship between ZCL occurrence and possible risk factors, and to develop a predicting model for ZCL's control and prevention purposes. Monthly reported ZCL cases, environmental and bioclimatic data were collected over 6 years (2009-2015. Three rural areas in the governorate of Sidi Bouzid were selected as the study area. Cross-correlation analysis was used to identify the relevant lagged effects of possible risk factors, associated with ZCL cases. Non-parametric modeling techniques known as generalized additive model (GAM and generalized additive mixed models (GAMM were applied in this work. These techniques have the ability to approximate the relationship between the predictors (inputs and the response variable (output, and express the relationship mathematically. The goodness-of-fit of the constructed model was determined by Generalized cross-validation (GCV score and residual test. There were a total of 1019 notified ZCL cases from July 2009 to June 2015. The results showed seasonal distribution of reported ZCL cases from August to January. The model highlighted that rodent density, average temperature, cumulative rainfall and average relative humidity, with different time lags, all play role in sustaining and increasing the ZCL incidence. The GAMM model could be applied to predict the occurrence of ZCL in central Tunisia and could help for the establishment of an early warning system to control and prevent ZCL in central Tunisia.

  13. DNA Immunization with the Gene Encoding P4 Nuclease of Leishmania amazonensis Protects Mice against Cutaneous Leishmaniasis

    Science.gov (United States)

    Campbell, Kimberly; Diao, Hong; Ji, Jiaxiang; Soong, Lynn

    2003-01-01

    Infection with the protozoan parasite Leishmania amazonensis can cause diverse clinical forms of leishmaniasis. Immunization with purified P4 nuclease protein has been shown to elicit a protective response in mice challenged with L. amazonensis and L. pifanoi. To explore the potential of a DNA-based vaccine, we tested the L. amazonensis gene encoding P4 nuclease as well as adjuvant constructs encoding murine interleukin-12 (IL-12) and L. amazonensis HSP70. Susceptible BALB/c mice were immunized with the DNA encoding P4 alone, P4/IL-12, or P4/HSP70 prior to challenge with L. amazonensis promastigotes. Mice given P4/IL-12 exhibited no lesion development and had a 3- to 4-log reduction in tissue parasite burdens compared to controls. This protection corresponded to significant increases in gamma interferon and tumor necrosis factor alpha production and a reduction in parasite-specific immunoglobulin G1, suggesting an enhancement in Th1 responses. Moreover, we immunized mice with the L. amazonensis vaccines to determine if this vaccine regimen could provide cross-protection against a genetically diverse species, L. major. While the P4/HSP70 vaccine led to self-healing lesions, the P4/IL-12 vaccine provided negligible protection against L. major infection. This is the first report of successful use of a DNA vaccine to induce protection against L. amazonensis infection. Additionally, our results indicate that different vaccine combinations, including DNA encoding P4, HSP70, or IL-12, can provide significant protection against both Old World and New World cutaneous leishmaniasis. PMID:14573646

  14. Development and validation of PCR-based assays for diagnosis of American cutaneous leishmaniasis and identificatio nof the parasite species

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    Grazielle Cardoso da Graça

    2012-08-01

    Full Text Available In this study, PCR assays targeting different Leishmania heat-shock protein 70 gene (hsp70 regions, producing fragments ranging in size from 230-390 bp were developed and evaluated to determine their potential as a tool for the specific molecular diagnosis of cutaneous leishmaniasis (CL. A total of 70 Leishmania strains were analysed, including seven reference strains (RS and 63 previously typed strains. Analysis of the RS indicated a specific region of 234 bp in the hsp70 gene as a valid target that was highly sensitive for detection of Leishmania species DNA with capacity of distinguishing all analyzed species, after polymerase chain reaction-restriction fragment length polymorfism (PCR-RFLP. This PCR assay was compared with other PCR targets used for the molecular diagnosis of leishmaniasis: hsp70 (1400-bp region, internal transcribed spacer (ITS1 and glucose-6-phosphate dehydrogenase (G6pd. A good agreement among the methods was observed concerning the Leishmania species identification. Moreover, to evaluate the potential for molecular diagnosis, we compared the PCR targets hsp70-234 bp, ITS1, G6pd and mkDNA using a panel of 99 DNA samples from tissue fragments collected from patients with confirmed CL. Both PCR-hsp70-234 bp and PCR-ITS1 detected Leishmania DNA in more than 70% of the samples. However, using hsp70-234 bp PCR-RFLP, identification of all of the Leishmania species associated with CL in Brazil can be achieved employing a simpler and cheaper electrophoresis protocol.

  15. A two years study on vectors of cutaneous leishmaniasis: Evidence for sylvatic transmission cycle in the State of Campeche, Mexico

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    Eduardo A Rebollar-Téllez

    1996-10-01

    Full Text Available Vectors of cutaneous leishmaniasis in the State of Campeche were studied in relation to the transmission cycle of Leishmania (Le. mexicana. To determine how transmission of leishmaniasis occurs, we collected phlebotomine sand flies for two years. In the first year (October 1990 to November 1991 the collections were made with CDC light traps, Shannon traps and direct captures at natural shelters around the village (<200 m of La Libertad. In the second year (February 1993 to January 1994 the catches were performed at 8 km southeast of La Libertad in the forest. Female sand flies were examined for Leishmania. During the first year, 347 sand flies of nine species were collected, most of which were Lutzomyia deleoni (61.3%. When all nine species were considered, more females than males were captured. Low densities of anthropophillic species of sand flies around the village indicated that sylvatic transmission was taking place. For the second year, 1484 sand flies of 16 species were caught. The most common were L. olmeca olmeca (21.7%, L. cruciata (19.2% and L. ovallesi (14.1%. Similarly, more females were caught than males. Thirty-five females of five species were found infected with flagellates believed to be Leishmania sp. The highest infection rate was found in L. olmeca olmeca (7.1% followed by L. cruciata (4.5% and L. ovallesi (1.1%. These data plus other evidence on the epidemiology of human cases and results from reservoir studies are discussed in relation to the sylvatic transmission cycle.

  16. Distribution and Dispersal of Phlebotomus papatasi (Diptera: Psychodidae) in a Zoonotic Cutaneous Leishmaniasis Focus, the Northern Negev, Israel

    Science.gov (United States)

    Orshan, Laor; Elbaz, Shirly; Ben-Ari, Yossi; Akad, Fouad; Afik, Ohad; Ben-Avi, Ira; Dias, Debora; Ish-Shalom, Dan; Studentsky, Liora; Zonstein, Irina

    2016-01-01

    Background Zoonotic cutaneous leishmaniasis has long been endemic in Israel. In recent years reported incidence of cutaneous leishmaniasis increased and endemic transmission is being observed in a growing number of communities in regions previously considered free of the disease. Here we report the results of an intensive sand fly study carried out in a new endemic focus of Leishmania major. The main objective was to establish a method and to generate a data set to determine the exposure risk, sand fly populations' dynamics and evaluate the efficacy of an attempt to create "cordon sanitaire" devoid of active jird burrows around the residential area. Methodology/Principal Findings Sand flies were trapped in three fixed reference sites and an additional 52 varying sites. To mark sand flies in the field, sugar solutions containing different food dyes were sprayed on vegetation in five sites. The catch was counted, identified, Leishmania DNA was detected in pooled female samples and the presence of marked specimens was noted. Phlebotomus papatasi, the vector of L. major in the region was the sole Phlebotomus species in the catch. Leishmania major DNA was detected in ~10% of the pooled samples and the highest risk of transmission was in September. Only a few specimens were collected in the residential area while sand fly numbers often exceeded 1,000 per catch in the agricultural fields. The maximal travel distance recorded was 1.91km for females and 1.51km for males. The calculated mean distance traveled (MDT) was 0.75km. Conclusions The overall results indicate the presence of dense and mobile sand fly populations in the study area. There seem to be numerous scattered sand fly microsites suitable for development and resting in the agricultural fields. Sand flies apparently moved in all directions, and reached the residential area from the surrounding agricultural fields. The travel distance noted in the current work, supported previous findings that P. papatasi like P

  17. [Study of the phlebotomines (Diptera, Psychodidae), in area of cutaneous leishmaniasis in the State of Mato Grosso do Sul, Brazil].

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    Galati, E A; Nunes, V L; Dorval, M E; Oshiro, E T; Cristaldo, G; Espíndola, M A; da Rocha, H C; Garcia, W B

    1996-04-01

    Studies of the phlebotomine sandflies on the Boa Sorte farm, Corguinho country, State of Mato Grosso do Sul, Central-West region of Brazil, were carried out, with the object of identifying local fauna and a cutaneous leishmaniasis vector. At the beginning of the studies, several types of primitive vegetation covering: gallery forest, forest slopes and the cerrados: s. str. and tropical xeromorphic semideciduous broadleaf forest, locally denominated "croa", existed. Four months after the beginning of the studies, a fire destroyed a significant part of the cerrados. Captures were made during the interval from July/91 to June/93, with a CDC trap, weekly, at 10 ecotopes: in the soil of forest slopes; in the soil and canopy of cerrado s. str., "croa" and gallery forest; in the peridomicile, in hen house and pigpen and in a storage shed. A Shannon's trap was used, monthly, from 18:00-24:00 hours, in the gallery forest and "croa". Human bait was used, monthly, for 24 hours, from June/91 to September/92. An investigation into natural infection in female phlebotomines was made through the dissection of specimens captured in the Shannon's trap and on human bait. The captures with CDC totalled in 2,281 specimens of 26 species: 2 of Brumptomyia and 24 of Lutzomyia. The "croa" was the environment that contributed with the greatest number of specimens and presented the largest diversity, together with the forest slope. L, withmani was the most abundant species captured with CDC, in all the ecotopes (Standardized abundance index = 0.991). However, in the storage shed its frequency was the lowest. This species presented a prevalence of 96.0% in the Shannon's trap and on human bait (3,265 and 516 specimens, respectively). It was the most frequent in the cold and dry periods. It presented almost exclusively nocturnal activity, with its peak at 18:00-19:00 hours and an infection rate by flagellates of 0.16% (613 females dissected). On the basis of its behavior, this species was

  18. Comparative Proteomic Profiling of Leishmania tropica: Investiga¬tion of a Case Infected with Simultaneous Cutaneous and Viscero¬tropic Leishmaniasis by 2-Dimentional Electrophoresis and Mass Spectrometry

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    Homa HAJJARAN

    2015-10-01

    Full Text Available Background: Viscerotropic leishmaniasis caused by Leishmania tropica poses a significant prob­lem in the diagnosis and treatment management. Since differential gene expression is more im­portant in outcome of the infection, we employed proteomic approach to identify potential pro­teins involved in visceralization of L. tropica.Methods: The proteomes profiling of L. tropica isolated from cutaneous and visceral tissues of one host were compared by 2-DE/MS proteomics study. Moreover, the transcript level of some identified proteins was confirmed using real-time RT-PCR.Results: Of the 700 protein spots that were detected reproducibly on each gel, 135 were found to be differentially expressed (P≤ 0.05. Most of responsive proteins in visceral isolate changed in less abundant compared to cutaneous isolate. Among differentially expressed proteins, 56 proteins were confidently identified and classified according to the biological process. The larg­est groups consist of proteins involved in carbohydrate metabolism and protein synthesis. Most of the identified proteins, which implicated in energy metabolism, cell signaling and virulence were down-regulated, whereas some proteins that have a role in protein folding, antioxidant defense and proteolysis were up-regulated in visceral form. Moreover, the transcript level of some identified proteins such as co-chaperon was confirmed using real-time RT-PCR.Conclusion: L. tropica probably uses different mechanisms for survival and multiplication in viscera to establish viscerotropic leishmaniasis. The current study provides some clues into the mechanisms underlying the dissemination of L. tropica.

  19. Leishmaniasis vector behaviour in Kenya

    International Nuclear Information System (INIS)

    Mutinga, M.J.

    1980-01-01

    Leishmaniasis in Kenya exists in two forms: cutaneous and visceral. The vectors of visceral leishmaniasis have been the subject of investigation by various researchers since World War II, when the outbreak of the disease was first noticed. The vectors of cutaneous leishmaniasis were first worked on only a decade ago after the discovery of the disease focus in Mt. Elgon. The vector behaviour of these diseases, namely Phlebotomus pedifer, the vector of cutaneous leishmaniasis, and Phlebotomus martini, the vector of visceral leishmaniasis, are discussed in detail. P. pedifer has been found to breed and bite inside caves, whereas P. martini mainly bites inside houses. (author)

  20. Eco-epidemiological survey of Leishmania (Viannia) braziliensis American cutaneous and mucocutaneous leishmaniasis in Ribeira Valley River, Paraná State, Brazil.

