Um caso atípico de leishmaniose cutâneo-mucosa (Espundia)

Barrientos, L Prado

doi:10.1590/s0074-02761948000200003

Cited by 25 publications

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“…The first Bolivian case reported by Prado Barrientos from the neighboring region of the Yungas was a typical case of CDL probably due to L. amazonensis. 14 Recently, we described an outbreak of cutaneous leishmaniasis in the province of Inquisivi, La Paz, 15 where the parasite was identified as L. amazonensis on the basis of biologic and molecular data. The present study provides evidence indicating that the vector of L. amazonensis is Lu.…”

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confidence: 99%

Lutzomyia nuneztovari anglesi (Le pont & Desjeux, 1984) as a vector of Leishmania amazonensis in a sub-Andean leishmaniasis focus of Bolivia.

Martínez¹,

Pont²,

Torrez³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. Recently, a new Leishmania amazonensis focus was described in a sub-Andean region (1,450-2,100 meters above sea level) of Bolivia. In this area, three anthropophilic sandfly species were identified: Lutzomyia nuneztovari anglesi Le Pont & Desjeux, 1984, which represented 86-99% of the captures, Lu. galatiae Lu. shannoni Dyar 1929. Only Lu. nuneztovari anglesi was found naturally infected by flagellates (16 of 1,715 females). Three Leishmania stocks were isolated and analyzed by isoenzyme electrophoresis at 11 loci. No significant isoenzymatic differences were demonstrated between them and 7 stocks isolated from patients from the same area, and previously characterized as L. amazonensis. Moreover, in a simplified protocol, the experimental infection of Lu. nuneztovari anglesi by L. amazonensis was successful in 92% of the surviving specimens. These data are discussed in relation to the Killick-Kendrick criteria. These results strongly suggest that Lu. nuneztovari anglesi is the vector of L. amazonensis at Cajuata, Inquisivi, La Paz, Bolivia.In Bolivia, only two Leishmania species have been identified as agents of human cutaneous leishmaniasis:The first one is a widespread parasite in Bolivia, 1-4 while the second one has been reported only rarely. 5-7 Leishmania amazonensis is better known from sylvatic lowlands, especially in Amazonia, 8,9 where all proven vectors belong to the Lutzomyia flaviscutellata complex, 9,10 but the cycle is able to survive in plantation woodland and deforested areas as in Brazil. 11 In the Venezuelan and Ecuadorian Andes, parasites related to L. amazonensis have been described (L. garnhami 12 and L. mexicana, 13 respectively). Leishmania amazonensis is potentially very dangerous and occasionally induces a chronic and eventually fatal disease known as cutaneous diffuse leishmaniasis (CDL). The first Bolivian case reported by Prado Barrientos from the neighboring region of the Yungas was a typical case of CDL probably due to L. amazonensis. 14 Recently, we described an outbreak of cutaneous leishmaniasis in the province of Inquisivi, La Paz, 15 where the parasite was identified as L. amazonensis on the basis of biologic and molecular data. The present study provides evidence indicating that the vector of L. amazonensis is Lu. nuneztovari anglesi Le Pont and Desjeux, 1984. MATERIALS AND METHODSStudy area. The L. amazonensis focus is located at Cajuata and surrounding communities in the province of Inquisivi in southeastern region (67º15ЈW, 16º42ЈS) of the Department of La Paz, Bolivia. The study area is at an altitude ranging from 1,450 to 2,100 meters above sea level. 15 It is a deforested valley with very steep slopes such that the bottom of the valley is shaded early in the afternoon. The human population lives in scattered adobe brick houses with corrugated iron roofs. Around the settlements, land is cultivated with coca plantations, root vegetables, and papaya crops, while residual deciduous forests with xerophytes and epiphytes cover the steepest places. The cumulative pr...

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confidence: 99%

Lutzomyia nuneztovari anglesi (Le pont & Desjeux, 1984) as a vector of Leishmania amazonensis in a sub-Andean leishmaniasis focus of Bolivia.

