Comparison of Cutaneous Leishmaniasis Due to Leishmania (Viannia) braziliensis and L. (V.) guyanensis in Brazil: Clinical Findings and Diagnostic Approach

Abstract

We compared the clinical findings and diagnostic methods for 66 patients with cutaneous leishmaniasis in the state of Bahia, Brazil, who were infected by Leishmania (Viannia) braziliensis (group A), with those for 68 patients in the state of Amazonas, Brazil, who were mainly infected by Leishmania (Viannia) guyanensis (group B). Differences were observed with regard to number, size, and location of skin lesions and to the pattern of lymphatic involvement. Patients in group B had smaller and more numerous lesions, which were frequently located above the waist, versus the larger but less numerous lesions among patients in group A, which were usually located on the lower limbs. Lymphatic involvement was present in 55 (83.3%) of the 66 patients in group A and in 42 (61.8%) of the 68 patients in group B (P=0.005). The positivity rates of imprints and skin culture procedures were higher in group B. Sensitivity of in vitro culture of skin aspirates was 47.0% and 91.2% for groups A and B, respectively (P<.001). Although hamster inoculation showed similar results in both groups, the interval before development of disease was shorter in group B. Our data provide substantial evidence that indicate that the disease caused by these species differs with regard to clinical presentation and diagnostic approach.

The skin homing receptor cutaneous leucocyte-associated antigen (CLA) is up-regulated byLeishmaniaantigens in T lymphocytes during active cutaneous leishmaniasis

“…Cutaneous leishmaniasis (CL) is caused by many Leishmania species, but differences in clinical, diagnostic and therapeutic aspects of the disease points to intrinsic characteristics of the parasite influencing the pathogenesis [1]. CL due to Leishmania (Viannia) braziliensis is the most common clinical form of leishmaniasis observed in Brazilian patients, characterized by a single or a few localized skin lesions [2].…”

Are Cytochrome B Gene Sequencing and Polymorphism-Specific Polymerase Chain Reaction as Reliable as Multilocus Enzyme Electrophoresis for Identifying Leishmania Spp. From Argentina?

“…[4][5][6][7][8][9] In particular, substantial evidence exists that the diseases caused by L. (V.) braziliensis and L. (V.) guyanensis differ in their clinical presentation, diagnostic approach required, and therapeutic response to antimonials. 10,11 For these reasons, the Leishmania spp. discrimination is important not only from an epidemiologic perspective but also from the clinical ones to improve the patients' prognosis, diagnostic methods, and to monitor clinical outcomes.…”

Specificity of the rapid rK39 antigen-based immunochromatographic test Kalazar Detect(r) in patients with cutaneous leishmaniasis in Brazil

“…The LCL diagnosis was confirmed by parasite culture or by kDNA detection with PCR using material that was obtained from ulcerated lesions, as previously reported (Ampuero et al 2009). The patients were from the south mesoregion of the state of Bahia, Brazil, an area that is endemic for L. brazi-liensis (Rosa et al 1988, Romero et al 2001). The patients were of both sexes (182 men and 90 women) and they had active disease with single or multiple skin lesions.…”