    Science.gov (United States)

    de Castro, Edilene Alcântara; Luz, Ennio; Telles, Flávio Queiroz; Pandey, Ashok; Biseto, Alceu; Dinaiski, Marlene; Sbalqueiro, Ives; Soccol, Vanete Thomaz

    2005-02-01

    Leishmaniasis is endemic since last century in Adrianópolis Municipality, Ribeira Valley and is a serious public health. A study carried out during 1993-2003 on epidemiological surveys conducted in rural communities showed 339 new cases of cutaneous leishmaniasis (CL) detected from four municipalities (Adrianópolis, Cerro Azul, Doutor Ulysses and Rio Branco do Sul). A larger prevalence of cutaneous lesions was observed in rural workers (36%), women with domestic activities (18%), and younger students (31%). Multiple lesions were noticed in 53% of patients, but only one case of mucocutaneous leishmaniasis was reported. Twenty stocks were isolated from patients with characteristics lesions and were identified as Leishmania (Viannia) braziliensis using multi-locus enzyme electrophoresis (MLEE) and Random Amplified DNA (RAPD). In Phlebotominae survey, five species were obtained. Lutzomyia intermedia sl. represented 97.5% in peridomiciliar area and 100% in domicile. A canine serological survey made (Indirect Immunofluorescence Antibody Test, IFAT and Enzyme Linked Immunosorbent Assay, ELISA) in six rural county of Adrianópolis Municipality during 1998-1999 showed that 15.1% (24/159) of dogs were sera reactive. No lesions were observed in dogs and no parasite was isolated from lymph node aspirates and biopsies. In wild reservoirs study, only seven animals (Cricetidae, Desmodus sp. and edentates) were captured, but no parasites were found in culture from deep organs. The paper presents results of our 10 years study on cutaneous leishmaniasis survey in the Ribeira River Valley, East Region of Paraná State, Brazil. Environment changes in this region are also discussed.

  1. [Mefloquine in the treatment of cutaneous leishmaniasis in an endemic area of Leishmania (Viannia) braziliensis].

    Science.gov (United States)

    Laguna-Torres, V A; Silva, C A; Correia, D; Carvalho, E M; Magalhães, A V; Macêdo, V de O

    1999-01-01

    The aim of this study was to evaluate the efficacy of mefloquine in the treatment of skin leishmaniasis in patients infected with Leishmania (Viannia) braziliensis at an endemic region. Mefloquine is an oral drug effective against malaria with a prolonged half-life, less toxicity and easier administration than pentavalent antimonials. At Corte de Pedra in the Southern litoral of Bahia State, two randomized groups of ten patients with leishmaniasis were treated. The first group was treated with oral mefloquine, 250 mg per day in a single dose for six days and repeated three weeks later. The second group received meglumine antimoniate (Glucantime), 20 mg/kg daily administered intravenously for 20 days. Only one patient in the group treated with mefloquine showed evidence of clinical success. During treatment, one patient with four lesions developed a new lesion. The other three patients with clinical leismaniasis did not show evidence of clinical success after nine weeks of treatment. The group treated with Glucantime showed evident clinical improvement of the skin lesions.

  2. Molecular and histological tools to diagnose an imported case of American cutaneous leishmaniasis in Cuba.

    Science.gov (United States)

    Montalvo, Ana M; De Armas, Yaxsier; Fraga, Jorge; Blanco, Orestes; Menéndez, Reinaldo; Montoto, Vicente; Capó de Paz, Virginia

    2015-10-01

    Leishmaniasis represents a polymorphous group of diseases caused by around 20 different species of Leishmania parasite. Increases in the number of cases of leishmaniasis reported as a consequence of the growth in travel and migration are of concern to epidemiologists and are diagnostically challenging in non-endemic areas. Molecular and histological analyses of a paraffin-embedded skin biopsy were used in parallel to detect Leishmania parasites in a Cuban woman with suspicious lesions arriving in Cuba from Venezuela. Primers based on the 18S fragment of ribosomal ribonucleic acid (rRNA) and heat shock protein 70 genes (hsp70) were used for molecular detection. Histological studies detected the presence of the parasite. A small fragment of Leishmania DNA was amplified by polymerase chain reaction (PCR) targeting the 18S fragment using, for the first time, nucleic acid obtained from paraffin-embedded tissue as a template. Amplification of a larger fragment from the hsp70 gene did not occur. The detection of Leishmania DNA from paraffin-embedded tissue by means of 18S-targeted PCR is a feasible approach to diagnosis. In combination with classical methods such as histology, the molecular detection of the parasite was demonstrated to be useful in confirming Leishmania infection in a traveler. © 2015 The International Society of Dermatology.

  3. Epidemiological aspects of American Cutaneous Leishmaniasis in a periurban area of the metropolitan region of Belo Horizonte, Minas Gerais, Brazil

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    V. M. A. Passos

    1993-03-01

    Full Text Available In order to characterize the epidemiology of American Cutaneous Leishmaniasis (ACL in a periurban area of the municipality of Sabará in the metropolitan region of Belo Horizonte (MRBH, an area until then considered free of the disease, a cross sectional survey was undertaken in 1990. The survey of the population consisted of 1119 interviews and 881 clinical examinations using Montenegro's skin test (MST. A low prevalence (3.7% of positive MST was encountered. The disease had been occuring in the area for about 20 years in the form of sporadic cases. The predominant species of sandfly both in domestic areas and nearby areas of secondary vegetation was Lutzomyia whitmani. A canine survey of delayed hypersensitivity to the antigen P10,000 identified only one dog with a positive reaction out of 113 examined. The transmission of ACL in MRBH was confirmed. The occurrence of the disease in women, children and individuals with no contact with forest areas as well as the presence of potential vector species in the domiciliar environment, suggests the transmission of the disease in this environment.

  4. Rodenticide Comparative Effect of Klerat® and Zinc Phosphide for Controlling Zoonotic Cutaneous Leishmaniasis in Central Iran

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    Arshad VEYSI

    2016-12-01

    Full Text Available Background: Zoonotic cutaneous leishmaniasis (ZCL is a neglected disease with public health importance that is common in many rural areas of Iran. In recent years, behavioral resistance and/or bait shyness against the common rodenticide among reservoir hosts of ZCL have been reported. The aim of this study was to evaluate the effectiveness of Klerat® and zinc phosphide against natural reservoir of ZCL.Methods: This survey was carried out in four villages located 45 to 95 km far from Esfahan City Esfahan province, central Iran from April to November 2011. The rodent burrows were counted destroyed and reopened holes baited around all villages. Effect of rodent control operation on the main vector density and incidence of ZCL were evaluated.Results: The reduction rate of rodent burrows after intervention calculated to be at 62.8% in Klerat® and 58.15% in zinc phosphide treated areas. Statistical analysis showed no difference between the densities of the vector in indoors and outdoors in intervention and control areas. The incidence of the disease between treated and control areas after intervention was statistically different (P< 0.05.Conclusion: Klerat® could be a suitable alternative for zinc phosphide in a specific condition such as behavior resistance or occurrence of bait shyness.

  5. Sandflies (Diptera: Psychodidae in rural and urban environments in an endemic area of cutaneous leishmaniasis in southern Brazil

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    Carolina Fordellone Rosa Cruz

    2013-05-01

    Full Text Available The high proportion of cases of cutaneous leishmaniasis reported amongst residents in the city of Bandeirantes, in the state of Paraná, Brazil, led the authors to investigate the phlebotomine fauna in both urban and rural environments. The sandflies were captured with automatic light traps from 07:00 pm-07:00 am fortnightly in 11 urban peridomiciles from April 2008-March 2009 and monthly in three ecotopes within four rural localities from April 2009-March 2010. In one of these latter localities, sandfly capture was conducted with white/black Shannon traps during each of three seasons: spring, summer and fall. A total of 5,729 sandflies of 17 species were captured. Nyssomyia neivai (46.7% and Nyssomyia whitmani (35.3% were the predominant species. In this study, 3,865 specimens were captured with automatic light traps: 22 (0.083 sandflies/trap in the urban areas and 3,843 (26.69 sandflies/trap in the rural areas. Ny. neivai was predominant in urban (68.2% and rural (42.8% areas. A total of 1,864 specimens were captured with the white/black Shannon traps and Ny. neivai (54.5% and Ny. whitmani (31.4% were the predominant species captured. The small numbers of sandflies captured in the urban areas suggest that the transmission of Leishmania has occurred in the rural area due to Ny. neivai and Ny. whitmani as the probable vectors.

  6. Sandflies (Diptera: Psychodidae) in rural and urban environments in an endemic area of cutaneous leishmaniasis in southern Brazil.

    Science.gov (United States)

    Cruz, Carolina Fordellone Rosa; Cruz, Mariza Fordellone Rosa; Galati, Eunice A Bianchi

    2013-05-01

    The high proportion of cases of cutaneous leishmaniasis reported amongst residents in the city of Bandeirantes, in the state of Paraná, Brazil, led the authors to investigate the phlebotomine fauna in both urban and rural environments. The sandflies were captured with automatic light traps from 07:00 pm-07:00 am fortnightly in 11 urban peridomiciles from April 2008-March 2009 and monthly in three ecotopes within four rural localities from April 2009-March 2010. In one of these latter localities, sandfly capture was conducted with white/black Shannon traps during each of three seasons: spring, summer and fall. A total of 5,729 sandflies of 17 species were captured. Nyssomyia neivai (46.7%) and Nyssomyia whitmani (35.3%) were the predominant species. In this study, 3,865 specimens were captured with automatic light traps: 22 (0.083 sandflies/trap) in the urban areas and 3,843 (26.69 sandflies/trap) in the rural areas. Ny. neivai was predominant in urban (68.2%) and rural (42.8%) areas. A total of 1,864 specimens were captured with the white/black Shannon traps and Ny. neivai (54.5%) and Ny. whitmani (31.4%) were the predominant species captured. The small numbers of sandflies captured in the urban areas suggest that the transmission of Leishmania has occurred in the rural area due to Ny. neivai and Ny. whitmani as the probable vectors.

  7. First report on isolation of Leishmania tropica from sandflies of a classical urban Cutaneous leishmaniasis focus in southern Iran.

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    Oshaghi, Mohammad A; Rasolian, Mohammad; Shirzadi, Mohammad Reza; Mohtarami, Fatemeh; Doosti, Sogra

    2010-12-01

    Shiraz district in south of Iran is a classical focus of Cutaneous leishmaniasis (CL) and previous research has consistently documented the etiologic agent to be Leishmania tropica and Leishmania major in urban and rural areas, respectively. However, none of the Phlebotomus sergenti, a known vector for L. tropica, of the region has been found infected. We report the first isolation of L. tropica from sandflies in urban community of southern part of Shiraz city. Parasite polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP) and gene sequencing analyses indicate CL cases in this community were caused by either L. major or L. tropica. Sandflies of P. sergenti were infrequent, however, three out of 10 (30.0%) females captured in urban area were found infected with L. tropica. But, no human cases were found to be infected with L. tropica. Phlebotomus papatasi were found the most dominant and infected species where 41 out of 207 (20%) tested individuals harboring L. major in suburb area of the city. Patients have been lived in the suburb area of the city where people keep normally domestic animals in their houses which provide appropriate environment for completion of sandfly life cycle and expansion of CL disease in the region.

  8. A molecular and parasitological survey on cutaneous leishmaniasis patients from historical city of Kashan in Isfahan province, center of Iran

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    Mohammad Reza Shiee

    2012-12-01

    Full Text Available Objective: To study cutaneous leishmaniasis (CL for identifying the dominant Leishmania species on CL patients referred to medical health centers of historical Kashan city and suburbs located in Isfahan province in central part of Iran during 2010 to 2011. Methods: From 137 CL cases, were microscopically positive, the skin lesion serosity materials of 103 cases were cultured in monophasic culture media (RPMI 1 640. We used the PCR-RFLP method for characterization the Leishmania isolates, by using specific internal transcribed spacer (ITS1 primers and HAEШ as the restriction fast enzyme. DNA was extracted from 63 samples. Results: L. tropica is main species in 58 (92.1% cases and L. major is identified in 5 (7.9% cases. Indeed randomly two isolates were the species characterized as L. major produced ulcer at the base tail of BALB/c mice after 3 weeks but from three L. tropica isolates none of them produced any lesion during 6 months post inoculation. Conclusions: The parasitological, epidemiological aspect and molecular methods of this study showed that, Kashan and suburb are anthroponetic CL area despite this city located in Isfahan province as an ancient focus of zoonotic CL in Iran.

  9. The role of inflammatory, anti-inflammatory, and regulatory cytokines in patients infected with cutaneous leishmaniasis in Amazonas State, Brazil.

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    Espir, Thaís Tibery; Figueira, Luanda de Paula; Naiff, Maricleide de Farias; da Costa, Allyson Guimarães; Ramalho-Ortigão, Marcelo; Malheiro, Adriana; Franco, Antonia Maria Ramos

    2014-01-01

    The authors discuss in this paper the role of inflammatory, anti-inflammatory, and regulatory cytokines in patients infected with different species of Leishmania in Amazonas State, Brazil. A comparative analysis was made of serum concentrations of these cytokines in the peripheral blood of 33 patients infected with cutaneous leishmaniasis. The isolates were identified as Leishmania guyanensis, L. naiffi, and L. amazonensis. Most (64%) of the patients were male ranging in age from 18 to 58 years. Protein expression profiles of IL-2, IL-4, IL-6, IL-10, IFN-γ, TNF-α, and IL-17 cytokines were shown to vary significantly between infected and noninfected (control group) individuals and according to the Leishmania species. Infection caused by L. guyanensis accounted for 73% of the cases and patients with this parasite also showed higher concentrations of IL-2, IFN-γ, IL-4, and IL-17 when compared to infection by L. amazonensis. Patients with infection caused by L. naiffi showed higher concentration of the cytokines analyzed when compared to uninfected patients; however, there was no statistically significant difference with the other species analyzed.

