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

Veland, Nicolás; Valencia, Braulio M.; Alba, Milena; Adaui, Vanessa; Llanos-Cuentas, Alejandro; Arévalo, Jorge; Boggild, Andrea K.

doi:10.4269/ajtmh.12-0594

Cited by 13 publications

(16 citation statements)

References 28 publications

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“…It causes CL with characteristic lesions similar to those caused by other Leishmania (Viannia) species: small ulcers or small self-limiting nodules [ 37 ]. The parasite was subsequently identified from patients in Sub-Andean and Amazonian areas of Peru [ 18 , 38 , 39 , 40 ], in subtropical climate areas and Sub Andean areas of Bolivia [ 41 , 42 ], Suriname [ 43 ], and French Giana [ 44 ]. Two L .…”

Section: Discussionmentioning

confidence: 99%

First Human Cases of Leishmania (Viannia) lainsoni Infection and a Search for the Vector Sand Flies in Ecuador

et al. 2016

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An epidemiological study of leishmaniasis was performed in Amazonian areas of Ecuador since little information on the prevalent Leishmania and sand fly species responsible for the transmission is available. Of 33 clinical specimens from patients with cutaneous leishmaniasis (CL), causative parasites were identified in 25 samples based on cytochrome b gene analysis. As reported previously, Leishmania (Viannia) guyanensis and L. (V.) braziliensis were among the causative agents identified. In addition, L. (V.) lainsoni, for which infection is reported in Brazil, Bolivia, Peru, Suriname, and French Guiana, was identified in patients with CL from geographically separate areas in the Ecuadorian Amazon, corroborating the notion that L. (V.) lainsoni is widely distributed in South America. Sand flies were surveyed around the area where a patient with L. (V.) lainsoni was suspected to have been infected. However, natural infection of sand flies by L. (V.) lainsoni was not detected. Further extensive vector searches are necessary to define the transmission cycle of L. (V.) lainsoni in Ecuador.

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Section: Discussionmentioning

confidence: 99%

First Human Cases of Leishmania (Viannia) lainsoni Infection and a Search for the Vector Sand Flies in Ecuador

et al. 2016

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“…Sand fly species of the genera Phlebotomus and Sergentomyia are two putative vectors in the transmission of Leishmania in West Africa (418). In South America, Leishmania braziliensis, Leishmania guyanensis, and Leishmania panamensis are responsible for cutaneous ulcers (259,419). One case of M. ulcerans and L. braziliensis coinfection in a European traveler in South America raised the question of possible cotransmission of the two pathogens (259).…”

Section: Cutaneous Leishmaniasismentioning

confidence: 99%

Buruli Ulcer, a Prototype for Ecosystem-Related Infection, Caused by Mycobacterium ulcerans

et al. 2018

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Buruli ulcer is a noncontagious disabling cutaneous and subcutaneous mycobacteriosis reported by 33 countries in Africa, Asia, Oceania, and South America. The causative agent, , derives from by genomic reduction and acquisition of a plasmid-borne, nonribosomal cytotoxin mycolactone, the major virulence factor. -specific sequences have been readily detected in aquatic environments in food chains involving small mammals. Skin contamination combined with any type of puncture, including insect bites, is the most plausible route of transmission, and skin temperature of<30°C significantly correlates with the topography of lesions. After 30 years of emergence and increasing prevalence between 1970 and 2010, mainly in Africa, factors related to ongoing decreasing prevalence in the same countries remain unexplained. Rapid diagnosis, including laboratory confirmation at the point of care, is mandatory in order to reduce delays in effective treatment. Parenteral and potentially toxic streptomycin-rifampin is to be replaced by oral clarithromycin or fluoroquinolone combined with rifampin. In the absence of proven effective primary prevention, avoiding skin contamination by means of clothing can be implemented in areas of endemicity. Buruli ulcer is a prototype of ecosystem pathology, illustrating the impact of human activities on the environment as a source for emerging tropical infectious diseases.

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“…If the VL of this patient was caused by L. infantum , this would highlight the possibility of a coinfection by two endemic species in the same focus. It is usually considered that vector and human hosts are infected by a single species and that the natural infection by one Leishmania species would protect against reinfections by homologous or heterologous species [ 25 , 26 ]. However, natural human coinfections have been reported in Bolivia, Brazil, Iran, Iraq, Mexico, and Peru [ 25 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is usually considered that vector and human hosts are infected by a single species and that the natural infection by one Leishmania species would protect against reinfections by homologous or heterologous species [ 25 , 26 ]. However, natural human coinfections have been reported in Bolivia, Brazil, Iran, Iraq, Mexico, and Peru [ 25 , 27 ]. In Morocco, these observations must be kept in mind due to the increasing number of reported co-endemic CL foci due to L. infantum and L. tropica , or L. tropica and L. major [ 8 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Concomitant visceral and localized cutaneous leishmaniasis in two Moroccan infants

et al. 2018

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BackgroundLeishmaniases are vector-borne diseases caused by the protozoa of the Leishmania genus. The clinical spectrum of these diseases extends from benign dermal lesions to visceral forms. In the Mediterranean region, zoonotic visceral leishmaniasis (ZVL) is caused by L. infantum. If untreated within two years, the disease usually leads to death. In Morocco, ZVL is endemic in the north, with a hundred cases notified each year, mostly in children aged below five years. Here, we report on two clinical observations in infants presenting unusual concomitant VL and cutaneous leishmaniasis (CL) in Morocco.Case presentationIn this case study, we report on two infants aged nine and 12 months old. They both have a history of febrile splenomegaly, anemia, and pallor of mucous membranes. Visceral leishmaniasis was confirmed by parasitological diagnosis (positive bone marrow smear and screening of anti-L. infantum antibodies). However, the clinical examination also showed cutaneous lesions that suggested the presence of CL. This was reinforced by the patients having a history of living or traveling to endemic foci. Thus, direct examination, culture, and PCR-RFLP (ITS1-Hae 3) were carried out on the patients’ dermal exudates. In one of the infants, CL was associated with L. infantum, while in the other it was associated with L. tropica. The infants were treated as according to the recommendations of the Ministry of Health. Both patients were cured in two months; defervescence, reduction of splenomegaly, and healing of cutaneous lesions were all observed.ConclusionsThese singular patients illustrate the clinical polymorphism of CL and the necessity of updating the differential diagnosis of leukemia-like syndromes, including VL, in children living in or travelling to known endemic areas. These observations suggest a change in the Mediterranean VL phenotype that may be associated with CL.Electronic supplementary materialThe online version of this article (10.1186/s40249-018-0413-8) contains supplementary material, which is available to authorized users.

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

Cited by 13 publications

References 28 publications

First Human Cases of Leishmania (Viannia) lainsoni Infection and a Search for the Vector Sand Flies in Ecuador

First Human Cases of Leishmania (Viannia) lainsoni Infection and a Search for the Vector Sand Flies in Ecuador

Buruli Ulcer, a Prototype for Ecosystem-Related Infection, Caused by Mycobacterium ulcerans

Concomitant visceral and localized cutaneous leishmaniasis in two Moroccan infants

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