DOCSLIB.ORG

Muco-Cutaneous Leishmaniasis in the New World: the Ultimate Subversion Catherine Ronet University of Lausanne

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Muco-Cutaneous Leishmaniasis in the New World: the Ultimate Subversion Catherine Ronet University of Lausanne Washington University School of Medicine Digital Commons@Becker Open Access Publications 2011 Muco-cutaneous leishmaniasis in the New World: The ultimate subversion Catherine Ronet University of Lausanne Stephen M. Beverley Washington University School of Medicine in St. Louis Nicolas Fasel University of Lausanne Follow this and additional works at: https://digitalcommons.wustl.edu/open_access_pubs Recommended Citation Ronet, Catherine; Beverley, Stephen M.; and Fasel, Nicolas, ,"Muco-cutaneous leishmaniasis in the New World: The ultimate subversion." Virulence.2,6. 547-552. (2011). https://digitalcommons.wustl.edu/open_access_pubs/2631 This Open Access Publication is brought to you for free and open access by Digital Commons@Becker. It has been accepted for inclusion in Open Access Publications by an authorized administrator of Digital Commons@Becker. For more information, please contact [email protected]. ARTICLE ADDENDUM ARTICLE ADDENDUM Virulence 2:6, 547-552; November/December 2011; © 2011 Landes Bioscience Muco-cutaneous leishmaniasis in the New World The ultimate subversion Catherine Ronet,1 Stephen M. Beverley2 and Nicolas Fasel1,* 1Department of Biochemistry; University of Lausanne; Epalinges, Switzerland; 2Department of Molecular Microbiology; Washington University School of Medicine; St. Louis, MO USA nfection by the human protozoan par- Additionally, host factors are thought to Iasite Leishmania can lead, depending play significant roles in determining the primarily on the parasite species, to either clinical course of the disease as well. cutaneous or mucocutaneous lesions, or Leishmania parasites exist as free- fatal generalized visceral infection. In living promastigotes in the sand fly vector. the New World, Leishmania (Viannia) Following differentiation to the infective species can cause mucocutaneous leish- metacyclic form, parasites are deposited in maniasis (MCL). Clinical MCL involves the skin of vertebrate host by the sand fly a strong hyper-inflammatory response bite. There promastigotes encounter sev- ©2011Landes Bioscience. and parasitic dissemination (metastasis) eral host cell types including neutrophils, from a primary lesion to distant sites, dendritic cells and skin macrophages, leading to destructive metastatic second- ultimately transiting and differentiating Donot distribute. ary lesions especially in the nasopha- into amastigotes which go on to repli- ryngal areas. Recently, we reported that cate within the phagolysosome of macro- metastasizing, but not non-metastatic phages. Leishmania parasites must change strains of Leishmania (Viannia) guya- their metabolism and adapt themselves to nensis, have high burden of a non-seg- this new environment, and resist the oxi- mented dsRNA virus, Leishmania RNA dative and other attacks activated by the Virus (LRV). Viral dsRNA is sensed by innate immune system of the host. the host Toll-like Receptor 3 (TLR3) Leishmania species of the L. (Viannia) thereby inducing a pro-inflammatory subgenus, including mainly L. brazilien- response and exacerbating the disease. sis, L. guyanensis and L. panamensis, give The presence of LRV in Leishmania rise to CL but are also responsible for Key words: leishmaniasis, Leishmania opens new perspectives not only in basic MCL in up to 5–10% of cases. MCL is RNA virus, hyperinflammation, TLR-3, understanding of the intimate relation clearly distinguishable from other cuta- IFNβ between the parasite and LRV, but also neous leishmaniases by its chronic, latent in understanding the importance of the and metastatic behavior. It is character- Submitted: 07/08/11 inflammatory response in MCL patients. ized by the dissemination of parasites and Revised: 08/22/11 secondary distant lesions development Accepted: 08/23/11 Leishmania are human protozoan para- (metastasis), especially in the oral and sites endemic in 88 countries, with a nasopharyngeal areas of the face, and is http://dx.doi.org/10.4161/viru.2.6.17839 disease prevalence of 12 million cases accompanied by extensive tissue destruc- *Correspondence to: Nicolas Fasel; accompanied by 80,000 annual fatalities. tion concomitant with high immune cell Email: [email protected] These infections induce a large spectrum infiltration, intense activation of inflam- of clinical pathologies, mainly cutane- matory cells and parasite presence (albeit Addendum to: Ives A, Ronet C, Prevel F, Ruzzante ous (CL), mucosal (MCL) and visceral at low levels).1 MCL can appear con- G, Fuertes Marraco S, Schutz F, et al. Leishmania RNA Virus controls the severity of mucocuta- leishmaniasis (VL). The differences comitantly, several years after the initial neous leishmaniasis. Science 2011; 331:775–8; arise primarily from infection by differ- infection, or even in patients without PMID:21311023; http://dx.doi.org/10.1126/ ent Leishmania species, such as L. major, any CL history. MCL lesions are not self- science.1199326. L. braziliensis and L. infantum respectively. healing and are more resistant to antimony www.landesbioscience.com Virulence 547 treatment than the primary lesions, with Th1/Th2 phenotype and elevated cyto- RNAi machinery was recently shown frequent relapses. The factors responsible toxic T cell activity. However, cells from to be functional in L. braziliensis and in for these relapses are not known; both MCL patients display impaired control of L. guyanensis.17 A second remarkable feature the emergence of antimony resistance as the immune response due to a defect in the presence of Leishmania RNA viruses well as differences among the infecting their ability to respond to IL-10.7-10 