  10. Pentalinon andrieuxii root extract is effective in the topical treatment of cutaneous leishmaniasis caused by Leishmania mexicana

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    Lezama-Dávila, Claudio M.; Pan, Li; Isaac-Márquez, Angelica P.; Terrazas, Cesar; Oghumu, Steve; Isaac-Márquez, Ricardo; Pech-Dzib, MY; Barbi, Joseph; Calomeni, Edward; Parinandi, Narasimham; Kinghorn, A. Douglas; Satoskar, Abhay R.

    2014-01-01

    Cutaneous leishmaniasis (CL) manifests as localized skin lesions, which lead to significant tissue destruction and disfigurement. In the Yucatan Peninsula, Mayan traditional healers use Pentalinon andrieuxii Muell.-Arg. (Apocynaceae) roots for the topical treatment of CL. Here, we studied the effect of P. andrieuxii root hexane extract (PARE) on the parasites and host cells in vitro and examined its efficacy in the topical treatment of CL caused by L. mexicana. PARE exhibited potent antiparasitic activity in vitro against promastigotes as well as amastigotes residing in macrophages. Electron microscopy of PARE-treated parasites revealed direct membrane damage. PARE also activated NF-κB and enhanced IFN-γR and MHC class II expression and TNF-α production in macrophages. In addition, PARE induced production of the Th1 promoting cytokine IL-12 in dendritic cells as well as enhanced expression of the co-stimulatory molecules CD40, CD80 and CD86. In vivo studies showed that L. mexicana-infected mice treated by topical application of PARE resulted in the significant reduction in lesion size and parasite burden compared to controls. These findings indicate that PARE could be used as an alternative therapy for the topical treatment of CL. PMID:24347110

  11. Epidemiologic profile of oriental sore caused by Leishmania parasites in a new endemic focus of cutaneous leishmaniasis, southern Iran.

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    Khosravani, Moosa; Moemenbellah-Fard, Mohammad Djaefar; Sharafi, Mehdi; Rafat-Panah, Azam

    2016-09-01

    Cutaneous leishmaniasis (CL) is the first and most important vector-borne zoonotic disease transmitted by sand flies in Iran. As a parasitic disease in the Old World, it is a complex zoonosis with multiple vertebrate hosts and arthropod vectors of pathogenic flagellate protozoan in the genus of Leishmania in different parts of its range. Phlebotomine sand flies are proven as vectors of this parasite which can be transmitted through the bite of an infected female sand fly distributed in almost all parts of Iran. This research performed on all CL patients as that were registered into special forms by physicians and experts during the study period 2006-2013 in the county town of Fasa, Iran. Data were analyzed by Chi square test using SPSS 17 statistics software. Overall, 1,908 patients (59.18 %) lived in rural and 1,316 (40.82 %) lived in urban areas. All ages were between 1 and ≥30 year. The most frequent age group was ≥20 years (54.6 %). Sex ratio of patients was almost 1:1 (1,561; 48.42 % male vs. 1,663; 51.58 % female). Most of them (66.84 %) had wet lesions and those with dry lesions were less frequent (33.16 %). There was a significant difference between the frequencies of these two groups (P counties in Iran showed that it was most likely an endemic disease in this region.

  12. Interleukin 4 (IL-4) gene promoter polymorphisms in Rhombomys opimus, the main reservoir of zoonotic cutaneous leishmaniasis.

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    Bakhshi, H; Borhani, N; Mohebali, M; Khamesipour, A; Abai, M R; Hajjaran, H; Tajedin, L; Rassi, Y; Akhavan, A A; Mohtarami, F; Oshaghi, M A

    2014-01-01

    Great gerbils (Rhombomys opimus) are the most common gerbils in center to northeast of Iran as well as central Asia and serve as reservoirs for the zoonotic agents, including Leishmania major, the principal etiologic agent of zoonotic cutaneous leishmaniasis (ZCL). The outcome of L. major infection in gerbils is not uniform. Among several immune-related factors including cytokine genes, the polymorphism in interleukin 4 (IL-4) promoter gene showed a great impact on outcome and pathological symptoms of L. major infection at least in mouse model. In this study gerbils' IL-4 promoter gene polymorphism is assessed. Specific primers were designed to develop a PCR-based assay to amplify IL-4 promoter gene to possibly define IL-4 promoter gene polymorphism in great gerbil populations with a range of Leishmania infection and symptoms collected from different foci of the central, north and northeast regions of Iran. The results showed that the designed primers amplify 689bp of the promoter gene. Sequence analysis of the promoter gene revealed five polymorphic sites assembly six haplotypes among the gerbil populations. Further studies are needed to assess whether or not the five polymorphisms cause different outcome phenotypes following infection with L. major in great gerbils. The data might be used to characterize the immune responses of R. opimus against L. major infection. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. The Contribution of the Fas/FasL Apoptotic Pathway in Ulcer Formation during Leishmania major-Induced Cutaneous Leishmaniasis

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    Eidsmo, Liv; Nylen, Susanne; Khamesipour, Ali; Hedblad, Mari-Anne; Chiodi, Francesca; Akuffo, Hannah

    2005-01-01

    Cutaneous leishmaniasis (CL), caused by the intracellular protozoan Leishmania major, is characterized by lesion formation and ulceration at the site of infection. The mechanism of ulcer formation during CL is not fully understood. The expression of Fas and FasL and the levels of apoptosis in skin biopsies and in restimulated blood mononuclear cells from patients with 1 to 7 months of L. major-induced CL were analyzed using immunohistochemistry and fluorescence-activated cell sorting analysis. The levels of soluble Fas and FasL were also analyzed by enzyme-linked immunosorbent assay. A substantial number of apoptotic keratinocytes were observed mainly in the superficial epidermis of morphologically active and healing CL skin samples. Fas expression was increased on epidermis in active CL, whereas Fas expression was similar in healing and healthy epidermis. FasL-expressing macrophages and T cells were found in subepidermal infiltrate, mainly in active disease. When CL peripheral blood mononuclear cells were restimulated with L. major, Fas was up-regulated on effector T cells, and high levels of sFasL were secreted. Supernatants from restimulated cultures induced apoptosis in human keratinocytes (HaCaT), possibly through Fas/FasL interactions. Our results indicate that FasL-expressing effector T cells and macrophages may act to induce apoptosis and ulcer formation in Fas-expressing keratinocytes during L. major infection. PMID:15793290

  14. Pentalinon andrieuxii root extract is effective in the topical treatment of cutaneous leishmaniasis caused by Leishmania mexicana.

    Science.gov (United States)

    Lezama-Dávila, Claudio M; Pan, Li; Isaac-Márquez, Angelica P; Terrazas, Cesar; Oghumu, Steve; Isaac-Márquez, Ricardo; Pech-Dzib, M Y; Barbi, Joseph; Calomeni, Edward; Parinandi, Narasimham; Kinghorn, A Douglas; Satoskar, Abhay R

    2014-06-01

    Cutaneous leishmaniasis (CL) manifests as localized skin lesions, which lead to significant tissue destruction and disfigurement. In the Yucatan Peninsula, Mayan traditional healers use Pentalinon andrieuxii Muell.-Arg. (Apocynaceae) roots for the topical treatment of CL. Here, we studied the effect of P. andrieuxii root hexane extract (PARE) on the parasites and host cells in vitro and examined its efficacy in the topical treatment of CL caused by Leishmania mexicana. PARE exhibited potent antiparasitic activity in vitro against promastigotes as well as amastigotes residing in macrophages. Electron microscopy of PARE-treated parasites revealed direct membrane damage. PARE also activated nuclear factor kappaB and enhanced interferon-γ receptor and MHC class II expression and TNF-α production in macrophages. In addition, PARE induced production of the Th1 promoting cytokine IL-12 in dendritic cells as well as enhanced expression of the co-stimulatory molecules CD40, CD80, and CD86. In vivo studies showed that L. mexicana-infected mice treated by topical application of PARE resulted in the significant reduction in lesion size and parasite burden compared to controls. These findings indicate that PARE could be used as an alternative therapy for the topical treatment of CL. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Gene expression profile of cytokines and chemokines in skin lesions from Brazilian Indians with localized cutaneous leishmaniasis.

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    Costa-Silva, Matheus Fernandes; Gomes, Luciana Inácia; Martins-Filho, Olindo Assis; Rodrigues-Silva, Renata; Freire, Janaína de Moura; Quaresma, Patrícia Flávia; Pascoal-Xavier, Marcelo Antônio; Mendes, Tiago Antônio de Oliveira; Serakides, Rogéria; Zauli, Danielle Alves Gomes; Campi-Azevedo, Ana Carolina; Melo, Maria Norma; Gontijo, Célia Maria Ferreira; Peruhype-Magalhães, Vanessa; Teixeira-Carvalho, Andréa

    2014-02-01

    Cutaneous leishmaniasis (CL) is a chronic inflammatory disease caused by dermotropic Leishmania species belonging to the Viannia subgenera, with Leishmania (V.) braziliensis considered the main agent in Brazil. After infection, a local inflammatory process is initiated, inducing the expression of several cytokine/chemokine genes. We evaluated the immunity to CL of patients living in the indigenous community Xakriabá, Minas Gerais state, Brazil, by performing detailed analyses of the mRNA expression of different cytokines and chemokines in CL lesions, considering the time evolution (recent or late). We also studied the profile of the inflammatory infiltrate by histopathological analysis. The histopathological features of recent CL lesions showed an intense inflammatory reaction, characterized by the presence of both mononuclear and polymorphonuclear cells, whereas late CL lesions exhibited a predominance of mononuclear leukocytes. The gene expression of cytokines/chemokines in skin biopsies from the CL group showed higher transcript levels of modulatory (IL10 and TGFB1), anti-inflammatory (IL4), and pro-inflammatory (TNF, IFNG, IL12B, CCL2, CCL3, CCL5, CXCL10) biomarkers in recent lesions than in late lesions. Our findings suggest that differential gene expression of cytokines and chemokines found in skin lesions from CL patients is associated with time evolution of lesions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. The Role of Inflammatory, Anti-Inflammatory, and Regulatory Cytokines in Patients Infected with Cutaneous Leishmaniasis in Amazonas State, Brazil

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    Thaís Tibery Espir

    2014-01-01

    Full Text Available The authors discuss in this paper the role of inflammatory, anti-inflammatory, and regulatory cytokines in patients infected with different species of Leishmania in Amazonas State, Brazil. A comparative analysis was made of serum concentrations of these cytokines in the peripheral blood of 33 patients infected with cutaneous leishmaniasis. The isolates were identified as Leishmania guyanensis, L. naiffi, and L. amazonensis. Most (64% of the patients were male ranging in age from 18 to 58 years. Protein expression profiles of IL-2, IL-4, IL-6, IL-10, IFN-γ, TNF-α, and IL-17 cytokines were shown to vary significantly between infected and noninfected (control group individuals and according to the Leishmania species. Infection caused by L. guyanensis accounted for 73% of the cases and patients with this parasite also showed higher concentrations of IL-2, IFN-γ, IL-4, and IL-17 when compared to infection by L. amazonensis. Patients with infection caused by L. naiffi showed higher concentration of the cytokines analyzed when compared to uninfected patients; however, there was no statistically significant difference with the other species analyzed.

  17. Epidemiological trends of cutaneous leishmaniasis in Al-Madinah Al-Munawarah Province, Western Region of Saudi Arabia

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    Miskelyemen Abdelatti Elmekki

    2017-01-01

    Full Text Available Objective: To investigate the epidemiological trends of cutaneous leishmaniasis (CL in Al-Madinah Al-Munawarah, western region of KSA. Materials and Methods: Four hundred and sixty-seven parasitologically confirmed CL cases attending Al-Meeqat Hospital, Al-Madinah, during 2012–2015, were included in this study. Results: Both Saudi and non-Saudi nationals were infected, with the highest infection rate being among Saudis (68.7%. Males were more affected than females as 86.9% of the total CL cases were males. Moreover, CL was prevalent in all age groups with higher frequency among young adults and adolescents (23.1% and 22.7%, respectively. Interestingly, almost all the patients in the adolescent and child age groups were Saudis (96.2% and 93.5%, respectively. Considering geographical distribution, the highest percentage of the cases (40.5% were from the northern parts of Al-Madinah province while the eastern parts reported the least infection rate (7.3%. Few cases (2.5% were supposed to encounter the infection abroad. Additionally, the frequency of infection was found to follow a seasonal distribution. Regarding treatment, pentostam, ketoconazole, or cryotherapy were the treatment options usually used. Conclusion: CL is prevalent in Al-Madinah Al-Munawarah area and new foci are being introduced. Thus, detailed studies with large surveillances regarding vector and reservoir hosts in and around the area are needed.

