Co-infection by Leishmania amazonensis and L. infantum/L. chagasi in a case of diffuse cutaneous leishmaniasis in Bolivia

Martínez, Eddy; Mollinedo, S.; Torrez, Miguel; Muñoz, M; Bañuls, Anne‐Laure; Pont, François Le

doi:10.1016/s0035-9203(02)90428-1

Cited by 32 publications

(25 citation statements)

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“…As it was proposed by Cupolillo (9,11,13), the polymorphism observed could be related to the great number of sand fly vectors and animal reservoir hosts of the rain forests, especially in the southern part of the country. This particular Leishmania species is said not to be very polymorphic; however, to our knowledge, no large-scale study on L. The possibility of mixed infections has been previously reported (23,29,31,49). However, in the present study, we did not observe any hybrid profiles and control genotyping did not detect any multiple infections.…”

Section: Discussionmentioning

confidence: 90%

Molecular Epidemiology of Leishmania ( Viannia ) guyanensis in French Guiana

et al. 2006

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Little information is available about the genetic variability of Leishmania populations and the possible correlations with ecoepidemiological features of leishmaniases. The present study was carried out in French Guiana, a country where cutaneous leishmaniases (CL) are endemic over the whole territory. The genetic polymorphism of a nuclear sequence encompassing the end of the ribosomal small subunit and the internal transcribed spacer 1 of 265 isolates from patients with CL was examined by restriction fragment length polymorphism analysis. Genotypes based on the fingerprinting phenetic integration were compared to epidemiological, clinical, and geographical data. In agreement with previous reports, five different Leishmania species were identified, but Leishmania (Viannia) guyanensis represented 95.8% of the samples. Two distinct L. (V.) guyanensis populations were found to originate in two ecologically characterized regions. Higher lesional parasite densities and the need for additional treatments were significantly linked to genotype group I. Parasites of genotype group II were more likely to cause chronic and disseminated cutaneous forms in patients. L. (V.) guyanensis was previously said not to be very polymorphic; however, the present analysis resulted in a significant degree of discrimination among L. (V.) guyanensis isolates from diverse ecological areas and with different clinical implications.In the highly biodiversified region of the New World (NW) that encompasses the northern Amazon Basin and the Guiana Shield, at least seven named species belonging to the Leishmania genus coexist with often overlapping hosts and vectors (39). American visceral leishmaniases due to Leishmania (Leishmania) infantum are found there, but cases of cutaneous leishmaniases (CL) are far more numerous. Human cutaneous infections may be unapparent; however, many of the Leishmania parasites are able to produce a spectrum of diseases rather than a single clinical form. Cases reported in that region range from localized and diffuse cutaneous forms to mucocutaneous leishmaniases. They are now being reported in areas where leishmaniases had previously not been endemic (2, 17): increasing risk factors related to natural and especially manmade environmental changes are making leishmaniases a growing public health concern in this particular region. However, little information is available about the genetic variability of parasite populations and the possible correlation with ecoepidemiological features of the diseases. The present study was carried out in French Guiana, a country where CL are endemic over the whole territory (incidence of 0. 2% between 1979 and 2000 [6, 14]). The genetic polymorphism of a nuclear sequence encompassing the end of the ribosomal small subunit (SSU) and the internal transcribed spacer 1 (ITS1) of 265 samples from patients with CL was examined by restriction fragment length polymorphism (RFLP) analysis. Genotypes based on the fingerprinting phenetic integration were then compared to epidemiological, clin...

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Section: Discussionmentioning

confidence: 90%

Molecular Epidemiology of Leishmania ( Viannia ) guyanensis in French Guiana

et al. 2006

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“…However, simultaneous infection with more than one causative species of Leishmania has been documented. [8][9][10][11][12][13][14] It has long been postulated that infection of the host with one species of Leishmania might protect against re-infection with homologous or heterologous species. 22,23 However, in vitro studies of individual macrophage co-infections with different species of Leishmania suggest an absence of mutual exclusion if a second infection with a different strain occurs within a short window, 24 and recurrent infections in humans also imply some plasticity of this protective immune phenomenon.…”