The in many isolates of the L. (Viannia) spe- L. (Viannia) species and its virulence have production of the different inflammatory cies. These Leishmaniaviruses have been been suggested.2,3 cytokines by the host is likely to increase classified as Totiviridae, which includes Reactivation of L. (Viannia) infection cellular recruitment and contribute to the RNA viruses detected in other protozoa can occur following stress or immuno- pathology of the disease. Thus by these such as Trichomonas vaginalis and Giardia suppression at a site of local inflammation, and potentially other mechanisms, immu- lamblia and a variety of fungi including raising the challenging question of how nological hyperactivity contributes to Saccharomyces cerevisiae. Totiviruses have these factors interact with slow-growing MCL pathology. In turn measures dimin- a small unsegmented dsRNA genome or dormant parasites and the immune ishing uncontrolled inflammation could between 5–7 kb in length, which encodes system to favor the reemergence of disease be one promising alternative or comple- a capsid protein and a capsid-RNA depen- pathology. Thus far, little is known about ment to the conventional drug therapy. dent RNA polymerase (RDRP) fusion the pathogenesis of MCL, especially fac- Interestingly, treatment with the anti- protein essential for replication. tors involved in the immune response of inflammatory TNFα inhibitor pentoxy- The existence of cytosolic dsRNA the host, in the parasite dissemination, phylline in combination with antimony viruses within Leishmania was first shown or in reactivation. It is likely that both was effective in MCL patients unrespon- in two L. guyanensis strains: MHOM/ L. (Viannia) oxidative stress and antimony sive to antimonial therapy alone.11 SR/81/CUMC1A and MHOM/BR/75/ resistance as well as genetic background of The susceptibility of the golden ham- M4147.18,19 Currently Leishmania the host (e.g., particular alleles encoding ster to infection with species of the viruses are given arbitrary identifiers at TNFα, TNFβ, IL-6, CXCR1 and CCL2/ L. (Viannia) subgenus has provided a the time of discovery, namely LRV1-1 MCP1) and particular species and/or iso- useful experimental model of mucocuta- and LRV1–4 for the viruses of the late specific virulence factors are impor- neous leishmaniasis. Hamsters infected L. guyanensis CUMC-1 and L. guyanen- tant parameters ©2011in the development of Landeswith L. (Viannia) guyanensis Bioscience. isolated sis M4147 strain respectively. These two MCL. The definition of such factors and from human MCL lesions reproduce the viruses share an overall 76% nucleotide of the immune response of the host could metastatic phenotype with primary and sequence identity.20,21 LRV1s have since be extremely useful, not only toDo predict metastaticnot lesion distribute. development.12 Different been identified in many isolates of New the outcome of the disease and diagnosis species and individual strains often differ World Leishmania (L. braziliensis and tools, but also to understand the meta- in their propensity to cause hyperinflam- L. guyanensis), but in just one isolate of Old static process and the inter-relationships matory cutaneous secondary metastatic World species L. major, which was showed of the parasite with its host. Currently the lesions.13 Diversity was even seen within a sufficient nucleotide sequence divergence immunological mechanisms of protection single strain, as infective clones from the to be termed LRV2-1 (compare taxonomy and factors controlling relapse and avoid- isolate of L. (Viannia) guyanensis (L.g.) browser at www.ncbi.nlm.nih.gov). LRV1 ing reactivation of the infection are not (WHI/BR/78/M5313) were either highly are present not only in laboratory strains well understood. metastatic, moderately metastatic or non- of L. guyanensis and L. braziliensis but In MCL, the immune response to metastatic in the hamster model. Non- importantly also in biopsies
Load more

Recommended publications
  • Vectorborne Transmission of Leishmania Infantum from Hounds, United States
    Vectorborne Transmission of Leishmania infantum from Hounds, United States Robert G. Schaut, Maricela Robles-Murguia, and Missouri (total range 21 states) (12). During 2010–2013, Rachel Juelsgaard, Kevin J. Esch, we assessed whether L. infantum circulating among hunting Lyric C. Bartholomay, Marcelo Ramalho-Ortigao, dogs in the United States can fully develop within sandflies Christine A. Petersen and be transmitted to a susceptible vertebrate host. Leishmaniasis is a zoonotic disease caused by predomi- The Study nantly vectorborne Leishmania spp. In the United States, A total of 300 laboratory-reared female Lu. longipalpis canine visceral leishmaniasis is common among hounds, sandflies were allowed to feed on 2 hounds naturally in- and L. infantum vertical transmission among hounds has been confirmed. We found thatL. infantum from hounds re- fected with L. infantum, strain MCAN/US/2001/FOXY- mains infective in sandflies, underscoring the risk for human MO1 or a closely related strain. During 2007–2011, the exposure by vectorborne transmission. hounds had been tested for infection with Leishmania spp. by ELISA, PCR, and Dual Path Platform Test (Chembio Diagnostic Systems, Inc. Medford, NY, USA (Table 1). L. eishmaniasis is endemic to 98 countries (1). Canids are infantum development in these sandflies was assessed by Lthe reservoir for zoonotic human visceral leishmani- dissecting flies starting at 72 hours after feeding and every asis (VL) (2), and canine VL was detected in the United other day thereafter. Migration and attachment of parasites States in 1980 (3). Subsequent investigation demonstrated to the stomodeal valve of the sandfly and formation of a that many US hounds were infected with Leishmania infan- gel-like plug were evident at 10 days after feeding (Figure tum (4).