  18. Epidemiology of cutaneous leishmaniasis in central Amazonia: a comparison of sex-biased incidence among rural settlers and field biologists.

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    Soares, Letícia; Abad-Franch, Fernando; Ferraz, Gonçalo

    2014-08-01

    Cutaneous leishmaniasis (CL) is more frequently reported in men than in women; this may be due to male-biased exposure to CL vectors, female-biased resistance against the disease or both. We sought to determine whether gender-specific exposure to vector habitats explains male-biased CL incidence in two human populations of central Amazonia. We compared the CL incidence in one population of field researchers (N = 166), with similar exposure for males and females, and one population of rural settlers (N = 646), where exposure is overall male-biased. We used a combination of questionnaires and clinical data to quantify CL cases, and modelled disease incidence in a Bayesian framework. There was a moderately higher incidence of CL among men than among women in both populations, but male bias decreased as exposure time increased. Disease incidence was overall higher among field researchers, suggesting that they are an important but understudied CL risk group. Our comparison of two contrasting populations provided epidemiological evidence that CL incidence can be male-biased even when exposure is comparable in both sexes. © 2014 John Wiley & Sons Ltd.

  19. [Epidemiologic aspects of Cutaneous Leishmaniasis in an endemic area of the state of Paraná, Brazil

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    Silveira; Teodoro; Lonardoni; Guilherme; Toledo; Ramos; Arraes; Bertolini; Spinoza; Barbosa

    1996-04-01

    An epidemiological investigation of cutaneous leishmaniasis (CL) was performed in 1992 and 1993 in an endemic area of Jussara and Terra Boa counties, in the Northern Paraná State. The study covered 684 individuals from a population of approximately 1,400 from six agricultural areas (Fazenda Palmital, Cerâmica Andirá, Fazenda Jussara, Fazenda Lagoa, Destilaria Melhoramentos, and Fazenda Mururê) in Northern Paraná, Brazil. The mean frequency of CL history was 19.9%. The highest frequency was at Fazenda Jussara (40.5%). Based on the indirect immunofluorescence test, 58 (8.5%) presented significant titers of anti-Leishmania antibody, 17 (29.3%) of whom had no history of CL. The Montenegro skin test was applied to 97 individuals with a history of CL and was positive in 80 (82.5%). During the survey, seven individuals presented lesions, four of which were positive for Leishmania sp. The strain isolated was identified as Leishmania (Viannia) braziliensis.

  20. The Emergence of Anthroponotic Cutaneous Leishmaniasis Following the Earthquake in Southern Villages of Bam District, Southeastern Iran, 2010

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    Mohammad Reza Aflatoonian

    2013-03-01

    Full Text Available Background: The objective of this study was to assess the epidemiological characteristics of a new emerging focus of cutaneous leishmaniasis (CL in southern villages of Bam District, southeastern Iran, 2010.Methods: A house-to- house census survey of 5544 individuals were interviewed and physically examined for the presence of active lesions or scars. Diagnosis was confirmed by direct smears, cultures and identification by PCR. The data were entered into a computer and SPSS ver. 15.Results: Overall, 1.2% of the inhabitants were infected, 0.5% active and 0.7% scars and females were more signifi­cantly infected (1.7% than males (0.8%, (P= 0.003. All age groups were equally affected. Most of the lesions were on the face and majority had single lesion. Most of the cases appeared from 2006 to 2008 during the CL epidemic in the city of Bam. PCR indicated L. tropica as the causative agent.Conclusion: The presence of non-immune individuals along with suitable ecological conditions could induce a new emerging focus of ACL in villages.

  1. MOLECULAR CHARACTERIZATION OF AMERICAN CUTANEOUS LEISHMANIASIS IN THE TRI‑BORDER AREA OF ASSIS BRASIL, ACRE STATE, BRAZIL

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    Carolina Bioni Garcia TELES

    2015-08-01

    Full Text Available SUMMARY In this study, Leishmaniaspecies were identified by Polymerase Chain Reaction (PCR. The epidemiology of patients suspected of having American Cutaneous Leishmaniasis in the municipality of Assis Brasil, Acre State, located in the Brazil/Peru/Bolivia triborder was also investigated. By PCR, the DNA of Leishmaniawas detected in 100% of the cases (37 samples and a PCR-Restriction Fragment Length Polymorphism (RFLP of the hsp 70gene identified the species in 32 samples: Leishmania (Viannia braziliensis (65.6% , L. (V. shawi (28.1% , L. (V. guyanensis (3.1% and mixed infection L. (V. guyanensis and L. (Leishmania amazonensis (3.1%This is the first report of L. (V. shawiand L. (L. amazonensis in Acre. The two predominant species were found in patients living in urban and rural areas. Most cases were found in males living in rural areas for at least three years and involved in rural work. This suggests, in most cases, a possible transmission of the disease from a rural/forest source, although some patients had not engaged in activities associated with permanence in forestall areas, which indicate a possible sandflies adaptation to the periurban setting.

  2. Faunistic study of the sandflies (Diptera: Psychodidae) in an emerging focus of cutaneous leishmaniasis in Al Haouz province, Morocco.

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    Boussaa, S; Pesson, B; Boumezzough, A

    2009-01-01

    The Moroccan province of Al Haouz is an emerging focus of human cutaneous leishmaniasis caused by Leishmania tropica. In an entomological investigation of three communes in the province (Ourika, Stti Fatma and Rhmate), 3440 sandflies were collected on sticky traps in 2005-2007. Of the six Phlebotomus species caught, Phlebotomus papatasi (13.3% of the total collection), P. sergenti (12.8%) and P. perniciosus (12.8%) were predominant, followed by P. longicuspis (7.9%), P. ariasi (2.6%) and P. alexandri (1.1%). All the other sandflies were Sergentomyia fallax (24.2%), S. minuta (22.0%) or S. dreyfussi (3.4%). The distribution of these species among the many biotopes, at varying altitudes (667-1772 m), is discussed. When the variability of the P. sergenti populations in Ourika and Rhmate and those at two sites in northern Morocco (Taounate and Chefchaouene) was investigated by iso-enzyme analysis, seven polymorphic loci (PGI, PGM, HK, MDH1, ME, 6PGD and ACO) were identified. None of the investigated populations of P. sergenti was in Hardy-Weinberg equilibrium for all the polymorphic loci. The results indicate that the taxon known as Phlebotomus sergenti in Morocco does not have the genetic characteristics of a single species.

  3. First molecular detection of Leishmania major within naturally infected Phlebotomus salehi from a zoonotic cutaneous leishmaniasis focus in southern Iran.

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    Azizi, K; Fakoorziba, M R; Jalali, M; Moemenbellah-Fard, M D

    2012-03-01

    Human cutaneous leishmaniasis (CL) is a major notifiable public health problem in many parts of Iran. It is often caused by the zooflagellate parasite Leishmania major which is mainly transmitted by the bites of female phlebotomine sandflies belonging to the genus Phlebotomus (Diptera: Psychodidae). The annual incidence of CL in Fars province, southern Iran, was about 108-144 in 2007. The leishmanial infections of wild sandflies that may act as vectors were thus investigated at an endemic focus in this province. In all 330 female Phlebotomus sandflies were screened for the detection of Leishmania-specific kinetoplast DNA (kDNA) by polymerase chain reaction (PCR) methods. A two stage nested PCR protocol was used to establish the identity of Leishmania major species in naturally infected sandflies. The L. major kDNA was detected in 18 (5.5%) individual sandflies which belonged to four different Phlebotomus species (Phlebotomus papatasi, Phlebotomus salehi, Phlebotomus sergenti and P. major group). For the first time, one naturally infected P. salehi specimen contained the kDNA of the protozoan parasite, L. major, with a main band of 560 base pairs identified using the nested PCR method. It seems most likely therefore that P. salehi is potentially a rare sylvatic vector of L. major parasites in parts of this province. This is the first combined morphological and molecular studies of P. salehi in Iran.

  4. Host genetic factors in American cutaneous leishmaniasis: a critical appraisal of studies conducted in an endemic area of Brazil

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    Léa Cristina Castellucci

    2014-06-01

    Full Text Available American cutaneous leishmaniasis (ACL is a vector-transmitted infectious disease with an estimated 1.5 million new cases per year. In Brazil, ACL represents a significant public health problem, with approximately 30,000 new reported cases annually, representing an incidence of 18.5 cases per 100,000 inhabitants. Corte de Pedra is in a region endemic for ACL in the state of Bahia (BA, northeastern Brazil, with 500-1,300 patients treated annually. Over the last decade, population and family-based candidate gene studies were conducted in Corte de Pedra, founded on previous knowledge from studies on mice and humans. Notwithstanding limitations related to sample size and power, these studies contribute important genetic biomarkers that identify novel pathways of disease pathogenesis and possible new therapeutic targets. The present paper is a narrative review about ACL immunogenetics in BA, highlighting in particular the interacting roles of the wound healing gene FLI1 with interleukin-6 and genes SMAD2 and SMAD3 of the transforming growth factor beta signalling pathway. This research highlights the need for well-powered genetic and functional studies on Leishmania braziliensis infection as essential to define and validate the role of host genes in determining resistance/susceptibility regarding this disease.

  5. FACTORS ASSOCIATED TO ADHERENCE TO DIFFERENT TREATMENT SCHEMES WITH MEGLUMINE ANTIMONIATE IN A CLINICAL TRIAL FOR CUTANEOUS LEISHMANIASIS

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    Madelon Novato Ribeiro

    2014-07-01

    Full Text Available The favorable outcome of the treatment of a disease is influenced by the adherence to therapy. Our objective was to assess factors associated with adherence to treatment of patients included in a clinical trial of equivalence between the standard and alternative treatment schemes with meglumine antimoniate (MA in the treatment of cutaneous leishmaniasis (CL, in the state of Rio de Janeiro. Between 2008 and 2011, 57 patients with CL were interviewed using a questionnaire to collect socioeconomic data. The following methods were used for adherence monitoring: counting of vial surplus, monitoring card, Morisky test and modified Morisky test (without the question regarding the schedule; we observed 82.1% (vial return, 86.0% (monitoring card, 66.7% (Morisky test and 86.0% (modified Morisky test adherence. There was a strong correlation between the method of vial counting and the monitoring card and modified Morisky test. A significant association was observed between greater adherence to treatment and low dose of MA, as well as with a lower number of people sleeping in the same room. We recommend the use of the modified Morisky test to assess adherence to treatment of CL with MA, because it is a simple method and with a good performance, when compared to other methods.

  6. Double blind, randomized controlled trial, to evaluate the effectiveness of a controlled nitric oxide releasing patch versus meglumine antimoniate in the treatment of cutaneous leishmaniasis [NCT00317629

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    Silva Federico A

    2006-05-01

    Full Text Available Abstract Background Cutaneous Leishmaniasis is a worldwide disease, endemic in 88 countries, that has shown an increasing incidence over the last two decades. So far, pentavalent antimony compounds have been considered the treatment of choice, with a percentage of cure of about 85%. However, the high efficacy of these drugs is counteracted by their many disadvantages and adverse events. Previous studies have shown nitric oxide to be a potential alternative treatment when administered topically with no serious adverse events. However, due to the unstable nitric oxide release, the topical donors needed to be applied frequently, making the adherence to the treatment difficult. The electrospinning technique has allowed the production of a multilayer transdermal patch that produces a continuous and stable nitric oxide release. The main objective of this study is to evaluate this novel nitric oxide topical donor for the treatment of cutaneous leishmaniasis. Methods and design A double-blind, randomized, double-masked, placebo-controlled clinical trial, including 620 patients from endemic areas for Leishmaniasis in Colombia was designed to investigate whether this patch is as effective as meglumine antimoniate for the treatment of cutaneous leishmaniasis but with less adverse events. Subjects with ulcers characteristic of cutaneous leishmaniasis will be medically evaluated and laboratory tests and parasitological confirmation performed. After checking the inclusion/exclusion criteria, the patients will be randomly assigned to one of two groups. During 20 days Group 1 will receive simultaneously meglumine antimoniate and placebo of nitric oxide patches while Group 2 will receive placebo of meglumine antimoniate and active nitric oxide patches. During the treatment visits, the medications will be daily administered and the presence of adverse events assessed. During the follow-up, the research group will visit the patients at days 21, 45, 90 and 180. The

  7. Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina.

    Science.gov (United States)

    Krolewiecki, Alejandro Javier; Almazan, Maria Cristina; Quipildor, Marcelo; Juarez, Marisa; Gil, Jose Fernando; Espinosa, Marco; Canabire, Maria; Cajal, Silvana Pamela

    2017-10-01

    Leishmania (Viannia) braziliensis is the species most frequently implicated with cutaneous and mucosal leishmaniasis in the Americas; its diagnosis is based on the identification of amastigotes in lesions, which is limited by low parasite burden. Leishmanin Skin Test (LST) is a support tool for diagnosis, based on delayed type hypersensitivity responses to Leishmania antigens injected intradermally, used in endemic areas as a complement to diagnosis. A retrospective analysis of individuals evaluated for their first episode of tegumentary leishmaniasis at a reference center in Argentina during the period 2006-2015 was performed, with the goal of assessing its usefulness as a support tool in the diagnosis of leishmaniasis. Demographic, clinical and diagnostic work-up were analyzed in individuals with clinically compatible lesions, lesion`s smear and LST. A total of 733 cases that met the case definition were included in the analysis; 678 (93%) localized cutaneous cases, 50 (7%) with mucosal involvement and 5 (high. Standardization of this technique and further research into its most adequate preparation and utilization protocols across different sites will help in the management of suspicious clinical cases.

