Leishmania mexicana infection of the eyelid in a traveler to Belize

Vinetz, Joseph M.; Soong, Lynn

doi:10.1590/s1413-86702007000100030

Cited by 11 publications

(4 citation statements)

References 18 publications

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“…Spontaneous healing occurred after 5 months in our patient, and after 11 months in the other untreated case reported in the literature [3]. However, recurrences were observed in two patients after systemic intravenous treatment (liposomal amphotericin B and IV sodium stilbogluconate) [7,10]. IV or oral fluconazole was not recommended, whereas it was administrated in two cases.…”

Section: Discussionmentioning

confidence: 55%

“…We performed a review of the literature in Medline in the English language using the following keywords "Cutaneous leishmaniasis", "Leishmania mexicana" AND "travel" OR "traveler". We found 12 references reporting a total of twenty-eight humans cases of CL caused by L. mexicana in travelers (Table 1) [1,3,[5][6][7][8][9][10][11][12][13]. Most cases were reported in male travelers returning from Belize, followed by Mexico.…”

Section: Case Report and Review Of The Literaturementioning

confidence: 99%

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“Chiclero’s Ulcer” Due to Leishmania mexicana in Travelers Returning from Central America: A Case Report and Review of the Literature

et al. 2021

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Cutaneous leishmaniasis (CL) due to a New World species of Leishmania is increasingly seen among returning international travelers, and most cases arise from travel to Mexico, Central and South America. We described a case of CL in a women presenting a nonhealing ulceration under her right ear with slight increase of size of the left parotid gland under the skin lesion, evolving for 4 months. In her history of travel, she reported a ten-day stay in Mexico during the Christmas vacation in the Yucatan region with only half a day walking in the tropical forest. Diagnosis of CL due to Leishmania mexicana was done via PCR detection and sequencing from swab sampling of the lesion. The patient recovered without antiparasitic treatment. Clinicians should consider diagnosing Chiclero’s ulcer in patients returning from endemic areas such as Central America and Texas who present with chronic ulceration. A noninvasive sampling is sufficient for the PCR-based diagnosis of this disease.

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Section: Discussionmentioning

confidence: 55%

Section: Case Report and Review Of The Literaturementioning

confidence: 99%

“Chiclero’s Ulcer” Due to Leishmania mexicana in Travelers Returning from Central America: A Case Report and Review of the Literature

et al. 2021

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“…In endemic regions and in travelers from endemic territories, it is essential for the physician to be attentive that any unusual lesion should be examined carefully for cutaneous leishmaniasis [ 25 ]. Our patients had been erroneously treated for bacterial infection, and eventually the diagnoses were based on the presence of amastigotes in lesion, and positive outcome of culture or PCR.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Leishmaniasis of the Eyelids: A Case Series with Molecular Identification and Literature Review

et al. 2016

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Cutaneous leishmaniasis (CL) is a protozoan disease which is endemic in Iran. It is transmitted by the Phlebotomus sand fly. The eyelid is rarely involved possibly because the movement of the lids impedes the sand fly from biting the skin in this region. Here, we report 6 rare cases of eyelid CL. The patients were diagnosed by skin scraping, culture, and PCR from the lesions. Skin scraping examination showed Leishmania spp. amastigotes in the cytoplasm of macrophages. Culture examination was positive for Leishmania spp. PCR was positive for Leishmania major and Leishmania tropica. The lesions were disguised as basal cell carcinoma, chalazion, hordeolum, and impetigo. The patients were treated with intramuscular meglumine antimoniate (20 mg/kg/day) for at least 3 weeks. They showed a dramatic response, and the lesions almost completely disappeared. We emphasized the importance of clinical and diagnostic features of lesions, characterized the phylogenetic relationship of isolated parasites, and reviewed the literature on ocular leishmaniasis.

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“…During a more recent outbreak in Belize in 2022, 33 CL cases were confirmed in British soldiers participating in a single 8-week jungle exercise (MOD data -restricted access). In addition to military jungle training (JT), infections leading to CL in Belize are predominantly associated with forest activites including chewing-gum latex collection, and tourism [16,[26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Cutaneous leishmaniasis in British troops following jungle training in Belize: cumulative incidence and potential risk practices

Niba Rawlings,

Bailey,

Craig

et al. 2024

Preprint

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Introduction British soldiers undergoing jungle training (JT) in Belize typically experience a relatively low risk of developing cutaneous leishmaniasis (CL). However, an uncharacteristically large outbreak of CL occurred in 2022. This study aimed to determine the cumulative incidence (CUMI) of the disease and highlight potential shortcomings in personal protective measures (PPMs) to mitigate exposure to sand fly vector bites. Methods A retrospective analysis was conducted on medical records of CL cases between 2005 and 2022, as well as on questionnaire responses regarding PPMs administered to CL cases in 2022. Data were sourced from Defence Public Health Unit, Military Environmental Health Department and British Army Training Support Unit Belize. Results Eighty one confirmed clinical CL cases were recorded between 2005 and 2022, with a substantial peak (38 cases) in 2022. Most cases occurred during the wet season. Pre 2022, the median CUMI per 8 week deployment was 0.90% (Q1, Q3: 0.34%, 1.34%), with an annual variation of 0.2% to 2.0%. In 2022, the CUMI spiked to 4.22%, associated with a risk ratio of 5.3 (95% C.I.s: 3.41, 8.16), and rising to a CUMI of 7.3% in a single unit of 450 men (33 CL cases) in late 2022. These values are significantly higher than the median CUMI of all previous years, and to published reports for other CL endemic regions. Troop responses identified limitations in the supply of optimal equipment, and in sand fly bite and leishmaniasis risk avoidance information provided by the pre deployment health education (PDHE) programme. Compliance with PDHE advice was also suboptimal, with irregular use of insect repellents, protective clothing, head netting, and insecticide treated hammocks. Conclusions The reasons behind the unusually high numbers of CL cases and CUMI in 2022 remain unclear, emphasising the need to improve PPM provision and implement a comprehensive PDHE programme for troops undergoing JT in Belize.

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Leishmania mexicana infection of the eyelid in a traveler to Belize

Cited by 11 publications

References 18 publications

“Chiclero’s Ulcer” Due to Leishmania mexicana in Travelers Returning from Central America: A Case Report and Review of the Literature

“Chiclero’s Ulcer” Due to Leishmania mexicana in Travelers Returning from Central America: A Case Report and Review of the Literature

Cutaneous Leishmaniasis of the Eyelids: A Case Series with Molecular Identification and Literature Review

Cutaneous leishmaniasis in British troops following jungle training in Belize: cumulative incidence and potential risk practices

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