Martínez¹,

Pont²,

Torrez³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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“…Balfour and Thompson's 21 1913 account of an African patient with widespread leishmaniasis is likely the earliest report of DCL. Barrientos 22 first characterized DCL in 1948 as a unique manifestation of leishmaniasis that clinically resembles lepromatous leprosy. DCL is the result of dysfunctional cell mediated immunity, which is necessary for clearance of the infection 23,24 .…”

Section: Discussionmentioning

confidence: 99%

Diffuse cutaneous leishmaniasis associated with the immune reconstitution inflammatory syndrome

et al. 2008

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Leishmaniasis is an emerging disease in HIV-infected persons; visceral leishmaniasis is an AIDS-defining opportunistic infection. The parasite that causes this infection is usually transmitted by the sandfly and occasionally by nonsterile needles among intravenous drug users. Diffuse cutaneous leishmaniasis (DCL) is a rare anergic variant of leishmanial infection with the characteristic presentation of numerous nonulcerating nodules with an abundant parasite load, lack of visceral involvement, negative reaction to the leishmanin skin test, and a chronic course with incomplete response to treatment and frequent relapses. We report a case of DCL that developed in the context of the immune reconstitution inflammatory syndrome (IRIS) in a man with AIDS following initiation of antiretroviral therapy. We also review DCL to emphasize the importance of recognizing and treating this evolving disease in the growing population of patients on immunorestorative therapy.

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“…Algunos de estos pacientes han sido tratados como enfermos de Hansen recluyéndolos en leprosarios por largos períodos (2,13,16,21). Todo esto por no someter el diagnóstico clínico a la confirmación histopatológica.…”

Section: Discusionunclassified

Leishmaniasis difusa

Rodríguez¹,

Corredor²,

Cáceres³

et al. 1985

biomedica

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Se presentan cuatro pacientes con leishmaniasis difusa, procedentes de cuatro regiones de Colombia, diagnosticados inicialmente mediante el estudio histopatológico. Dos casos tenian lesiones diseminadas, en una nifia de 10 afios y en u n hombre de 80 aííos.Los otros dos casos, hombres de 33 y 62 afios, presentaron lesiones nodulares iniciales que curaron con calor local y Glucantime. Todos tuvieron leishmaninas negativas. Se confirma que la entidad puede curar cuando no está diseminada. El calor local fue muy útil en un caso con lesión única inicial. La inoculación al hamster con macerados de biopsias de dos de los pacientes les originó prominentes "histiocitomas" en el hocico y las almohadillas plantares. En un caso no diseminado se identificó el parasito como L. m. amazonensis mediante isoenzimas. En el paciente de 80 aííos, el agente causal fue una cepa de L. mexicana. llustramos las lesiones cllnicas, enfatisamos el aspecto tlpico de la imagen histopatológica e ilustramos y discutimos la relación leishmaniamacrófago mediante imágenes de microscopla electrónica. Las caracterlsticas de la enfermedad y la literatura sobre la misma se revisa ampliamente. SINONIMOSLeishmaniasis anérgica tegumentaria difusa, leishmaniasis difusa (LD), leishmaniasis anérgica leproide, leishmaniasis cutánea pseudolepromatoide, leishmaniasis leproide, leishmaniasis nodular, leishmaniasis queloidea, leishmaniasis anérgica hansenoide. INTRODUCCIONLa LD se describió inicialmente en el Brasil en 1945 (1). La presentación e ilustración de un paciente boliviano (2) en 1948 y los trabajos realizados en Venezuela desde esta misma época (3-8), así como los estudios sobre la enfermedad en Etiopía 19-13), han contribuído a definir que sus características principales son:1. Lesiones nodulares numerosas, usualmente sin ulceración, que pueden afectar cualquier parte del tegumento, con excepción del cuero cabelludo.2. Discreta infiltración y exulceración de la parte anterior de la mucosa nasal, sin perforación del tabique pero con compromiso laringofaringeo tardío (8).

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Um caso atípico de leishmaniose cutâneo-mucosa (Espundia)

Cited by 25 publications

References 0 publications

Lutzomyia nuneztovari anglesi (Le pont & Desjeux, 1984) as a vector of Leishmania amazonensis in a sub-Andean leishmaniasis focus of Bolivia.

Lutzomyia nuneztovari anglesi (Le pont & Desjeux, 1984) as a vector of Leishmania amazonensis in a sub-Andean leishmaniasis focus of Bolivia.

Diffuse cutaneous leishmaniasis associated with the immune reconstitution inflammatory syndrome

Leishmaniasis difusa

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