  8. Lésion ulcérocroûteuse de l’angle interne de l’œil droit: a leishmaniose cutanée en est une cause [A crushing ulcerous lesion of the internal angle of the right eye: Cutaneous leishmaniasis is one of the causes

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    Laouali Salissou

    2018-04-01

    Full Text Available Niger is a tropical country where leishmaniasis is endemic. The first case was reported in 1911. Leishmania major is practically the pathogen found in Niger, a country lying between 8° and 20° north latitudes from the Atlantic to the Chadian border. We report a case of cutaneous leishmaniasis in the type of ulcerative lesion, characterized by its localization at the internal angle of the right eye posing a diagnostic problem. The diagnosis of leishmaniasis was made by parasitological examination. Anatomipathologic examination eliminated cutaneous tuberculosis, pyogenic granuloma, molluscum contagiosum and basal cell epithelioma. Metronidazole management has accelerated healing. Thus in a tropical country, in front of any chronic, painless ulcerative lesion and resistant to all therapeutics, the diagnosis of cutaneous leishmaniasis must be evoked, for a consequent management after confirmation.

  9. What about Th1/Th2 in cutaneous leishmaniasis vaccine discovery?

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    Campos-Neto A.

    2005-01-01

    Full Text Available The T helper cell type 1 (Th1 response is essential to resist leishmaniasis, whereas the Th2 response favors the disease. However, many leishmanial antigens, which stimulate a Th1 immune response during the disease or even after the disease is cured, have been shown to have no protective action. Paradoxically, antigens associated with an early Th2 response have been found to be highly protective if the Th1 response to them is generated before infection. Therefore, finding disease-associated Th2 antigens and inducing a Th1 immune response to them using defined vaccination protocols is an interesting unorthodox alternative approach to the discovery of a leishmania vaccine.

  10. A Novel Field Deployable Point of Care Diagnostic Test for Cutaneous Leishmaniasis

    Science.gov (United States)

    2015-10-01

    TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON USAMRMC a. REPORT...Brazil. Annales de parasitologie humaine 266 et comparée. 1989;64(3):200. 267 15. Shaw J, Ishikawa E, Lainson R, Braga R, Silveira F. Cutaneous...parasitologie humaine et comparée. 1990;66(6):243-6. 270 16. Brito ME, Andrade MS, Mendonca MG, Silva CJ, Almeida EL, Lima BS, et al. Species diversity of271

  11. ITS1 PCR-RFLP Diagnosis and Characterization of Leishmania in Clinical Samples and Strains from Cases of Human Cutaneous Leishmaniasis in States of the Mexican Southeast

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    Amalia Monroy-Ostria

    2014-01-01

    Full Text Available American cutaneous leishmaniasis includes a spectrum of clinical forms localized cutaneous, diffuse cutaneous, and mucocutaneous leishmaniasis which can be caused by different strains of Leishmania belonging to the L. mexicana or L. braziliensis complexes which may coexist in the same endemic area. We evaluated the PCR-RFLP assay of the ITS1 genes for direct identification of Leishmania species in 163 clinical samples and 21 Mexican isolates of Leishmania. In relation to the Mexican isolates of Leishmania 52% displayed a pattern similar to the L. (L. mexicana, 5% showed a mixed pattern compatible with L. (L. mexicana and L. (V. braziliensis, eight with L. (L. amazonensis and L. (L. mexicana, and one to L. (V. braziliensis. Most of the clinical samples, 109/116 (94%, gave a pattern similar to that of the L. mexicana, two clinical samples gave similar patterns to that of Leishmania braziliensis, and 5 samples gave patterns that suggest a coinfection of L. (L. mexicana and L. (V. braziliensis or L. (L. mexicana and L. (L. amazonensis. The ITS1 PCR-RFLP assay is a multipurpose tool for diagnosis of Leishmania from clinical samples and enables determination of the infecting species of New World Leishmania in the field in relatively short time and low cost.

  12. Attraction of the cutaneous leishmaniasis vector Nyssomyia neivai (Diptera: Psychodidae) to host odour components in a wind tunnel

    Science.gov (United States)

    2012-01-01

    Background Laboratory studies of host-seeking olfactory behaviour in sandflies have largely been restricted to the American visceral leishmaniasis vector Lutzomyia longipalpis. In comparison, almost nothing is known about the chemical ecology of related species, which transmit American cutaneous leishmaniasis (ACL), due in part to difficulties in raising these insects in the laboratory. Understanding how ACL vectors locate their hosts will be essential to developing new vector control strategies to combat this debilitating disease. Methods This study examined host-odour seeking behaviour of the ACL vector Nyssomyia neivai (Pinto) (=Lutzomyia neivai) using a wind tunnel olfactometer. The primary aim was to determine whether field-collected female N. neivai would respond to host odours in the laboratory, thereby eliminating the need to maintain colonies of these insects for behavioural experiments. Responses to two key host odour components, 1-octen-3-ol and lactic acid, and a commercially-available mosquito lure (BG-Lure™) were assessed and compared relative to an air control. We also tested whether trials could be conducted outside of the normal evening activity period of N. neivai without impacting on fly behaviour, and whether the same flies could be used to assess baseline responses to air without affecting responses to octenol, thereby reducing the number of flies required for experiments. Results Octenol was found to both activate host-seeking behaviour and attract female N. neivai in the wind tunnel, while lactic acid elicited weaker responses of activation and attractiveness under identical conditions. The BG-Lure did not activate or attract N. neivai under test conditions. Further experiments showed that sandfly behaviour in the wind tunnel was not affected by time of day, such that experiments need not be restricted to nocturnal hours. Moreover, using the same flies to measure both baseline responses to air and attraction to test compounds did not affect

  13. The new situation of cutaneous leishmaniasis after Syrian civil war in Gaziantep city, Southeastern region of Turkey.

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    Özkeklikçi, Ahmet; Karakuş, Mehmet; Özbel, Yusuf; Töz, Seray

    2017-02-01

    Cutaneous leishmaniasis (CL) is an important public health problem with around 2.000 autochthonous reported cases each year in Turkey. Due to the civil war in Syria, Turkey received around three million refugees and they are mainly located at either camps or homes in south/southeastern part of Turkey. In the present study, we aimed to collect samples from CL suspected patients admitting to State Hospital in Gaziantep City and perform parasitological and DNA-based techniques for diagnosis as well as species identification of the parasite for better understanding the prevalence of each species among Turkish and Syrian patients in the region. The collection of samples was carried out between January 2009 and July 2015. The lesion aspiration samples were taken and stained with Giemsa stain followed by microscopical examination for parasitological diagnosis. After the DNA extraction from Giemsa stained slides, real time and semi-nested PCRs both targeting ITS1 region were performed for molecular diagnosis and species identification. A total of 567 people were admitted to the hospital with the suspicion of CL and 263 (46.4%) of them were found to be positive by parasitological examination. One hundred seventy-four (66.15%), 88 (33.46%) and 1 (0.38%) of them were Turkish, Syrians and Afghan, respectively. Slide samples obtained from 34 CL suspected patients were analyzed by PCR and 20 of them were found positive. Eighteen (13 Turkish and 13 Syrians) of the positive samples were identified as L. tropica, while two (1 Turkish and 1 Syrian) of them were L. infantum. In conclusion, the effects of Syrian civil war on the epidemiology of CL in Gaziantep city is demonstrated in the present study. The use of molecular tool in the diagnosis of leishmaniasis is effective, sensitive and time saving which will enable the species typing. Species typing of the causative agent in endemic areas will bring valuable data to epidemiological knowledge. Copyright © 2016 Elsevier B.V. All

  14. Microscopic and Molecular Detection of Leishmania Species Among Suspected Patients of Cutaneous Leishmaniasis Using ITS-r DNA in Fars Province

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    O Dehnam

    2012-10-01

    Full Text Available Introduction: Fars province is one of the most important foci of leishmaniasis that includes two types of cutaneous (urban and rural forms and visceral leishmaniasis in sympatry. To study leishmaniasis among suspected patients of cutaneous leishmaniasis in 5 counties of Shiraz, Firouz abad, GhirـKarzin, Farashband and Larestan, both microscopic and molecular analysis were carried out in the present study. Methods: The samples were smeared on the microscopic slides and were also stained by Giemsa. All smears were examined under a light microscope and the positive smears were scored for amastigote frequency. DNA was extracted from stained smears and Leishmania DNA was detected by amplification of ITS1ـ5.8sـITS2 fragments. Amplicons were analyzed using electrophoresis in 1.5 % agarose gel containing ethidium bromide. Results: Among 34 studied patients, 29 cases (%85 were positive in microscopic and 32 (%94 in molecular analysis using standard PCR. All examined samples were infected with L.major except one (%3 that was infected with L.tropica. Most lesions due to L.major were located on the feet, whereas ulcer due to L.tropica was on the forehead. Conclusions: Preparing stained smears from active lesions of suspected patients (microscopic analysis removes the problem of Leishmania preservation and transition to culture media. Also, intergenic variations in amplified fragment of ITS-rDNA cause to produce fragments with different length and based on this difference, we can identify L. major and L. tropica separately. Using microscopic and molecular methods in present study confirmed presence of L.major and L.tropica as the causative agents of CL in studied regions of Fars.

  15. Flow Cytometric Determination of Cellular Sources and Frequencies of Key Cytokine-Producing Lymphocytes Directed against Recombinant LACK and Soluble Leishmania Antigen in Human Cutaneous Leishmaniasis

    Science.gov (United States)

    Bottrel, R. L. A.; Dutra, W. O.; Martins, F. A.; Gontijo, B.; Carvalho, E.; Barral-Netto, M.; Barral, A.; Almeida, R. P.; Mayrink, W.; Locksley, R.; Gollob, K. J.

    2001-01-01

    Leishmaniasis, caused by infection with the protozoan parasite Leishmania, affects millions of individuals worldwide, causing serious morbidity and mortality. This study directly determined the frequency of cells producing key immunoregulatory cytokines in response to the recombinant antigen Leishmania homolog of receptors for activated kinase C (LACK) and soluble leishmania antigen (SLA), and it determined relative contributions of these antigens to the overall cytokine profile in individuals infected for the first time with Leishmania braziliensis. All individuals presented with the cutaneous clinical form of leishmaniasis and were analyzed for proliferative responses to LACK antigen and SLA, frequency of lymphocyte subpopulations (analyzed ex vivo), and antigen-induced (LACK and SLA) cytokine production at the single-cell level (determined by flow cytometry). The following were determined. (i) The Th1-type response previously seen in patients with cutaneous leishmaniasis is due to gamma interferon (IFN-γ) production by several different sources, listed in order of contribution: CD4+ T lymphocytes, CD4−, CD8− lymphocytes, and CD8+ T lymphocytes. (ii) SLA induced a higher frequency of lymphocytes producing IFN-γ and tumor necrosis factor alpha (TNF-α) than did LACK. (iii) LACK induced an activation of monocyte populations as reflected by an increased percentage of CD14-positive cells. (iv) Neither SLA nor LACK induced detectable frequencies of cells producing interleukin-4 (IL-4) or IL-5. These data demonstrated a multifaceted immune response to SLA in human leishmaniasis involving Th1 CD4+ T lymphocytes (IFN-γ+ and IL-10−/IL-4−), Tc1 CD8+ T cells (IFN-γ+, and IL-10−/IL-4−), and a high frequency of TNF-α-producing lymphocytes. Moreover, it was determined that the recombinant antigen LACK acts as a weak inducer of Th1-type lymphocyte responses compared to SLA. PMID:11292745

  16. The Study of Sand Fly Fauna in an Endemic Focus for Cutaneous Leishmaniasis in Fasa from April to October in the year 2013

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    Mehdi Sharafi

    2015-02-01

    Full Text Available Background & Objectives: Leishmaniasis as a zoonosis disease seen in three forms including Cutaneous, mucocutaneous, and visceral (kala- azar. The Leishmania transferred by sand flies is the causative agent of this disease. Considering that leishmaniasis is an endemic disease in Fasa, this study was performed to determine the sand fly species of Fasa, Materials & Methods: In this cross- sectional study from April to September 2014, the fauna of sand flies was investigated. Sampling was done in villages with above, medium, and low incidence by using sticky traps every 15 days. Then, captured specimens were mounted and identified by specific key. Results: 3842 sand flies were captured for ecological studies. 2305 of them (60% were males and the rest of them were females. 1152 specimens (30% of them were from indoors and the rest were from outdoors. Totally, 10 species were identified including Phlebotomus. Papatasi, Ph. Alexandri, Ph. Sergenti, Ph. Mongolensis, Ph. Bergeroti, Ph. Caucasicus, Sergentomyia theodori, S. Baghdadis, S. sintuni, and S. antennata. Among captured specimens Phlebotomus Papatasi, Ph. Sergenti had the first and the second places, respectively. Conclusion: Sandflies in Fasa are very active with high prevalence and species diversity. Phlebotomus Papatasi as the predominant species transfers Leishmania from rodents to humans. This subject is related to the prevalence of rural leishmaniasis in this area. According to the semi-domestic vector, spraying is not helpful in a rural foci of cutaneous leishmaniasis. But the control of reservoir and educating the residents about prevention ways of bite are effective in disease control and prevention.

