Case Report: Atypical Cutaneous Leishmaniasis in a Patient with Mixed Leishmania guyanensis and Leishmania amazonensis Infection

Gosch, Carina Scolari; Resende, Bruna Silva; Amorim, Célia Bastos; Marques, Cálita Pollyanna; Pereira, Ledice Inácia de Araújo; Pinto, Sebastião Alves; Uliana, Sílvia Reni Bortolin; Coelho, Adriano C.; Ribeiro‐Dias, Fátima; Dorta, Miriam Leandro

doi:10.4269/ajtmh.17-0760

Cited by 8 publications

(4 citation statements)

References 22 publications

(25 reference statements)

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“…Previous studies have suggested that preceding Leishmania infections may confer protection against reinfection with other homologous or heterologous species ( 31 , 32 ). Multiple studies from Mexico, Perú, Ecuador, Bolivia, Brazil, and more recently Colombia have demonstrated the presence of mixed infection with different Leishmania species in CL patients ( 5 , 6 , 9 , 10 , 12 ). Such findings also raise questions regarding possible synergistic or antagonizing effects between species in the context of coinfections.…”

Section: Discussionmentioning

confidence: 99%

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Development of an Amplicon-Based Next-Generation Sequencing Protocol to Identify Leishmania Species and Other Trypanosomatids in Leishmaniasis Endemic Areas

et al. 2021

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Traditionally, there has been a frequent, yet incorrect assumption that phlebotomine vectors, animal reservoirs, and human hosts are susceptible to Leishmania infection by a single parasite species. However, current evidence supports that these new vector-parasite-reservoir associations lend vectors and reservoirs greater permissiveness to certain Leishmania species, thus promoting the appearance of coinfection events, particularly in disease-endemic regions.

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Section: Discussionmentioning

confidence: 99%

“…More interestingly, the presence of Leishmania guyanensis and Leishmania panamensis hybrid strains causing both CL and MCL has been described in Ecuador ( 10 ). Furthermore, studies from Brazil have revealed the presence of double and triple infections caused by several Leishmania species, both in mammals and humans ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

Development of an Amplicon-Based Next-Generation Sequencing Protocol to Identify Leishmania Species and Other Trypanosomatids in Leishmaniasis Endemic Areas

et al. 2021

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“…A previous screening of PM susceptibility in vitro against a panel of clinical isolates from Instituto de Infectologia Emílio Ribas, a reference center for treatment of leishmaniasis in the city Sao Paulo, allowed us identify a clinical isolate, ER256, highly susceptible to PM. This isolate was typed as L. amazonensis by sequencing the internal transcribed ribosomal DNA (ITS), as previously described ( Gosch et al, 2018 ). Sequence analysis of full sequence of ITS indicated 99% identity with the reference strain L. amazonensis (MHOM/BR/73/M2269) (GenBank accession number AJ000316.1 ), a strain isolated from a patient of the Amazon region ( Miles et al, 1980 ).…”

Section: Resultsmentioning

confidence: 99%

Activity of paromomycin against Leishmania amazonensis: Direct correlation between susceptibility in vitro and the treatment outcome in vivo

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Ferreira

Branco

et al. 2020

International Journal for Parasitology: Drugs and Drug Resistan

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Paromomycin is an aminoglycoside antibiotic approved in 2006 for the treatment of visceral leishmaniasis caused by Leishmania donovani in Southeast Asia. Although this drug is not approved for the treatment of visceral and cutaneous leishmaniasis in Brazil, it is urgent and necessary to evaluate the potential of this drug as alternative for the treatment against species responsible for these clinical forms of the disease. In Brazil, Leishmania amazonensis is responsible for cutaneous and diffuse cutaneous leishmaniasis. The diffuse cutaneous form of the disease is difficult to treat and frequent relapses are reported, mainly when the treatment is interrupted. Here, we evaluated paromomycin susceptibility in vitro of a L. amazonensis clinical isolate from a patient with cutaneous leishmaniasis and the reference strain L. amazonensis M2269, as well as its in vivo efficacy in a murine experimental model . Although never exposed to paromomycin, a significant differential susceptibility between these two lines was found. Paromomycin was highly active in vitro against the clinical isolate in both forms of the parasite, while its activity against the reference strain was less active. In vivo studies in mice infected with each one of these lines demonstrated that paromomycin reduces lesion size and parasite burden and a direct correlation between the susceptibility in vitro and the effectiveness of this drug in vivo was found. Our findings indicate that paromomycin efficacy in vivo is dependent on intrinsic susceptibility of the parasite. Beyond that, this study contributes for the evaluation of the potential use of paromomycin in chemotherapy of cutaneous leishmaniasis in Brazil caused by L. amazonensis .

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“…amazonensis infection, and multiple concomitant lesions with a low antibody titer, which are consistent with L . guyanensis infection [ 40 ]. In Iran, a patient presenting mucosal leishmaniasis was reported to have nasal and oral lesions caused by L .…”

Section: Natural Mixed Infections By Leishmania Sp...mentioning

confidence: 99%

Interspecies and Intrastrain Interplay among Leishmania spp. Parasites

et al. 2022

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Leishmania parasites present astonishing adaptative abilities that represent a matter of life or death within disparate environments during the heteroxenous parasite life cycle. From an evolutionary perspective, organisms develop methods of overcoming such challenges. Strategies that extend beyond the genetic diversity have been discussed and include variability between parasite cells during the infections of their hosts. The occurrence of Leishmania subpopulation fluctuations with variable structural genomic contents demonstrates that a single strain might shelter the variability required to overcome inconsistent environments. Such intrastrain variability provides parasites with an extraordinary ability to adapt and thus survive and propagate. However, different perspectives on this evolution have been proposed. Strains or species living in the same environment can cooperate but also compete. These interactions might increase the replication rate of some parasites but cause the loss of more aggressive competitors for others. Adaptive responses to intra- and interspecific competition can evolve as a fixed strategy (replication is adapted to the average genetic complexity of infections) or an optional strategy (replication varies according to the genetic complexity of the current infection). This review highlights the complexity of interspecies and intrastrain interactions among Leishmania parasites as well as the different factors that influence this interplay.

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Case Report: Atypical Cutaneous Leishmaniasis in a Patient with Mixed Leishmania guyanensis and Leishmania amazonensis Infection

Cited by 8 publications

References 22 publications

Development of an Amplicon-Based Next-Generation Sequencing Protocol to Identify Leishmania Species and Other Trypanosomatids in Leishmaniasis Endemic Areas

Development of an Amplicon-Based Next-Generation Sequencing Protocol to Identify Leishmania Species and Other Trypanosomatids in Leishmaniasis Endemic Areas

Activity of paromomycin against Leishmania amazonensis: Direct correlation between susceptibility in vitro and the treatment outcome in vivo

Interspecies and Intrastrain Interplay among Leishmania spp. Parasites

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