Visceral Leishmaniasis in a Soldier Returning from Operation Enduring Freedom

Halsey, Eric S.; Lee, Bryce; Wortmann, Glenn; Weina, Peter J.; Ryan, Jeffrey R.; DeWitt, Caroline C.

doi:10.7205/milmed.169.9.699

Cited by 15 publications

(7 citation statements)

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“…During 2002 to 2004, more than 500 cases of cutaneous leishmaniasis, caused by L. major, were reported in military personnel stationed in the Middle East and Central Asia 18 . In addition, four cases of visceral leishmaniasis, caused by L. donovani infantum, have been reported from 2002 to 2004 19 . This species has previously been documented to be associated with blood transfusion, although the risk exists for all species.…”

Section: Discussionmentioning

confidence: 99%

Leishmania inactivation in human pheresis platelets by a psoralen (amotosalen HCl) and long‐wavelength ultraviolet irradiation

et al. 2005

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This study demonstrates the effectiveness of photochemical treatment to inactivate Leishmania in PLT concentrates intended for transfusion. Both metacylic promastigotes, which represent the infectious form from the sand fly vector, and amastigotes, which represent the form that grows in mononuclear phagocytes, were extremely susceptible to photochemical inactivation by this process. Thus, the photochemical treatment of PLT concentrates inactivates both forms of Leishmania that would be expected to circulate in blood products collected from infected donors.

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Section: Discussionmentioning

confidence: 99%

Leishmania inactivation in human pheresis platelets by a psoralen (amotosalen HCl) and long‐wavelength ultraviolet irradiation

et al. 2005

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“…Immunologically naive individuals from the developed world traveling to areas of endemicity are particularly prone to infection. Leishmaniasis has been found among American soldiers deployed to the Middle East during both Gulf wars, current conflicts in Afghanistan, and Central America (3,7,12,14,18,20,24,29). Civilians traveling into these areas are also at risk (2).…”

mentioning

confidence: 99%

The Antituberculosis Drug Pyrazinamide Affects the Course of Cutaneous Leishmaniasis In Vivo and Increases Activation of Macrophages and Dendritic Cells

Méndez

Traslavina

Hinchman

et al. 2009

Antimicrob Agents Chemother

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Antileishmanial therapy is suboptimal due to toxicity, high cost, and development of resistance to available drugs. Pyrazinamide (PZA) is a constituent of short-course tuberculosis chemotherapy. We investigated the effect of PZA on Leishmania major promastigote and amastigote survival. Promastigotes were more sensitive to the drug than amastigotes, with concentrations at which 50% of parasites were inhibited (MIC 50 ) of 16.1 and 8.2 M, respectively (48 h posttreatment). Moreover, 90% of amastigotes were eliminated at 120 h posttreatment, indicating that longer treatments will result in parasite elimination. Most strikingly, PZA treatment of infected C57BL/6 mice resulted in protection against disease and in a 100-fold reduction in the parasite burden. PZA treatment of J774 cells and bone marrow-derived dendritic cells and macrophages increased interleukin 12, tumor necrosis factor alpha, and activation marker expression, as well as nitric oxide production, suggesting that PZA enhances effective immune responses against the parasite. PZA treatment also activates dendritic cells deficient in Toll-like receptor 2 and 4 expression to initiate a proinflammatory response, confirming that the immunostimulatory effect of PZA is directly caused by the drug and is independent of Toll-like receptor stimulation. These results not only are strongly indicative of the promise of PZA as an alternative antileishmanial chemotherapy but also suggest that PZA causes collateral immunostimulation, a phenomenon that has never been reported for this drug.