  17. The sesquiterpene (-)-α-bisabolol is active against the causative agents of Old World cutaneous leishmaniasis through the induction of mitochondrial-dependent apoptosis.

    Science.gov (United States)

    Corpas-López, V; Merino-Espinosa, G; Díaz-Sáez, V; Morillas-Márquez, F; Navarro-Moll, M C; Martín-Sánchez, J

    2016-10-01

    Cutaneous leishmaniasis treatment remains challenging due to the absence of a satisfactory treatment. The screening of natural compounds is a valuable strategy in the search of new drugs against leishmaniasis. The sesquiterpene (-)-α-bisabolol is effective in vivo against visceral leishmaniasis due to Leishmania infantum, but its mechanism of action remains elusive. The aim of this study is to validate this promising compound against the causative species of Old World cutaneous leishmaniasis and to get an insight into its antileishmanial mode of action. The compound was evaluated on L. tropica promastigotes and intracellular amastigotes using bone marrow-derived macrophages and its cytotoxicity was evaluated on L929 fibroblasts. The reactive oxygen species generation was evaluated using a sensitive probe. Mitochondrial depolarization was assessed evaluating the fluorescence due to rhodamine 123 in a flow cytometer. Apoptosis was investigated by measuring the fluorescence due to annexin V and propidium iodide in a flow cytometer. The ultrastructure of treated promastigotes and intracellular amastigotes was analysed through transmission electron microscopy. (-)-α-Bisabolol was active against L. tropica intracellular amastigotes displaying an inhibitory concentration 50 % of 25.2 µM and showing low cytotoxicity. This compound induced time and dose-dependent oxidative stress, mitochondrial depolarization and phosphatidilserine externalization (a marker of apoptosis). These effects were noticed at a low concentration and short exposure time. In the ultrastructural analyses, the treated parasites showed mitochondrial disruption, presence of electron-dense structures and chromatin condensation. These results suggest that this natural compound induces oxidative stress and mitochondrial-dependent apoptosis on Leishmania without disturbing the plasma membrane.

  18. Physiological age in Lutzomyia youngi (Diptera: Psychodidae populations from an endemic area for cutaneous leishmaniasis, Venezuela

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    Scorza José V.

    1994-01-01

    Full Text Available Batches of sylvatic females of Lutzomyia youngi (Phlebotominae captured in a Shannon trap on twelve occasions over one year in a locality where subcutaneous leishmaniasis is endemic, near the city of Trujillo, Venezuela, were used to study: 1 the percentages of parous females according to previously established criteria and 2 the average number of eggs laid spontaneously by isolated females during 7 days after feeding on hamsters. The data on the batches of females captured on nights previous to the rainy period (prepluvial were compared with those on females captured after the rains (postpluvial . Significant differences were detected by variation analysis for two variables and different number of N, as also were consistent groupings by Duncan's Test for pre-and postpluvial lots of females. The females captured on nights prior to the rainy periods (January-March and August-September presented higher rates of nulliparity (86-72% and contained or laid a greater number of eggs (71-67 than those captured after the rains (March-June and November-December which presented lower rates of nulliparity (60-24% and a smaller number of eggs (50-30. The rainfall peaks occurred in April and September-October, respectively. It is considered that these differences can be used by epidemiological studies as a means of estimating the physiological age of female populations of L. youngy.

  19. Risk Mapping and Situational Analysis of Cutaneous Leishmaniasis in an Endemic Area of Central Iran: A GIS-Based Survey.

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    Abedi-Astaneh, Fatemeh; Hajjaran, Homa; Yaghoobi-Ershadi, Mohammad Reza; Hanafi-Bojd, Ahmad Ali; Mohebali, Mehdi; Shirzadi, Mohammad Reza; Rassi, Yavar; Akhavan, Amir Ahmad; Mahmoudi, Bagher

    2016-01-01

    Cutaneous leishmaniasis (CL) is among the top 10 infectious disease priorities in the world, and the leading cause of morbidity in Iran. The present study was conducted to assess the risk of CL, and to determine some epidemiological features of the disease in endemic areas of Qom Province in Central Iran during 2009 to 2013. Data regarding human cases of the disease were obtained from the Qom Province Health Center, prepared and stored in a spatial database created in ArcGIS10.3. A total of 9 out of 212 Leishmania spp. positive slides taken in 2013 from patients residing in Qom city were examined using molecular methods and the species of Leishmania was identified by PCR-RFLP. Those 9 patients had no history of travel outside the city. Spatial analysis and clustering methods were applied to find major hot spots and susceptible areas for the establishment of novel foci of the disease. Transmission patterns were examined for spatial autocorrelation using the Moran's I statistical application, and for the clustering of high or low values using the Getis-Ord Gi* statistics. During the period of study, a total of 1767 CL cases were passively reported in the area, out of which were 65% males and 35% females. The highest and lowest numbers of cases were reported in 2010 and 2013, respectively. Importantly, 979 cases were reported from urban areas, while the remainder came from rural areas. Leishmania major was detected as the causative agent of CL in the city of Qom. Remarkably, most patients recorded in Qom city were associated with a history of travel to the endemic areas of CL within the province, or to other endemic areas of the disease in Iran. Spatial distribution of CL cases revealed northeastern and southwestern quarters of the city were the major hot spots of the disease (P<0.05). Hot spot and CL transmission risk analysis across the province indicated that more than 40 villages were located in high and very high risk areas of CL transmission. Due to the

  20. Risk Mapping and Situational Analysis of Cutaneous Leishmaniasis in an Endemic Area of Central Iran: A GIS-Based Survey.

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    Fatemeh Abedi-Astaneh

    Full Text Available Cutaneous leishmaniasis (CL is among the top 10 infectious disease priorities in the world, and the leading cause of morbidity in Iran. The present study was conducted to assess the risk of CL, and to determine some epidemiological features of the disease in endemic areas of Qom Province in Central Iran during 2009 to 2013.Data regarding human cases of the disease were obtained from the Qom Province Health Center, prepared and stored in a spatial database created in ArcGIS10.3. A total of 9 out of 212 Leishmania spp. positive slides taken in 2013 from patients residing in Qom city were examined using molecular methods and the species of Leishmania was identified by PCR-RFLP. Those 9 patients had no history of travel outside the city. Spatial analysis and clustering methods were applied to find major hot spots and susceptible areas for the establishment of novel foci of the disease. Transmission patterns were examined for spatial autocorrelation using the Moran's I statistical application, and for the clustering of high or low values using the Getis-Ord Gi* statistics.During the period of study, a total of 1767 CL cases were passively reported in the area, out of which were 65% males and 35% females. The highest and lowest numbers of cases were reported in 2010 and 2013, respectively. Importantly, 979 cases were reported from urban areas, while the remainder came from rural areas. Leishmania major was detected as the causative agent of CL in the city of Qom. Remarkably, most patients recorded in Qom city were associated with a history of travel to the endemic areas of CL within the province, or to other endemic areas of the disease in Iran. Spatial distribution of CL cases revealed northeastern and southwestern quarters of the city were the major hot spots of the disease (P<0.05. Hot spot and CL transmission risk analysis across the province indicated that more than 40 villages were located in high and very high risk areas of CL transmission

  1. American cutaneous leishmaniasis caused by Leishmania (Viannia braziliensis resistant to meglumine antimoniate, but with good response to pentamidine: a case report

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    Maria Inês Fernandes Pimentel

    2011-04-01

    Full Text Available This is a case report of a Brazilian soldier with cutaneous leishmaniasis. The lesion relapsed following two systemic treatments with meglumine antimoniate. The patient was treated with amphotericin B, which was interrupted due to poor tolerance. Following isolation of Leishmania sp., six intralesional infiltrations of meglumine antimoniate resulted in no response. Leishmania sp promastigotes were again isolated. The patient was submitted to intramuscular 4mg/kg pentamidine. Parasites from the first and second biopsies were identified as Leishmania (Viannia braziliensis; those isolated from the first biopsy were more sensitive to meglumine antimoniate in vitro than those isolated from the second biopsy. No relapse was observed.

  2. Nota sobre leishmaniose tegumentar no litoral sul do Estado de São Paulo, Brasil Cutaneous leishmaniasis at the South Coastal region of the S. Paulo State, Brazil

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    Oswaldo Paulo Forattini

    1973-12-01

    Full Text Available Relata-se a existência de área endêmica de leishmaniose tegumentar na região Sul do litoral do Estado de São Paulo, Brasil. Descrevem-se 17 casos a maioria dos quais foram diagnosticados parasitologicamente. As características observadas permitem supor a possibilidade de transmissão intradomiciliar.An endemic area of cutaneous leishmaniasis, in the South Coastal region of S. Paulo State, Brazil, is reported. Seventeen cases were found and diagnostic was made mainly through parasitologic evidences. Probability of local intradomiciliary transmission is suspected.

  3. The sand fly fauna (Diptera: Psychodidae: Phlebotominae of a focus of cutaneous leishmaniasis in Ilhéus, state of Bahia, Brazil

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    Alfredo CR Azevedo

    1996-02-01

    Full Text Available The municipality of Ilhéus, State of Bahia, has a focus of cutaneous leishmaniasis where entomological studies were carried out to determine the sand fly species and their habits. Lutzomyia migonei, L. sallesi, L. tupynambai, L. schreiberi, L. intermedia, L. whitmani, L. yuilli yuilli, L. fischeri, L. pessoai, L. shannoni and L. misionensis were identified. Lutzomyia whitmani was the predominant species. Specimens were collected indoors, at peridomestic sites, in the cocoa plantations and in other types of collections. Females fed readily on humans and were attracted to domestic animals. Our evidence suggests that L. whitmani is a probable vector.

  4. Leishmanioses tegumentares: aspectos clínicos e imunopatológicos Cutaneous leishmaniasis: clinical and immunopathological aspects

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    Gabriel Grimaldi Júnior

    1982-06-01

    Full Text Available Foi visto nesta revisão que os parasitas do gênero Leishmania induzem uma variedade de respostas complexas nos hospedeiros vertebrados, efetuadas e/ou moduladas pelo seu sistema imunológico. Foi também salientado que o destino da Leishmania no interior de macrófagos depende de relações particulares parasito-hospedeiro, envolvendo não apenas as propriedades intrísecas do parasita, mas também as características, geneticamente determinadas, da cédula hospedeira ou das suas interações com outras células imunocompetentes. Atráves de uma revisão das evidências consubstanciando essesconceitos, os mesmos foram aplicados na descrição do espectro clínico e imunopatológico da doença humana, particularmente das leishmanioses cutâneas e mucocutâneas do Novo e do Velho Mundo. Finalmente, baseando-se nos resultados obtidos em modelos experimentais de leishmaniose cutânea, os quais reproduzem os achados das formas resolutiva e persistentes da doença humana, o autor apresenta uma análise esquemática da evolução das características histopatológicas das lesões leishmanióticas.Parasites of the genus Leishmania induce a complex variety of responses in their mammalian hosts, effected and/or modulated by the immune system. The outcome of leishmanial infection of macrophages depends on factors particular to each host-parasite combination, involving not only intrinsic properties of the parasite, but also genetically determined characteristics of the host cell or of its interactions with immunocompetent cells. Following a review of evidence supporting these concepts, they are applied in describing the clinical and immunopathological spectrum of the disease as it occurs in man, with emphasis on the cutaneous and mucocutaneous leishmaniases of the Old and New World. Based on results obtained in experimental models of cutaneous leishmaniasis which reproduce features of healing and non-healing human disease, the author presents a schematic

  5. Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador: the vector Lutzomyia sand flies and reservoir mammals.

