Detection of Leishmania parasites in the blood of patients with isolated cutaneous leishmaniasis

Chmaisse, Hania Nakkash; Makki, Raja; Nahhas, Georges J.; Knio, Khouzama; Nuwayri-Salti, Nuha

doi:10.1016/j.ijid.2011.03.022

Cited by 19 publications

(14 citation statements)

References 31 publications

(40 reference statements)

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“…Further variation of the CL disease caused by L . donovani exists wherein the parasite is detected in blood culture with no visceral manifestation [ 37 ].…”

Section: Cutaneous Leishmaniasismentioning

confidence: 99%

Atypical leishmaniasis: A global perspective with emphasis on the Indian subcontinent

et al. 2018

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BackgroundAmong the neglected tropical diseases, leishmaniasis continues to be prevalent in many tropical and subtropical countries despite international, national, and local efforts towards its control and elimination over the last decade. This warrants a critical evaluation of such factors as under-reporting, asymptomatic infections, post kala azar dermal leishmaniasis (PKDL) cases, and drug resistance. In this review, we highlight lesser-understood atypical presentations of the disease involving atypical parasite strains against a background of classical leishmaniasis with a focus on the Indian subcontinent.Methods and findingsA literature review based on endemic areas, the nature of disease manifestation, and underlying causative parasite was performed with data collected from WHO reports for each country. Searches on PubMed included the term ‘‘leishmaniasis” and “leishmaniasis epidemiology” alone and in combination with each of the endemic countries, Leishmania species, cutaneous, visceral, endemic, non-endemic, typical, classical, atypical, and unusual with no date limit and published in English up to September 2017. Our findings portray a scenario with a wider distribution of the disease in new endemic foci, with new discoveries of parasite-driven atypical disease manifestations in different regions of the world. Unlike the classical picture, some Leishmania species are associated with more than one disease presentation, e.g., the L. donovani complex, generally associated with the visceral form, is now also associated with a cutaneous disease presentation, while L. tropica species complex, known to cause cutaneous disease, can cause viscerotropic disease. This phenomenon points towards the discovery of novel parasite variants as etiologic agents of atypical disease manifestations and represents an excellent opportunity to identify and study genes that control disease virulence and tropism.ConclusionsThe increased recognition of atypical leishmaniasis as an outcome of parasite variants has major implications for leishmaniasis control and elimination. Identifying molecular correlates of parasite isolates from distinct regions associated with different disease phenotypes is required to understand the current epidemiology of leishmaniasis in regions with atypical disease.

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“…Further variation of the CL disease caused by L . donovani exists wherein the parasite is detected in blood culture with no visceral manifestation [ 37 ].…”

Section: Cutaneous Leishmaniasismentioning

confidence: 99%

Atypical leishmaniasis: A global perspective with emphasis on the Indian subcontinent

et al. 2018

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“…During active LCL, Leishmania parasites are not restricted to the skin lesions but are also detectable at extralesional sites including blood monocytes, tonsils and normal skin 83 84. Viable Leishmania parasites have also been found in scarred skin lesions and lymph nodes after clinical cure,85–87 as well as in the blood of asymptomatically infected humans 88–90.…”

Section: Infection Cycle Pathogenesis and Immunologymentioning

confidence: 99%

Leishmaniasis in rheumatology, haematology and oncology: epidemiological, immunological and clinical aspects and caveats: Figure 1

Bogdan

2012

Ann Rheum Dis

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Leishmaniasis is an intracellular protozoan infection that can lead to cutaneous, mucocutaneous, visceral or systemic manifestations depending on the parasite species and virulence and on the host immune response. It is endemic in countries of Europe (Mediterranean basin), Asia, Africa, Central and South America, but autochthonous cases begin to emerge outside classical disease areas. CD4+ T helper cells, interferon γ, dendritic cells and macrophages are the key components of antileishmanial defence. Leishmaniasis is an important differential diagnosis in patients with chronic lesions of the skin or mucous membranes or with fever, hepatosplenomegaly, lymphadenopathy, pancytopenia, histocytosis, haemophagocytic syndrome or glomerulonephritis. Organ transplant recipients and patients with autoimmune syndromes are at particular risk of developing visceral leishmaniasis following immunosuppressive therapy (eg, with steroids, methotrexate, ciclosporin or tumour necrosis factor-neutralising biological agents). Diagnosis and adequate treatment of leishmaniasis requires the combined use of culture, microscopic and nucleic acid amplication methods and species identification by sequencing and other molecular techniques. Standard regimens for the treatment of visceral leishmaniasis are intravenous liposomal amphotericin B (3 mg/kg body weight for 10 days) or oral miltefosine (150 mg/day for 28 days).

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“…In a sample population ( n = 162), parasites were obtained from 85 patients (52.5%), and were isolated from the blood by cultures of 50 patients (30.9%). Isoenzyme analysis confirmed that the organisms in blood and skin were the same, which underlines the invasive potential of the parasite that escaped the skin [3]. …”

Section: Introductionmentioning

confidence: 97%

Clinical and Immunological Analysis of Cutaneous Leishmaniasis before and after Different Treatments

O'Daly¹,

Spinetti

Gleason³

et al. 2013

Journal of Parasitology Research

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Amastigotes from L. (L.)amazonensis (La), L. (L.)venezuelensis (Lv), L. (V.)brasiliensis (Lb), and L. (L.)chagasi (Lch) were cultured in a free cells liquid culture medium. Patients (n = 87) from a cutaneous leishmaniasis (CL) hyperendemic region receiving different treatments were followed up from January 1994 to August 2000. Time for remission of lesions were spontaneous remission (SR) 7 weeks; Glucantime (Glu) chemotherapy 9 weeks; immunotherapy with La, Lv, Lb, and Lch amastigotes Tosyl-Lysil Chloromethyl-ketone (TLCK) treated and Nonidet P-40(NP-40) extracted (VT) 7 weeks. Delayed type hypersensitivity (DTH) response with leishmanine intradermic reaction (IDR) was higher in CL patients than healthy controls (P < 0.05) and increased in active secondary versus primary infection (P < 0.001) with diagnostic value 1.74 for active infection and 1.81 postclinical remission. Antibodies to amastigotes characterized by Enzyme Linked Immunosorbent Assay (ELISA) decreased in sera postclinical remission versus active infections (P < 0.001), with a diagnostic value from 1.50 to 1.84. Immunoblottings antigenic bands frequency as well as Integral Optical Density (IOD) Area Densitometry decreased with sera from SR, after Glu or VT treatments in CL volunteers. Intracellular parasitism is due to normal antibodies recognizing parasite antigens after inoculation by vector. VT vaccine induced mainly cellular immunity, for remission of lesions and protection from CL infection.

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Detection of Leishmania parasites in the blood of patients with isolated cutaneous leishmaniasis

Cited by 19 publications

References 31 publications

Atypical leishmaniasis: A global perspective with emphasis on the Indian subcontinent

Atypical leishmaniasis: A global perspective with emphasis on the Indian subcontinent

Leishmaniasis in rheumatology, haematology and oncology: epidemiological, immunological and clinical aspects and caveats: Figure 1

Clinical and Immunological Analysis of Cutaneous Leishmaniasis before and after Different Treatments

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