Section: Discussionmentioning

confidence: 99%

“…1,6 Traditionally, it is assumed that leishmaniasis vectors and human hosts are infected with one single species, However, it has been reported in Brazil and Mexico that two different species have naturally co-infected the same reservoir. [8][9][10][11][12][13] Moreover, previous work in Bolivia using molecular methods detected patients with co-infection of different Leishmania species as well as Leishmania-Trypanosoma cruzi co-infections. 14 We report a case of two different Leishmania (Viannia) species, namely L. (V.) braziliensis and L. (V.) lainsoni, identified by molecular means as causing distinct lesions in a Peruvian patient with CL.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Infection with Leishmania (Viannia) braziliensis and L. (V.) lainsoni in a Peruvian Patient with Cutaneous Leishmaniasis

Veland

Valencia²,

Alba³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…In the sub-Andean region of Bolivia, coinfection with L. amazonensis and L. infantum/L. chagasi has been identified in a patient with diffuse CL (20). In the suburban district of Campo Grande, Municipality of Rio de Janeiro, Brazil, L. donovani and L. braziliensis have been isolated from the bone marrow and forehead of a patient with concurrent asymptomatic visceral leishmaniasis (VL) and typical CL (24).…”

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Mixed Mucosal Leishmaniasis Infection Caused by Leishmania tropica and Leishmania major

et al. 2012

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cMixed infections with different Leishmania species could explain differences in the clinical courses of these infections. On identification of Leishmania parasites from Iranian patients with mucosal leishmaniasis (ML), a patient with both oral and nasal lesions was found to be concomitantly infected with Leishmania tropica and L. major. Mixed infection was identified by PCR amplification of Leishmania kinetoplast DNA on scraping of cytological smears and histopathological sections. L. major and L. tropica were isolated from the nasal and oral lesions, respectively. These species were also confirmed by immunohistochemistry. This seems to be the first reported case of concurrent ML infection with two Leishmania species. It indicates that, at least in this patient, previous infection with one of these Leishmania species did not protect against infection with the other. This result has important implications for the development of vaccines against leishmaniases and implies careful attention in the treatment of this infectious disease. CASE REPORTA 34-year-old immunocompetent male patient presented with lesions of the mucous membranes of the nose and mouth. The patient was from Fars Province, southern Iran. He presented with a 7-and 5-month history of intranasal and oral lesions, respectively. No scar or other lesion was found in other parts of the body. On examination, there were multiple tiny erythematous lesions, varying in size from 0.1 to 0.3 cm in diameter. The nasal pyramid was edematous, and bloody crusts were observed on the inferior conchae, septum, and floor of the nasal fossa. The nasal lesions were located in the intranasal portion in the mucous membrane over the turbinates, far from the cutaneous lesions. Clinically, diffuse yellowish white erosions with grayish fibrinous membranes were seen on a reddish edematous background on the involved oral mucosa (Fig. 1).His blood biochemistry and complete blood count were within the reference range. His hemoglobin level was 13.6 g/dl, his total leukocyte count was 6,600/mm 3 , his serum creatinine level was 0.8 mg/dl, and his blood urea nitrogen level was 18 mg/dl. Serological studies for human immunodeficiency virus and hepatitis B and C viruses were negative.Tissue samples from the lesions were fixed in 10% neutral buffered formalin, embedded in paraffin, sectioned at a 5-m thickness, and stained with hematoxylin and eosin.Cytologic smears were prepared by scraping of the oral lesions with a scalpel. In addition, exfoliative cytology from the nasal lesions was performed by washing the nasal cavity as previously noted (7). Multiple smears were made on slides and were both air dried and alcohol fixed and then stained by the Wright method. Review of the cytologic smears and histologic sections was conducted blindly by three pathologists. Microscopic examination showed the amastigote forms of Leishmania ( Fig. 2A and B).The antibodies IS2-2B4 (A11; specific for L. tropica) and XLVI-5B8-B3 (T1; specific for L. major) were kindly provided by the Special Programme f...

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Co-infection by Leishmania amazonensis and L. infantum/L. chagasi in a case of diffuse cutaneous leishmaniasis in Bolivia

Cited by 32 publications

References 20 publications

Molecular Epidemiology of Leishmania ( Viannia ) guyanensis in French Guiana

Molecular Epidemiology of Leishmania ( Viannia ) guyanensis in French Guiana

Simultaneous Infection with Leishmania (Viannia) braziliensis and L. (V.) lainsoni in a Peruvian Patient with Cutaneous Leishmaniasis

Mixed Mucosal Leishmaniasis Infection Caused by Leishmania tropica and Leishmania major

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