    Science.gov (United States)

    Hashiguchi, Yoshihisa; Gomez L, Eduardo A; Cáceres, Abraham G; Velez, Lenin N; Villegas, Nancy V; Hashiguchi, Kazue; Mimori, Tatsuyuki; Uezato, Hiroshi; Kato, Hirotomo

    2018-02-01

    The vector Lutzomyia sand flies and reservoir host mammals of the Leishmania parasites, causing the Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador were thoroughly reviewed, performing a survey of literatures including our unpublished data. The Peruvian L. (V.) peruviana, a principal Leishmania species causing Andean-CL in Peru, possessed three Lutzomyia species, Lu. peruensis, Lu. verrucarum and Lu. ayacuchensis as vectors, while the Ecuadorian L. (L.) mexicana parasite possessed only one species Lu. ayacuchensis as the vector. Among these, the Ecuadorian showed a markedly higher rate of natural Leishmania infections. However, the monthly and diurnal biting activities were mostly similar among these vector species was in both countries, and the higher rates of infection (transmission) reported, corresponded to sand fly's higher monthly-activity season (rainy season). The Lu. tejadai sand fly participated as a vector of a hybrid parasite of L. (V.) braziliensis/L. (V.) peruviana in the Peruvian Andes. Dogs were considered to be principal reservoir hosts of the L. (V.) peruviana and L. (L.) mexicana parasites in both countries, followed by other sylvatic mammals such as Phyllotis andium, Didelphis albiventris and Akodon sp. in Peru, and Rattus rattus in Ecuador, but information on the reservoir hosts/mammals was extremely poor in both countries. Thus, the Peruvian disease form demonstrated more complicated transmission dynamics than the Ecuadorian. A brief review was also given to the control of vector and reservoirs in the Andes areas. Such information is crucial for future development of the control strategies of the disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Molecular characterization of Leishmania spp. in reservoir hosts in endemic foci of zoonotic cutaneous leishmaniasis in Iran.

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    Akhoundi, Mohammad; Mohebali, Mehdi; Asadi, Mina; Mahmodi, Mohamad Reza; Amraei, Kamyar; Mirzaei, Asad

    2013-07-01

    Zoonotic cutaneous leishmaniasis (ZCL) is an expanding disease and a public health issue in Iran. In the present study, rate of natural infection of rodent populations with Leishmania was investigated in six endemic foci including 28 villages in Golestan, Esfahan, Yazd, Fars, Khuzestan and Ilam provinces. A total of 593 rodents were captured and identified as Rhombomys opimus (n = 325), Meriones libycus (n = 171), Meriones persicus (n = 27), Tatera indica (n = 37), Nesokia indica (n = 12), Rattus rattus (n = 13) and Mus musculus (n = 8). Microscopic examinations of Giemsa-stained smears showed that 108 out of 593 (18.2%) rodents were infected with Leishmania spp., whereas infection of 186 out of 593 (31.4%) rodents with Leishmania was then confirmed by ITS1-PCR. The highest rate of infection was found in R. opimus (prevalence of 35%) and M. libycus (31%). Based on Restriction Fragment Length Polymorphism (RFLP), 145 (78%) of 186 samples detected as Leishmania DNA were identified as L. major, 8 (4%) samples as L. turanica and 33 (18%) as mixed infection (L. major and L. turanica). Samples from infected rodents were inoculated subcutaneously at tail base of BALB/c mice. In 35 of them, nodules and ulcers containing amastigotes appeared at the inoculation site. The samples prepared from infected rodents were cultured in NNN medium and only two samples werepositive. Rhombomys opimus, M. libycus, M. persicus, T. indica and N. indica were confirmed as reservoir hosts of ZCL in the studied regions. Leishmania major infection was usually accompanied L. turanica in naturally infected gerbils (R. opimus and M. libycus) in Golestan, Esfahan and Fars provinces.

  7. Environmental and socio-economic determinants associated with the occurrence of cutaneous leishmaniasis in the northeast of Colombia.

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    Gutierrez, Juan D; Martínez-Vega, Ruth; Ramoni-Perazzi, Josefa; Diaz-Quijano, Fredi A; Gutiérrez, Reinaldo; Ruiz, Freddy J; Botello, Hector A; Gil, María; González, Juan; Palencia, Mario

    2017-12-01

    Cutaneous leishmaniasis (CL) is a vector-borne disease that is widely distributed in most tropical regions. Colombia has experienced an important increase in its incidence during the last decade. There are CL transmission foci in the Colombian departments of Santander and Norte de Santander. To identify environmental and socio-economic variables associated with CL incidence in the municipalities of the northeast of Colombia between 2007 and 2016. This was an ecological study of CL cases aggregated by municipality. The cases reported during the study period were analyzed with a negative binomial regression to obtain the adjusted incident rate ratio for environmental and socio-economic variables. During the study period, 10 924 cases of CL were reported, and 110 (86.6%) municipalities reported at least one CL case. The coverages of forest (aIRR 1.05, 95% CI 1.03-1.07), heterogeneous agricultural zones (aIRR 1.04, 95% CI 1.02-1.06) and permanent crops (aIRR 1.07, 95% CI 1.02-1.12) were associated with a higher incidence of CL. Conversely, urban functionality (aIRR 0.95, 95% CI 0.92-0.96), minimal-altitude above sea level (aIRR 0.84, 95% CI 0.79-0.90) and shrub coverage (aIRR 0.98, 95% CI 0.95-1.0) were negatively associated with the incidence of CL in the municipality. Our results confirm the importance of environmental determinants, such as height above sea level, and coverage of forest, permanent crops and heterogeneous agricultural zones, for the occurrence of CL; these findings also suggest the importance of shrub coverage. Furthermore, urban functionality was a socio-economic determinant independently associated with CL incidence.

  8. Zoophilic feeding behaviour of phlebotomine sand flies in the endemic areas of cutaneous leishmaniasis of Sindh Province, Pakistan.

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    Tiwananthagorn, Saruda; Bhutto, Abdul Manan; Baloch, Javed Hussain; Soomro, Farooq Rahman; Kawamura, Yuta; Nakao, Ryo; Aoshima, Keisuke; Nonaka, Nariaki; Oku, Yuzaburo; Katakura, Ken

    2012-07-01

    Leishmania (Leishmania) major has been identified as the major causative agent of cutaneous leishmaniasis in Sindh Province of southern Pakistan. To make a rational approach for understanding the pathogen transmission cycles, the sand fly species and their natural blood meals in the endemic areas were examined. Total DNA was individually extracted from sand flies collected in four villages in Sindh Province. PCR-RFLP (restriction fragment length polymorphism) and sequence analysis of the 18S ribosomal RNA gene revealed that female sand flies identified were Sergentomyia clydei/Sergentomyia ghesquierei/Sergentomyia magna (68.6%), Sergentomyia dubia (17.1%), Phlebotomus papatasi (7.4%), Phlebotomus alexandri-like sand flies (3.4%) and Sergentomyia dentata (3.4%). PCR amplification of leishmanial kinetoplast DNA did not result in positive signals, suggesting that all 175 tested female sand flies were not infected with leishmanial parasites or contained undetectable levels of leishmanial DNA. Amplification and sequencing of the vertebrate cytochrome b gene in 28 blood-fed sand flies revealed that P. papatasi fed on cattle and wild rat whereas P. alexandri-like specimens fed on human, cattle, goat and dog. Although Sergentomyia sand flies are generally known to feed on cold-blooded animals, S. clydei, S. dubia and S. ghesquierei preferred humans, cattle, goat, sheep, buffalo, dog, donkey, wild rat and Indian gerbil. The epidemiological significance of the zoophilic feeding on various host species by Phlebotomus and Sergentomyia sand flies in Pakistan is further required to study for better understanding the zoonotic transmission of sand-fly-borne pathogens and for appropriate management of the vectors.

  9. Molecular variation in Leishmania parasites from sandflies species of a zoonotic cutaneous leishmaniasis in northeast of Iran.

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    Sharbatkhori, Mitra; Spotin, Adel; Taherkhani, Heshmatollah; Roshanghalb, Mona; Parvizi, Parviz

    2014-03-01

    In the well-known zoonotic cutaneous leishmaniasis (ZCL) focus in Turkmen Sahara, border of Iran and Turkmenistan, ZCL has increased among humans in the past five years. The present study was undertaken to incriminate vectors of ZCL in the region, and to find molecular variation in Leishmania parasites. The sandflies were sampled using CDC light-traps and sticky papers. All the sandflies were identified using morphological characters of the head and abdominal terminalia. DNA was extracted from the dissected thorax and attached anterior abdomen of individual female sandfly. Leishmania detection and identification of sandflies were performed using PCR, digestion of BsuRI restriction enzyme and sequencing of ITS-rDNA gene and also by semi-nested PCR to amplify minicircle kinetoplast (k) DNA of Leishmania. Leishmania infections were detected in 26 out of 206 female sandflies. Of the infected sandflies, 18 were Phlebotomus papatasi while eight were P. caucasicus/P. mongolensis. Two infections of L. turnica were detected, one in P. papatasi and other in P. caucasicus/P. mongolensis and the rest of the sandflies were found infected with L. major. Our finding showed that L. major had low diversity with only one common haplotype (GenBank Access No. EF413075). The novel haplotypes were discovered in L. major (GenBank Access No. KF152937) and in L. turanica (GenBank Access No. EF413079) in low frequency. These Leishmania parasites are circulating to maintain infections in the P. papatasi and P. caucasicus/P. mongolensis in Turkmen Sahara.

  10. Risk Mapping of Cutaneous Leishmaniasis via a Fuzzy C Means-based Neuro-Fuzzy Inference System

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    P. Akhavan

    2014-10-01

    Full Text Available Finding pathogenic factors and how they are spread in the environment has become a global demand, recently. Cutaneous Leishmaniasis (CL created by Leishmania is a special parasitic disease which can be passed on to human through phlebotomus of vector-born. Studies show that economic situation, cultural issues, as well as environmental and ecological conditions can affect the prevalence of this disease. In this study, Data Mining is utilized in order to predict CL prevalence rate and obtain a risk map. This case is based on effective environmental parameters on CL and a Neuro-Fuzzy system was also used. Learning capacity of Neuro-Fuzzy systems in neural network on one hand and reasoning power of fuzzy systems on the other, make it very efficient to use. In this research, in order to predict CL prevalence rate, an adaptive Neuro-fuzzy inference system with fuzzy inference structure of fuzzy C Means clustering was applied to determine the initial membership functions. Regarding to high incidence of CL in Ilam province, counties of Ilam, Mehran, and Dehloran have been examined and evaluated. The CL prevalence rate was predicted in 2012 by providing effective environmental map and topography properties including temperature, moisture, annual, rainfall, vegetation and elevation. Results indicate that the model precision with fuzzy C Means clustering structure rises acceptable RMSE values of both training and checking data and support our analyses. Using the proposed data mining technology, the pattern of disease spatial distribution and vulnerable areas become identifiable and the map can be used by experts and decision makers of public health as a useful tool in management and optimal decision-making.

  11. Is paromomycin an effective and safe treatment against cutaneous leishmaniasis? A meta-analysis of 14 randomized controlled trials.

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    Dae Hyun Kim

    Full Text Available BACKGROUND: High cost, poor compliance, and systemic toxicity have limited the use of pentavalent antimony compounds (SbV, the treatment of choice for cutaneous leishmaniasis (CL. Paromomycin (PR has been developed as an alternative to SbV, but existing data are conflicting. METHODOLOGY/PRINCIPAL FINDINGS: We searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials, without language restriction, through August 2007, to identify randomized controlled trials that compared the efficacy or safety between PR and placebo or SbV. Primary outcome was clinical cure, defined as complete healing, disappearance, or reepithelialization of all lesions. Data were extracted independently by two investigators, and pooled using a random-effects model. Fourteen trials including 1,221 patients were included. In placebo-controlled trials, topical PR appeared to have therapeutic activity against the old world and new world CL, with increased local reactions, when used with methylbenzethonium chloride (MBCL compared to when used alone (risk ratio [RR] for clinical cure, 2.58 versus 1.01: RR for local reactions, 1.60 versus 1.07. In SbV-controlled trials, the efficacy of topical PR was not significantly different from that of intralesional SbV in the old world CL (RR, 0.70; 95% confidence interval, 0.26-1.89, whereas topical PR was inferior to parenteral SbV in treating the new world CL (0.67; 0.54-0.82. No significant difference in efficacy was found between parenteral PR and parenteral SbV in the new world CL (0.88; 0.56-1.38. Systemic side effects were fewer with topical or parenteral PR than parenteral SbV. CONCLUSIONS/SIGNIFICANCE: Topical PR with MBCL could be a therapeutic alternative to SbV in selected cases of the old world CL. Development of new formulations with better efficacy and tolerability remains to be an area of future research.

  12. Gene Expression Profile of High IFN-γ Producers Stimulated with Leishmania braziliensis Identifies Genes Associated with Cutaneous Leishmaniasis.

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    Carneiro, Marcia W; Fukutani, Kiyoshi F; Andrade, Bruno B; Curvelo, Rebecca P; Cristal, Juqueline R; Carvalho, Augusto M; Barral, Aldina; Van Weyenbergh, Johan; Barral-Netto, Manoel; de Oliveira, Camila I

    2016-11-01

    The initial response to Leishmania parasites is essential in determining disease development or resistance. In vitro, a divergent response to Leishmania, characterized by high or low IFN-γ production has been described as a potential tool to predict both vaccine response and disease susceptibility in vivo. We identified uninfected and healthy individuals that were shown to be either high- or low IFN-γ producers (HPs and LPs, respectively) following stimulation of peripheral blood cells with Leishmania braziliensis. Following stimulation, RNA was processed for gene expression analysis using immune gene arrays. Both HPs and LPs were shown to upregulate the expression of CXCL10, IFI27, IL6 and LTA. Genes expressed in HPs only (CCL7, IL8, IFI44L and IL1B) were associated with pathways related to IL17 and TREM 1 signaling. In LPs, uniquely expressed genes (for example IL9, IFI44, IFIT1 and IL2RA) were associated with pathways related to pattern recognition receptors and interferon signaling. We then investigated whether the unique gene expression profiles described here could be recapitulated in vivo, in individuals with active Cutaneous Leishmaniasis or with subclinical infection. Indeed, using a set of six genes (TLR2, JAK2, IFI27, IFIT1, IRF1 and IL6) modulated in HPs and LPs, we could successfully discriminate these two clinical groups. Finally, we demonstrate that these six genes are significantly overexpressed in CL lesions. Upon interrogation of the peripheral response of naive individuals with diverging IFN-γ production to L. braziliensis, we identified differences in the innate response to the parasite that are recapitulated in vivo and that discriminate CL patients from individuals presenting a subclinical infection.

