Consecutive Cutaneous and Visceral Leishmaniasis Manifestations Involving a Novel Leishmania Species in Two HIV Patients in Thailand

Abstract

Abstract. Leishmaniasis is an emerging disease in Thailand. Herein, we report on two human immunodeficiency virus (HIV)-infected patients with leishmaniasis who presented with overlapping manifestations between cutaneous and visceral leishmaniasis. Sequencing analysis of the internal transcribed spacer 1 (ITS1) of the ribosomal RNA gene showed that the species was identical to a new species recently described in Thailand. The detection of DNA of this Leishmania species in saliva may have important implications for transmission and epidemiological studies.

Leishmaniasis in Thailand: A Review of Causative Agents and Situations

“…However, the majority of lesions on skin in HIV/AIDS cases could be single, multiple nodular, or generalized papular forms. The lesion could be disseminated as multiple nonulcerative nodules, papular with ulcerative lesions or chronic generalized fibrotic lesions to other parts of the body besides a primary lesion on the face, ears (along the helix and antihelix of the pinna), the dorsum of hands, knuckles of fingers, elbows, extensor surface of the forearm, or on the trunk and lower extremities, 19,20,23,28 called DCL. For L. siamensis infection, only one DCL was reported in a person with AIDS.…”

“…The phylogenetic tree showed that the L. martiniquensis reference sequence was grouped with the same taxa that have been identified as L. siamensis suggesting that most isolates would belong to L. martiniquensis. Figure 2 includes the Leishmania sequences obtained from sandflies and black rats in the study of animal reservoirs and potential vectors of L. siamensis by Chusri and others (JQ866907, JQ866906) 25 and sequences belong to L. siamensis lineage PG previously isolated from Thai patients (GQ226034, GQ293226, JQ001751, and JQ001752), 10,18,19 horses (JQ617283, GQ281278, GQ281279, GQ281280, and GQ281281), 16,21 and cows (GQ281282). 17 However, the L. siamensis lineage TR, ∥The sequences of accession number JQ001752 and KF227887 to KF227892 were obtained from the specimens collected from the same source but different site of specimen collection.…”

“…E-mail: sleelayoova@gmail.com As shown in Table 2, all L. siamensis published papers from 2008 to 2016 [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] were reviewed and the species of Leishmania were confirmed using nucleotide sequences of the SSU-rRNA, ITS1 region of SSU-rRNA, and hsp70 genes from GenBank database and were compared with the nucleotide sequences of each gene using axenic cul- those reported in horses and cow. 16,17,21 Only one published paper by Bualert and others in 2012 identified L. siamensis infection.…”

Detection of Leishmania siamensis DNA in Saliva by Polymerase Chain Reaction

“…[5][6][7] In comparisons of microscopic examination, culture, and PCR in detecting Leishmania parasites, PCR has shown to have a significantly higher sensitivity than culture and microscopic examination (97%, 78%, and 76% [8][9][10] sensitivity, respectively). New cases of leishmaniasis caused by L. siamensis, a novel species of Leishmania, have been documented in patients in Thailand [11][12][13][14][15][16][17] and Myanmar (unpublished data). The infection was described in immunocompromised patients, mostly persons infected with human immunodeficiency virus (HIV).…”

“…[11][12][13][14][15][16][17] Clinical presentations of these patients have included visceral, [11][12][13] diffuse cutaneous, 15 and overlapping diffuse cutaneous and visceral forms. 14 With low prevalence of leishmaniasis in Thailand and Myanmar, screening tests for leishmaniasis such as enzymelinked immunosorbent assay, direct agglutination test, and recombinant protein K39 dipstick test are not readily available. Moreover, sensitivity and specificity of these serologic tests for detection of L. siamensis infection have never been fully documented.…”