Recurrent lesions in human Leishmania braziliensis infection—reactivation or reinfection?

Saravia, Nancy Gore; Segura, Iris; Labrada, Luz Angela; Weigle, Kristen A.; Giannini, Suzanne Holmes; Pacheco, Raquel da Silva; Gonçalves, Antônio José

doi:10.1016/0140-6736(90)91945-7

Cited by 130 publications

(89 citation statements)

References 25 publications

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“…Others papers reinforce this view , Stenger et al 1996, Bogdan & Röllinghoff 1998. Such mechanisms, possibly related to reinfection (Saravia et al 1990) due to repeated phlebotomine bites in former patients that kept living in ATL endemic areas, could have contributed to the maintenance of the immune response.…”

Section: Discussionmentioning

confidence: 86%

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Leishmanial antigens in the diagnosis of active lesions and ancient scars of American tegumentary leishmaniasis patients

Schubach

Cuzzi-Maya

Oliveira

et al. 2001

Mem. Inst. Oswaldo Cruz

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Cutaneous biopsies (n = 94) obtained from 88 patients with American tegumentary leishmaniasis were studied by conventional and immunohistochemical techniques. Specimens were distributed as active lesions of cutaneous leishmaniasis (n = 53) (Group I), cicatricial lesions of cutaneous leishmaniasis (n = 35) (Group II) and suggestive scars of healed mucosal leishmaniasis patients (n = 6) (Group III). In addition, active cutaneous lesions of other etiology (n = 24) (Group C1) and cutaneous scars not related to leishmaniasis (n = 10) (Group C2) were also included in the protocol. Amastigotes in

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Section: Discussionmentioning

confidence: 86%

“…In these cases, diagnosis depends on the finding of parasites in the reactivated lesion, what is another evidence that scars may shelter amastigotes that could be responsible for active lesions, although the possibility of a new infection can not be excluded (Oliveira 1977, Saravia et al 1990). …”

mentioning

confidence: 99%

Leishmanial antigens in the diagnosis of active lesions and ancient scars of American tegumentary leishmaniasis patients

Schubach

Cuzzi-Maya

Oliveira

et al. 2001

Mem. Inst. Oswaldo Cruz

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“…However, the recurrence of cutaneous lesions and parasite persistence has been reported in patients treated for CL 24 ; there are also reports describing the detection of leishmanial DNA by means of polymerase chain reaction in patients with visceral leishmaniasis who received treatment with antimonials and were believed to be cured. 25,26 …”

Section: Discussionmentioning

confidence: 99%

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

Arana¹,

Mendoza²,

Rizzo³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

113

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Abstract. A double-blind, randomized trial was undertaken in Guatemala to determine the therapeutic efficacy of an ointment for the treatment of cutaneous leishmaniasis that contained 15% paromomycin and 12% methylbenzethonium chloride and that was applied twice a day for 20 days. The treatment group included 35 patients, and the placebo group included 33 patients. The initial clinical response rate (13 weeks after completing the treatment) was 91.4% in the treatment group and 39.4% in the placebo group. The final clinical response rate at the 12-month followup examination was 85.7% (31 of 35) in the treatment group and 39.4% (13 of 33) in the placebo group (P Յ 0.001). In general, the treatment was well tolerated and was never interrupted because of adverse effects. The number of adverse effects reported in the placebo group was lower than in the treatment group (16 events versus 30 events). All adverse effects reported by patients disappeared within 1 week of completing the treatment. Our findings show that the combination of paromomycin with methylbenzethonium chloride for 20 days is a good alternative for antimonial treatments of cutaneous leishmaniasis in Guatemala.

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“…There are no appropriate biochemical or molecular markers to distinguish a resident parasite from a newcomer, unless the latter clearly belongs to a different group or population. Karyotype analyses lacks of sensitivity and do not seem to correlate with the zymodeme analysis (Saravia et al 1990); isoenzymes are useful in discriminating species but lack the sensitivity to distinguish or-ganisms of the same population (Saravia et al 1990), restriction fragment length polymorphism analysis (RFLP) involving unique nuclear genes are in general insensitive, and kinetoplast minicircle restriction analysis analysis (Morel et al 1980) provide unstable markers, as Pacheco et al (1995) have shown, variable sequence polymorphisms can emerge during experimental infections with cloned L. guyanensis cells. It remain to be tested whether RAPDs analysis targeted in other Leishmania sequences can provide the right tool (Macedo et al 1992).…”

Section: Persistencymentioning

confidence: 99%

Persistent Infections by Leishmania (Viannia) braziliensis

Ramı́rez¹,

Guevara²

1997

Mem. Inst. Oswaldo Cruz

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Here we review the phenomenon of persistency in Leishmania (Viannia) braziliensis infections. In other Leishmania species where appropriate animal models exist, considerable advances in the understanding of basic immunologic mechanisms of persistency have been made; for a review see Aebisher (1994). On the contrary, the evidences of persistence in infections with L. braziliensis rest on studies of human clinical cases many of which we summarized and discussed in this work.

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Recurrent lesions in human Leishmania braziliensis infection—reactivation or reinfection?

Cited by 130 publications

References 25 publications

Leishmanial antigens in the diagnosis of active lesions and ancient scars of American tegumentary leishmaniasis patients

Leishmanial antigens in the diagnosis of active lesions and ancient scars of American tegumentary leishmaniasis patients

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

Persistent Infections by Leishmania (Viannia) braziliensis

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