Disseminated cutaneous leishmaniasis caused by Leishmania braziliensis in Southern Brazil

Abstract

The authors report a case of disseminated cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis, in a 55 years old patient with 1,119 lesions distributed throughout the body. The patient resides in Sabáudia municipality, North of Paraná State, Southern Brazil, where there was no previous report of this form of leishmaniasis. Treatment with meglumine antimoniate was successful, although the diagnosis was made only five months later.

Disseminated leishmaniasis: clinical, pathogenic, and therapeutic aspects

“…14 Although DL can be caused by more than one species of Leishmania , such as L. guyanensis and L. panamensis , in the Americas, L. braziliensis is the main cause of the disease. 4,7-10 An interesting finding in the study conducted by Queiroz et al. 15 in the region of Corte de Pedra is that L. braziliensis has a multiclonal population structure, in which different genotypes are associated with different clinical manifestations, including the disseminated form of the disease.…”

“…Disseminated leishmaniasis was described in the state of Bahia by Torres in 1920, 6 and was initially studied in relation to its clinical and immunological aspects in an endemic region of Northeast Brazil by Carvalho et al 3 DL has also been documented in other regions of Brazil and South America, as well as in Europe and in the Middle East. 7-11…”

From Biology to Disease: Importance of Species-Specific Leishmania Antigens from the Subgenera Viannia (L. braziliensis) and Leishmania (L. amazonensis) in the Pathogenesis of American Cutaneous Leishmaniasis

“…The first point that must be clarified is why the term "borderline" is being used here to designate this form of the disease that is referred by most authors as "Disseminated cutaneous leishmaniasis" [66][67][68][69][70][71][72][73]. In fact, this term was first used by Moriearty et al [74] to designate a clinical case of ACL in a patient with long-lasting disseminated skin lesions, and atypical intradermal reaction to Leishmania-antigen [DTH−] from northeast Brazil [Três Braços municipality, Bahia State], where the species L. (V.) braziliensis predominates.…”

Mechanisms of Immunopathogenesis in Cutaneous Leishmaniasis And Post Kala-azar Dermal Leishmaniasis (PKDL)

“…DL is mainly endemic in the New World, almost exclusively in northern and northeastern Brazil, and is caused primarily by L. braziliensis ( Costa et al., 1986 ; Galvão et al., 1993 ; Membrive et al., 2017 ). However, L. amazonensis and L. panamensis/guyanensis have also been reported as the causative agents of DL in Brazil and Colombia ( Carvalho et al., 1994 ; Hashiguchi et al., 2016 ; Cataño and Pinzón, 2019 ; Ovalle-Bracho et al., 2019 ) ( Table 1 ).…”