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“…Several studies in India and Brazil have concluded that the InBios rapid strip test for diagnosis of VL is highly sensitive and specific (2,9,14), and the U.S. Army currently uses the InBios rapid strip on suspected VL in returning soldiers and on the local Iraq population (3,6,15). The results of these studies and our own demonstrate that the InBios rapid strip has a high sensitivity and specificity for VL detection in multiple countries on different continents, where the species responsible for VL may differ (7).…”

Section: Visceral Leishmaniasis (Vl) Is the Results Of Infection By Thementioning

confidence: 99%

“…The recommended method for diagnosis has been microscopic determination of parasites from bone marrow, splenic, or lymphatic tissue biopsy specimens (7); however, these tests are invasive as well as difficult to perform in rural areas, where VL may be endemic and carry a high risk of complication (6,17). Recently, real-time PCR has been utilized to diagnose Leishmania infection and appears promising; nevertheless, the ability to perform the assay becomes prohibitive in many regions of endemicity with limited medical resources (10,12,16).…”

Section: Visceral Leishmaniasis (Vl) Is the Results Of Infection By Thementioning

confidence: 99%

Rapid Immunochromatographic Strip Test for Detection of Anti-K39 Immunoglobulin G Antibodies for Diagnosis of Visceral Leishmaniasis

Welch

Anderson

Litwin

2008

Clin Vaccine Immunol

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InBios International has developed an immunochromatographic rapid strip for the detection of visceral leishmaniasis that requires minimal equipment and only a small amount of blood to run a test. We compared the InBios rapid strip test with the CDC immunofluorescent antibody assay, and the agreement, sensitivity, and specificity were 98%, 90%, and 100%, respectively. Visceral leishmaniasis (VL) is the result of infection by theLeishmania donovani species complex (including L. donovani, Leishmania chagasi, and Leishmania infantum) and Leishmania tropica (11,15). The recommended method for diagnosis has been microscopic determination of parasites from bone marrow, splenic, or lymphatic tissue biopsy specimens (7); however, these tests are invasive as well as difficult to perform in rural areas, where VL may be endemic and carry a high risk of complication (6,17). Recently, real-time PCR has been utilized to diagnose Leishmania infection and appears promising; nevertheless, the ability to perform the assay becomes prohibitive in many regions of endemicity with limited medical resources (10,12,16). It has therefore been a goal in VL testing to produce a rapid, noninvasive technique for diagnosis that can be used in the field (5, 7, 13). InBios International, Inc. (Seattle, WA), has developed such a test that has been approved by the Food and Drug Administration.The InBios Kalazar Detect rapid test utilizes the recombinant L. chagasi antigen rK39, which is a 39-amino-acid repeat section in the 230-kDa LcKin protein (1). It has previously been reported that L. chagasi, L. donovani, and L. infantum all contain the gene encoding the LcKin protein (1). A membrane strip which also contains a conjugate dye region is coated with this protein. Through capillary action, the patient serum will react with the dye and antigen to quickly indicate the presence of anti-rK39 immunoglobulin G (IgG) in a patient sample.In this study, we determined the efficacy of the InBios VL test by comparing results of the InBios test with results from the test used by the Centers for Disease Control and Prevention (CDC; Atlanta, GA).Human sera. This study was approved by the Institutional Review Board of the University of Utah (IRB 7275). Serum samples were divided into two categories: samples that were obtained from patients proven to have leishmaniasis by the CDC, and samples that were sent to ARUP Laboratories (Salt Lake City, UT) for leishmaniasis serological testing. Sixteen samples that had been collected from patients treated by the CDC for leishmaniasis and pathologically confirmed by PCR, culture, or direct detection at the CDC for leishmaniasis were de-identified and stored at 2 to 8°C. Seventy-eight serum samples that were originally collected between 2007 and 2008 and sent to ARUP Laboratories for leishmaniasis testing were deidentified and stored at 2 to 8°C.InBios Kalazar Detect rapid test. All 94 samples were tested for anti-rK39 IgG antibodies using the InBios Kalazar Detect rapid test (Seattle, WA) according to the manufacturer's ...

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Visceral Leishmaniasis in a Soldier Returning from Operation Enduring Freedom

Cited by 15 publications

References 0 publications

Leishmania inactivation in human pheresis platelets by a psoralen (amotosalen HCl) and long‐wavelength ultraviolet irradiation

Leishmania inactivation in human pheresis platelets by a psoralen (amotosalen HCl) and long‐wavelength ultraviolet irradiation

The Antituberculosis Drug Pyrazinamide Affects the Course of Cutaneous Leishmaniasis In Vivo and Increases Activation of Macrophages and Dendritic Cells

Rapid Immunochromatographic Strip Test for Detection of Anti-K39 Immunoglobulin G Antibodies for Diagnosis of Visceral Leishmaniasis

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