Accidental <i>Leishmania</i> mexicana infection in an immunosuppressed laboratory technician

Knobloch, Jürgen; Demar, Magalie

doi:10.1046/j.1365-3156.1997.d01-216.x

Cited by 10 publications

(2 citation statements)

References 20 publications

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“…Although the most common transmission mechanism is by female sandflies' bite, cases of direct cutaneous inoculation have been reported in the literature [4][5][6][7], thereby making it an occupational infection. Occupational infections are defined by a particular infectious agent or organism associated with an occupational setting and specific work activities that predispose to exposure and, therefore, to the infection [8].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous leishmaniasis by a needlestick injury, an occupational infection?

et al. 2023

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Leishmaniasis is a parasitic disease caused by over 20 species of Leishmania. Transmission is mainly via sandfly bites infected with promastigotes, through the placenta from mother to child, by sexual intercourse, blood transfusion, and occupationally acquired by direct inoculation into the skin. Clinical manifestations vary from self-limited cutaneous disease to a life-threatening visceral infection. In November 2021, a 29-year-old otherwise healthy dermatology resident suffered an accidental needlestick injury while performing a biopsy on a patient with a presumptive diagnosis of an infectious dermatosis, later confirmed as mucocutaneous leishmaniasis caused by Leishmania panamensis. Later, the resident developed an erythematous, painless papule at the point of inoculation, with a central ulcer and painful enlargement of ipsilateral lymph nodes. Biopsy was compatible with leishmaniasis. After completing a 20-day treatment with meglumine antimoniate, the ulcer had healed completely. At the 6-month follow-up, both patients remain asymptomatic. This case serves as a reminder that health providers should have the proper training and knowledge of their hospital management protocol for occupational injuries. Moreover, physicians should bear in mind that leishmaniasis is not exclusively transmitted by sandfly vectors.

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Section: Discussionmentioning

confidence: 99%

Cutaneous leishmaniasis by a needlestick injury, an occupational infection?

et al. 2023

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“…Infections due to accidental exposure can be affected by a variety of factors, including kinematics (e.g., the path and characteristics of exposure and the amount of inoculum), parasite characteristics (e.g., pathogenicity, virulence, viability and infective dose) and host characteristics (e.g., immune status, barrier status and actions following the accident) [80]. However, the possibility of infection due to vector exposure in an endemic region should not be ruled out when performing questioning [81]. The first case of work-related leishmaniasis was reported in 1930, and to date, there have been 12 reported cases of Leishmania infection due to accidents at work; these have included 6 different Leishmania species, with L. donovani being implicated in half of the affected individuals.…”

Section: Work Environment Transmissionmentioning

confidence: 99%

Transmission to Humans

Avila-García¹,

Mancilla²,

Segura-Cervantes³

et al. 2014

Leishmaniasis - Trends in Epidemiology, Diagnosis and Treatment

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Bloodborne Pathogens in the Workplace

Yadav¹,

Kapoor²

2012

Patty's Toxicology

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Occupational risk to healthcare workers from infections with bloodborne pathogens has been recognized since the mid‐twentieth century. Early reports around 1950s on “serum hepatitis” subsequently led to identification of hepatitis B as the causative agent in the bloodborne infection. In the early 1970s, serological tests became available for the diagnosis of infection with both hepatitis B and hepatitis A viruses. Non‐A, non‐B hepatitis (hepatitis C) emerged as a second bloodborne infection but, because of the lack of a serologic marker, the prevalence of the disease and its occupational risks were not appreciated. With the identification of human immunodeficiency virus (HIV) as the viral pathogen of the acquired immunodeficiency syndrome (AIDS) in the mid‐1980s, healthcare workers became very concerned about the occupational risk to HIV infections due to exposure to the infected patients. The potential occult infectivity of blood has been emphasized with the documentation of 57 occupationally transmitted infections with HIV‐1 in the United States. Since the first occupational transmission was reported in 1984, healthcare and laboratory administrators, as well as those in the public sector, have reexamined the infection control aspects of their work practices and have begun to analyze and develop equipment and procedures to minimize exposures. While majority of the occupational infections in healthcare workers are due to the three bloodborne viruses, HBV, HCV, and HIV, any septicemic infection (viremia, parasitemia, bacteriemia, or fungemia) may pose a potential risk of transmission of the pathogen to healthcare professionals via either percutaneous route (needlestick or sharps injury) or mucocutaneous route (contact with nonintact skin or mucosa of the eyes or mouth). Because infection with HIV and other bloodborne pathogens is not always clinically apparent, and the infectious potential of blood and other body fluids is not always known, the Centers for Disease Control (CDC) recommended “universal blood and body fluid precautions” in 1987. This approach emphasizes that blood and body fluid precautions should be consistently used for all patients and their clinical specimens and tissues. The “universal precautions” strategy has formed the foundation for federal guidelines through the CDC and regulations from the Occupational Safety and Health Administration (OSHA). Both organizations recognize that this practical approach to safety will not only minimize the risk of occupationally acquired HIV‐1 infection but also serve to protect against occupational infection with other bloodborne pathogens such as hepatitis B, hepatitis C, human T‐cell leukemia viruses I and II, HIV‐2, and, to a large extent, prions (agents causing Creutzfeldt–Jakob disease). Nonetheless, a substantial number of percutaneous exposures continue to occur in the healthcare setting, despite implementation of the universal precautions guidelines. The risks to healthcare and laboratory workers are dynamic because of the availability of vaccines, antiviral treatment, and recognition of new agents and interactions with old ones. It is the purpose of this chapter to provide an overview of the epidemiology, risk of transmission, and the recommended or regulated strategies to prevent occupational transmission of viruses (HIV and hepatitis) and other bloodborne pathogens.

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Accidental Leishmania mexicana infection in an immunosuppressed laboratory technician

Abstract: SummaryA

Cited by 10 publications

References 20 publications

Cutaneous leishmaniasis by a needlestick injury, an occupational infection?

Cutaneous leishmaniasis by a needlestick injury, an occupational infection?

Transmission to Humans

Bloodborne Pathogens in the Workplace

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