  13. Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador: the causative Leishmania parasites and clinico-epidemiological features.

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    Hashiguchi, Yoshihisa; Gomez, Eduardo A L; Cáceres, Abraham G; Velez, Lenin N; Villegas, Nancy V; Hashiguchi, Kazue; Mimori, Tatsuyuki; Uezato, Hiroshi; Kato, Hirotomo

    2018-01-01

    This study provides comprehensive information on the past and current status of the Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador, mainly focusing on the causative Leishmania parasites and clinico-epidemiological features. Available information and data including our unpublished works were analyzed thoroughly. Endemic regions of the Andean-CL (uta) in Peru run from the north Piura/Cajamarca to the south Ayacucho at a wide range of the Pacific watersheds of the Andes through several departments, while in Ecuador those exist at limited and spotted areas in the country's mid-southwestern two provinces, Azuay and Chimborazo. The principal species of the genus Leishmania are completely different at subgenus level, L. (Viannia) peruviana in Peru, and L. (Leishmania) mexicana and L. (L.) major-like (infrequent occurrence) in Ecuador. The Peruvian uta is now prevalent in different age and sex groups, being not clearly defined as found in the past. The precise reasons are not known and should be elucidated further, though probable factors, such as emergence of other Leishmania parasites, non-immune peoples' migration into the areas, etc., were discussed briefly in the text. The Andean-CL cases in Ecuador are more rural than before, probably because of a rapid development of the Leishmania-positive communities and towns, and the change of life-styles of the inhabitants, including newly constructed houses and roads in the endemic areas. Such information is helpful for future management of the disease, not only for Leishmania-endemic areas in the Andes but also for other endemic areas. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Clinical and laboratory profiles of patients with early spontaneous healing in cutaneous localized leishmaniasis: a historical cohort study.

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    Oliveira-Ribeiro, Carla; Pimentel, Maria Inês Fernandes; Oliveira, Raquel de Vasconcellos Carvalhaes; Fagundes, Aline; Madeira, Maria de Fatima; Mello, Cintia Xavier; Mouta-Confort, Eliame; Valete-Rosalino, Claudia Maria; Vasconcellos, Erica de Camargo Ferreira; Lyra, Marcelo Rosandiski; Quintella, Leonardo Pereira; Fatima Antonio, Liliane de; Schubach, Armando; Conceição-Silva, Fatima

    2017-08-10

    Skin ulcers in American cutaneous leishmaniasis (ACL) may heal spontaneously after months/years. However, few cases may present quick heal even during diagnosis procedure (early spontaneous healing- ESH). The main objective of this study was to compare ESH patients with cases requiring specific treatment [non-ESH (NESH)]. A historical cohort study of ACL patients (n = 445) were divided into 2 groups: ESH - spontaneously healed patients (n = 13; 2.90%), and NESH- treated patients (n = 432; 97.10%). We compared clinical and laboratorial findings at diagnosis, including the lesion healing process. ESH patients had a higher percentage of single lesions (p = 0.027), epithelialized lesion on initial examination (p = 0.001), lesions located in the dorsal trunk (p = 0.017), besides earlier healing (p < 0.001). NESH presents higher frequency of ulcerated lesions (p = 0.002), amastigotes identified in histopathology exams (p = 0.005), positive cultures (p = 0.001), and higher positivity in ≥3 parasitological exams (p = 0.030). All ESH cases were positive in only a single exam, especially in PCR. ESH group apparently presented a lower parasitic load evidenced by the difficulty of parasitological confirmation and its positivity only by PCR method. The absence or deficiency of specific treatment is commonly identified as predisposing factors for recurrence and metastasis in ACL. However, due to the drugs toxicity, the treatment of cases which progress to early spontaneous healing is controversial. ESH patients were followed for up to 5 years after cure, with no evidence of recrudescence, therefore suggesting that not treating these patients is justifiable, but periodic dermatological and otorhinolaryngological examinations are advisable to detect a possible relapse.

  15. Variability of Cutaneous Leishmaniasis Lesions Is Not Associated with Genetic Diversity ofLeishmania tropicain Khyber Pakhtunkhwa Province of Pakistan.

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    Khan, Nazma Habib; Llewellyn, Martin S; Schönian, Gabriele; Sutherland, Colin J

    2017-11-01

    Leishmania tropica is the causative agent of cutaneous leishmaniasis in Pakistan. Here, intraspecific diversity of L. tropica from northern Pakistan was investigated using multilocus microsatellite typing. Fourteen polymorphic microsatellite markers were typed in 34 recently collected L. tropica isolates from Pakistan along with 158 archival strains of diverse Afro-Eurasian origins. Previously published profiles for 145 strains of L. tropica originating from different regions of Africa, Central Asia, Iran, and Middle East were included for comparison. Six consistently well-supported genetic groups were resolved: 1) Asia, 2) Morroco A, 3) Namibia and Kenya A, 4) Kenya B/Tunisia and Galilee, 5) Morocco B, and 6) Middle East. Strains from northern Pakistan were assigned to Asian cluster except for three that were placed in a geographically distant genetic group; Morocco A. Lesion variability among these Pakistani strains was not associated with specific L. tropica genetic profile. Pakistani strains showed little genetic differentiation from strains of Iraq, Afghanistan, and Syria (F ST = 0.00-0.06); displayed evidence of modest genetic flow with India (F ST = 0.14). Furthermore, genetic structuring within these isolates was not geographically defined. Pak-Afghan cluster was in significant linkage disequilibrium (I A = 1.43), had low genetic diversity, and displayed comparatively higher heterozygosity (F IS = -0.62). Patterns of genetic diversity observed suggest dominance of a minimally diverse clonal lineage within northern Pakistan. This is surprising as a wide clinical spectrum was observed in patients, suggesting the importance of host and other factors. Further genotyping studies of L. tropica isolates displaying different clinical phenotypes are required to validate this potentially important observation.

  16. Triphenylmethane Derivatives Have High In Vitro and In Vivo Activity against the Main Causative Agents of Cutaneous Leishmaniasis

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    de Souza Pietra, Renata Celi Carvalho; Rodrigues, Lucas Fonseca; Teixeira, Eliane; Fried, Levi; Lefkove, Benjamin; Rabello, Ana; Arbiser, Jack; Ferreira, Lucas Antônio Miranda; Fernandes, Ana Paula

    2013-01-01

    The current standard of care for cutaneous leishmaniasis (CL) is organic antimonial compounds, but the administration of these compounds is complicated by a low therapeutic - toxic index, as well as parenteral administration. Thus, there is an urgent need for the development of new and inexpensive therapies for the treatment of CL. In this study, we evaluate the activity of the triphenylmethane (TPM) class of compounds against three species of Leishmania which are pathogenic in humans. The TPM have a history of safe use in humans, dating back to the use of the original member of this class, gentian violet (GV), from the early 20th century. Initially, the in vitro efficacy against Leishmania (Viannia) braziliensis, L. (Leishmania) amazonensis and L. (L.) major of 9 newly synthesized TPM, in addition to GV, was tested. Inhibitory concentrations (IC) IC50 of 0.025 to 0.84 µM had been found in promastigotes in vitro assays. The four most effective compounds were then tested in amastigote intracellular assays, resulting in IC50 of 0.10 to 1.59 µM. A high degree of selectivity of antiparasitic activity over toxicity to mammalian cells was observed. Afterwards, GV and TPM 6 were tested in a topical formulation in mice infected with L. (L.) amazonensis leading to elimination of parasite burdens at the site of lesion/infection. These results demonstrated that TPM present significant anti-leishmanial activities and provide a rationale for human clinical trials of GV and other TPM. TPM are inexpensive and safe, thus using them for treatment of CL may have a major impact on public health. PMID:23341885

  17. Macroecological patterns of American Cutaneous Leishmaniasis transmission across the health areas of Panamá (1980–2012

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    Koji Yamada

    2016-06-01

    Full Text Available American Cutaneous Leishmaniasis (ACL is a neglected vector-borne zoonosis that persists despite increasing socio-economic development and urbanization in Panamá. Here, we investigate the association between environmental changes and spatio-temporal ACL transmission in the Republic of Panamá (1980–2012. We employ a macroecological approach, where patterns of variation in ACL incidence at the spatially coarse-grained scale of health areas are studied considering factors linked to the ecology of ACL transmission. We specifically study impacts of climatic variability, measured by the different phases of El Niño Southern Oscillation (ENSO, within diverse ecosystems and sand fly (Diptera: Psychodidae vector species, as well as heterogeneous local climatic patterns, deforestation, population growth rates, and changes in social marginalization. We found that over the study period, patterns of ACL incidence: (i were asynchronous with clusters changing from east to west of the Panamá Canal, (ii trends increased in the west, and decreased or remained nearly constant in the east, independent of human population growth, (iii generally increased in years following El Niño, and (iv decreased as forest cover increased. We found no significant association between changes in socio-economic indicators and ACL transmission. Regarding vector abundance and presence, we found that studies had been biased to locations east of the Panamá canal, and that, in general, the abundance of dominant vector species decreased during the cold phase of ENSO. Finally, our results indicate that a macroecological approach is useful to understand heterogeneities related to environmental change impacts on ACL transmission.

  18. "The mosquitoes that destroy your face". Social impact of Cutaneous Leishmaniasis in South-eastern Morocco, A qualitative study.

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    Bennis, Issam; Belaid, Loubna; De Brouwere, Vincent; Filali, Hind; Sahibi, Hamid; Boelaert, Marleen

    2017-01-01

    To document the psychosocial burden of Cutaneous Leishmaniasis (CL) in rural communities in Southeastern Morocco. Between March and April 2015, we conducted qualitative research in communities exposed to Leishmania major or L. tropica in Errachidia and Tinghir provinces. Twenty-eight focus groups discussions (FGDs) were realized, with a stratification by gender and tradition of medicine (users of folk versus professional medicine). Data were analyzed using content analysis. This rural population most exposed to CL in Morocco lacks access to health care in general and clearly points out there are other major public health issues that need to be resolved. Nonetheless, respondents consider the impact of CL lesions and scars as important and similar to that of burn scar tissue. Young women with CL scars in the face are stigmatized and will often be rejected for marriage in these communities. People usually try a long list of folk remedies on the active lesions, but none was felt adequate. There was a clear demand for better treatment as well as for treatment of the scars. The psycho-social impact of CL due to L.major and L.tropica is substantial, especially for young single women with facial scars. These generate social and self-stigma and diminish their marriage prospects. CL is well known, but not considered as a major health priority by these poor rural communities in South-eastern Morocco where gender discrimination is still an issue and access to basic health care is as neglected as CL. Early CL diagnosis and new treatment options with better skin outcomes are urgently needed.

  19. Detection of DNA from Leishmania (Viannia: accuracy of polymerase chain reaction for the diagnosis of cutaneous leishmaniasis.

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    Herintha Coeto Neitzke-Abreu

    Full Text Available Cutaneous leishmaniasis (CL can occur in skin and mucosa, causing disfiguring lesions. The laboratory diagnosis of CL involves immunological methods and optical detection of the parasite, al of which have limitations. There is a need for more effective diagnostic methods for CL which wil allow treatment to be initiated more promptly in order to help prevent the development of severe forms of mucosal disease, and to estimate the prognosis of the infection. The polymerase chain reaction (PCR has been widely used to diagnose CL, because of its higher sensitivity. This study estimated the accuracy and compared PCRs of samples from lesion scarification (PCR-L and blood sample-enriched leukocytes (PCR-B with three conventional diagnostic techniques: parasite direct search (DS, Montenegro skin test (MST, and indirect immunofluorescence reaction (IIF. The study included 276 patients under suspicion of CL. We conducted a cross-sectional study, in which patients were selected by convenience sampling. We used MP3H/MP1L primers to generate a Leishmania (Viannia (minicircle kDNA fragment of 70-bp. Of 106 patients with CL, 83.87%, 51.67%, 64.52%, 85.71%, or 96.10% tested positive by PCR-L, PCR-B, DS, IIF, or MST, respectively. Five patients tested positive only by PCR-L, and two other patients only by PCR-B. PCR-L is indicated for use in patients with chronic lesions or Leishmania reinfection, which may progress to mucosal lesion. PCR-B is indicated for use in patients with negative results in conventional tests or for patients with no apparent lesion. PCR is not only useful in diagnosing CL but also helps to identify the infecting species.