Biopsies of 71 cases of atypical cutaneous leishmaniasis from Costa Rican patients were evaluated by histopathological procedures and attempts were made to culture Leishmania from nine biopsies. Leishmanin skin tests were carried out in 31 patients and 112 healthy individuals. Additional biopsies from 19 patients from Nicaragua were evaluated by routine histopathology. Ten biopsies were studied by confocal and nine by scanning electron microscopy. Inorganic material was analysed using an electron probe for microanalysis. Leishmania parasites were isolated from only two biopsies, but 90.3% of the patients from Costa Rica were leishmanin-positive, as were 27.7% of healthy individuals. Routine histopathological studies revealed naked granulomas formed by differentiated macrophages. Abundant inorganic material was observed in sections examined by confocal microscopy. Electron probe analysis revealed that silica and aluminium were the predominant elements in large particles. We postulate that the presence of this inorganic material, possibly of volcanic origin, in the skin may modulate the immunological response to Leishmania and may inhibit visceralization in the cases caused by Leishmania chagasi.
Passively transferred immune serum provided significantly greater protection to BALB/c mice against attenuated Brucella abortus 19 than against virulent strain 2308, whether serum donors had been infected with strain 19 or 2308. In contrast, immune T cells conferred better protection upon recipients challenged with the homologous strain of B. abortus. It is hypothesized that strain 2308, but not strain 19, can survive in macrophages after opsonization and that epitopes which induce protective cell-mediated immunity may differ between strains 19 and 2308.
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