Lacrimal excretory system sequelae in patients treated for leishmaniasis

Hoyama, Érika; Schellini, Silvana Artioli; Stolf, Hamílton Ometto; Nakajima, Victor

doi:10.1590/s0004-27492006000300010

Cited by 2 publications

(4 citation statements)

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“…L. donovani and L. infantum have been identified in gastrointestinal mucosa [23], the genitourinary tract [24], and the eye and lacrimal excretory system [25, 26]. Although these clinical manifestations of infection affecting the gamut of mucosal surfaces involved viscerotropic species of Leishmania, they portray a pattern of dissemination to mucosal tissues that—in the light of the findings of this study—may be more frequent and common than previously suspected for other species of Leishmania .…”

Section: Discussionmentioning

confidence: 52%

“…The presence of parasites in tonsilar tissue is consistent with lymphatic dissemination [30] to mucosal sites. Nevertheless hematologic dissemination also occurs in mucosal leishmaniasis, as shown by hemoculture [10, 31]; PCR and Southern blot analysis have provided evidence of parasitemia in at least 30% of blood samples from patients with cutaneous disease [6] and in asymptomatically infected individuals [26]. In a separate study, Leishmania (Viannia) kDNA was amplified from blood monocytes from 19 (68%) of the 28 patients included in this study (I.C.R.…”

Section: Discussionmentioning

confidence: 99%

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Detection ofLeishmaniain Unaffected Mucosal Tissues of Patients with Cutaneous Leishmaniasis Caused byLeishmania (Viannia)Species

et al. 2009

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Background Leishmania (Viannia) species are the principal cause of mucosal leishmaniasis. The natural history and pathogenesis of mucosal disease are enigmatic. Parasitological evaluation of mucosal tissues has been constrained by the invasiveness of conventional sampling methods. Methods We evaluated the presence ofLeishmania in the mucosa of 26 patients with cutaneous leishmaniasis and 2 patients with mucocutaneous leishmaniasis. Swab samples of the nasal mucosa, tonsils, and conjunctiva were analyzed using polymerase chain reaction with LV-B1 primers and Southern blot hybridization. Results Two patients with mucocutaneous leishmaniasis and 21 (81%) of 26 patients with cutaneous leishmaniasis had Leishmania kinetoplast minicircle DNA (kDNA) in mucosal tissues. kDNA was amplified from swab samples of nasal mucosa from 14 (58%) of 24 patients, tonsils from 13 (46%) of 28 patients, and conjunctiva from 6 (25%) of 24 patients. kDNA was detected in the mucosa of patients with cutaneous disease caused by Leishmania panamensis, Leishmania guyanensis, and Leishmania braziliensis. Conclusion The asymptomatic presence of parasites in mucosal tissues may be common in patients with Leishmania (Viannia) infection.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Detection ofLeishmaniain Unaffected Mucosal Tissues of Patients with Cutaneous Leishmaniasis Caused byLeishmania (Viannia)Species

et al. 2009

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“…Nasolacrimal duct function was found to be impaired in a significant proportion of patients having suffered from MCL, secondary to lesions affecting the nasal septum and nasopharynx, leading to epiphoria or a burning sensation. [ 24 ] A single case of orbital Leishmaniasis was found. It described the case of an HIV-positive young man presenting with sinusitis, exophthalmos, and unilateral visual impairment.…”

Section: Resultsmentioning

confidence: 99%

“…[ 53 54 ] In cases of uveitis, due to the absence of adnexal lesions and the temporal association with previous systemic Leishmaniasis, it appears the hematogenous route plays the most important role. [ 24 54 55 ] When attempting to obtain microbiological confirmation of Leishmanial uveitis, it is essential to bear in mind that negative splenic and bone marrow aspirate often co-exist with positive ocular samples. [ 38 48 ] It is therefore crucial to obtain samples from the eye itself.…”

Section: Resultsmentioning

confidence: 99%

Ocular Leishmaniasis - A systematic review

Mignot

Bhattacharya

Reddy

2021

Indian J Ophthalmol

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The incidence of leishmaniasis is reported to be up to 1 million per year. To date, there has been no comprehensive review describing the diversity of clinical presentations of ocular leishmaniasis (OL) and its treatment. This systematic review aims to address this knowledge gap and provide a summary of the clinical presentation, natural course, and treatment options for OL. Our study identified a total of 57 published articles as describing cases of OL involving: adnexa ( n = 26), orbit ( n = 1), retina ( n = 7), uvea ( n = 18) and cornea ( n = 6). Though well described and easily treated, palpebral leishmaniasis is often misdiagnosed and may lead to chronic issues if untreated. The retinal manifestations of Leishmaniasis consist of self-resolving hemorrhages secondary to thrombocytopenia. Two main uveitis etiologies have been identified: uveitis in the context of active Leishmanial infection (associated with immunosuppression) and uveitis occurring as an immune reconstitution syndrome. Corneal involvement in most geographic areas generally follows an aggressive course, most often ending in corneal perforation if left untreated. In the Americas, a chronic indolent interstitial keratitis may also occur. Topical steroids are of little use in keratitis (systemic antileishmanials being the cornerstone of treatment). However, these are essential in cases of uveitis, with or without concomitant systemic antileishmanial therapy. In conclusion, though ocular involvement in Leishmaniasis is rare, severe sight-threatening consequences follow if left untreated. Early diagnosis, enthusiastic follow-up and aggressive treatment are essential for good outcomes.

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Lacrimal excretory system sequelae in patients treated for leishmaniasis

Cited by 2 publications

References 10 publications

Detection ofLeishmaniain Unaffected Mucosal Tissues of Patients with Cutaneous Leishmaniasis Caused byLeishmania (Viannia)Species

Detection ofLeishmaniain Unaffected Mucosal Tissues of Patients with Cutaneous Leishmaniasis Caused byLeishmania (Viannia)Species

Ocular Leishmaniasis - A systematic review

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