Sensitivity of Lymph Node Aspiration in Localized Cutaneous Leishmaniasis Due to Leishmania (Viannia) braziliensis

Romero, Gustavo; Sampaio, Raimunda Nonata Ribeiro; Macêdo, Vanize; Marsden, Philip D.

doi:10.1590/s0074-02761999000400015

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…1999a). Some patients underwent satellite lymph node aspiration for the same purposes employing the procedures described already (Romero et al. 1999b).…”

Section: Methodsmentioning

confidence: 99%

Species diversity causing human cutaneous leishmaniasis in Rio Branco, state of Acre, Brazil

Silva

Cupolillo

Volpini

et al. 2006

Tropical Med Int Health

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Summaryobjective Information on Leishmania species diversity in western Brazilian Amazon and the clinical picture of human cutaneous leishmaniasis it causes is scarce. We describe clinical findings, diagnostic procedures and identification of Leishmania species in patients from that region.methods The sample consisted of 50 patients, prospectively evaluated for epidemiological and clinical characteristics by means of a structured questionnaire. Conventional and molecular tools were applied to confirm the parasitological diagnosis and identify the species responsible for the disease.results Patients were predominantly male (76.5%) and living in rural areas. Median average age was 18 years 1 and median average disease evolution was 8 weeks. For the diagnostic procedures of leishmanin skin test, direct visualization of amastigotes in dermal scrapings and parasite culture of aspirates of the ulcer border were positive for 98%, 52% and 34%, respectively. Molecular methods applied to DNA extracted from skin biopsies of the 50 patients yielded 100%, 82% and 44% positivity by PCR minicircle kDNA, PCR-RFLP ITS1rDNA and PCR-glucose-6-phosphate (G6P), respectively. Fourteen samples from 13 patients were successfully isolated and identified. Multilocus enzyme electrophoresis, PCR-RFLP ITS1rDNA and PCR-G6P permitted identification of the Leishmania species responsible for the aetiology of American tegumentary leishmaniasis in 60% of the examined patients: 16 Leishmania (Viannia) braziliensis, 12 Leishmania (Viannia) lainsoni, 1 Leishmania (Viannia) guyanensis and 1 putative hybrid of Leishmania (Viannia) naiffi and L. (V.) lainsoni.conclusion The clinical and epidemiological behaviour of cutaneous leishmaniasis in Acre, Brazil, is similar to other Amazon scenarios previously described; however Acre's complex parasite diversity may be contributed to the concomitant circulation of at least three distinct Leishmania species. The implementation of control interventions in the studied area must take into consideration the possibility of various expected phlebotomine vectors and reservoirs.

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“…1999a). Some patients underwent satellite lymph node aspiration for the same purposes employing the procedures described already (Romero et al. 1999b).…”

Section: Methodsmentioning

confidence: 99%

Species diversity causing human cutaneous leishmaniasis in Rio Branco, state of Acre, Brazil

Silva

Cupolillo

Volpini

et al. 2006

Tropical Med Int Health

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“…22 Parasitologic diagnosis and parasite identification. A parasitologically proven case was considered when positive results were obtained with any of the following methods: direct examinations of skin biopsy imprints obtained from the ulcer border, skin ulcer or satellite lymph node culture through a vacuum aspiratory technique, 26,27 or successful isolation in inoculated hamsters. All isolates were identified with 23 monoclonal antibodies using an immunofluorescent technique, 28 and the electrophoretic patterns of six enzymes following previously described methods.…”

Section: Methodsmentioning

confidence: 99%

Comparison of cutaneous leishmaniasis due to Leishmania (Viannia) braziliensis and L. (V.) guyanensis in Brazil: therapeutic response to meglumine antimoniate.

Romero¹,

Guerra²,

Paes³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

176

122

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We conducted a quasi-experimental study to compare the response to meglumine antimoniate in patients with localized cutaneous leishmaniasis from two endemic areas of Brazil that were infected by two Leishmania species. Sixty-one were infected by Leishmania (Viannia) braziliensis (group B) and 57 by L. (V.) guyanensis (group G). All had a parasitologically proven diagnosis and were treated with 20 mg of pentavalent antimonial (Sb V)/kg/day given intravenously or intramuscularly for 20 days. Main outcomes were diagnosed using clinical criteria three months after treatment and patients were followed for six months. Intention-to-treat analysis showed a higher failure rate in group G (relative risk [RR] ϭ 1.5, 95% confidence interval [CI] ϭ 1.1-2.0, 2 ϭ 7.44, P ϭ 0.006). The analysis using an explanatory approach including 52 patients from group B and 49 from group G, who were regularly treated and followed for six months, showed a low cure rate (50. 8% in group B and 26.3% in group G) with a greater risk of failure in the latter group (RR ϭ 1.7, 95% CI ϭ 1.2-2.5, 2 ϭ 8.56, P ϭ 0.003). The effect of the etiologic agent remained significant after adjusting for age, disease duration, and site and number of lesions that were identified as predictors of failure in a logistic regression model. We concluded that Leishmania species constitute an important factor in predicting the outcome of cutaneous leishmaniasis treated with a pentavalent antimonial.

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“…Furthermore, cultures have the additional disadvantage of potential contamination with fungi or bacteria, which has been associated with prolonged observation (Cuba Cuba et al 1986a, b). In recent years, the collection method has been optimised to reduce the problem of contamination and to increase the sensitivity of the diagnostic methods (Marzochi et al 1993, Romero et al 1999a. Recently, the use of molecular diagnostic tools such as PCR assays specific to different DNA targets has increased (Marques et al 2001, Safaei et al 2002, Schallig & Oskam 2002, Weigle et al 2002.…”

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confidence: 99%

Genus-specific kinetoplast-DNA PCR and parasite culture for the diagnosis of localised cutaneous leishmaniasis: applications for clinical trials under field conditions in Brazil

Ampuero

Rios

Carranza-Tamayo

et al. 2009

Mem. Inst. Oswaldo Cruz

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Sensitivity of Lymph Node Aspiration in Localized Cutaneous Leishmaniasis Due to Leishmania (Viannia) braziliensis

Abstract: 45; 0,28) showing the potential complementary roles in diagnostic approach.

Cited by 8 publications

References 7 publications

Species diversity causing human cutaneous leishmaniasis in Rio Branco, state of Acre, Brazil

Species diversity causing human cutaneous leishmaniasis in Rio Branco, state of Acre, Brazil

Comparison of cutaneous leishmaniasis due to Leishmania (Viannia) braziliensis and L. (V.) guyanensis in Brazil: therapeutic response to meglumine antimoniate.

Genus-specific kinetoplast-DNA PCR and parasite culture for the diagnosis of localised cutaneous leishmaniasis: applications for clinical trials under field conditions in Brazil

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