    [Show full text]
  • Cutaneous Leishmaniasis Due to Leishmania (Viannia) Panamensis in Two Travelers Successfully Treated with Miltefosine
    Am. J. Trop. Med. Hyg., 103(3), 2020, pp. 1081–1084 doi:10.4269/ajtmh.20-0086 Copyright © 2020 by The American Society of Tropical Medicine and Hygiene Case Report: Cutaneous Leishmaniasis due to Leishmania (Viannia) panamensis in Two Travelers Successfully Treated with Miltefosine S. Mann,1* T. Phupitakphol,1 B. Davis,2 S. Newman,3 J. A. Suarez,4 A. Henao-Mart´ınez,1 and C. Franco-Paredes1,5 1Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado; 2Division of Pathology, University of Colorado School of Medicine, Aurora, Colorado; 3Division of Dermatology, University of Colorado School of Medicine, Aurora, Colorado; 4Gorgas Memorial Institute of Tropical Medicine, Panama ´ City, Panama; ´ 5Hospital Infantil de Mexico, ´ Federico Gomez, ´ Mexico ´ City, Mexico ´ Abstract. We present two cases of Leishmania (V) panamensis in returning travelers from Central America suc- cessfully treated with miltefosine. The couple presented with ulcerative skin lesions nonresponsive to antibiotics. Skin biopsy with polymerase chain reaction (PCR) revealed L. (V) panamensis. To prevent the development of mucosal disease and avoid the inconvenience of parental therapy, we treated both patients with oral miltefosine. We suggest that milte- fosine represents an important therapeutic alternative in the treatment of cutaneous lesions caused by L. panamensis and in preventing mucosal involvement. A 31-old-man and a 30-year-old woman traveled to Costa Because of the presence of a thick fibrous scar at the ul- Rica for their honeymoon. They visited many regions of this cerative lesion border, we recommended a short course of country and participated in hiking, rafting, and camping.
    [Show full text]
  • Relevance of Epidemiological Surveillance in Travelers: an Imported Case of Leishmania Tropica in Mexico
    CASE REPORT http://doi.org/10.1590/S1678-9946202062041 Relevance of epidemiological surveillance in travelers: an imported case of Leishmania tropica in Mexico Edith Araceli Fernández-Figueroa 1,2, Sokani Sánchez-Montes 2, Haydee Miranda-Ortíz 3, Alfredo Mendoza-Vargas 3, Rocely Cervantes-Sarabia4, Roberto Alejandro Cárdenas-Ovando 5, Adriana Ruiz-Remigio4, Ingeborg Becker 2,4 ABSTRACT We report the case of a patient with cutaneous leishmaniasis who showed a rapidly progressing ulcerative lesion after traveling to multiple countries where different Leishmania species are endemic. Diagnosis of Leishmania tropica, an exotic species in Mexico was established by using serological and molecular tools. KEYWORDS: Leishmania tropica. Molecular epidemiology. Local cutaneous leishmaniasis. Travel medicine. 1Instituto Nacional de Medicina Genómica, Departamento de Genómica Poblacional, Genómica Computacional e Integrativa, Ciudad de México, Mexico INTRODUCTION 2Universidad Nacional Autónoma de México, Facultad de Medicina, Unidad de Human cutaneous leishmaniasis is a zoonotic emerging tropical disease caused Investigación en Medicina Experimental, by 20 species of flagellated protozoa of the genus Leishmania, generating 150,000 Centro de Medicina Tropical, Ciudad de new human cases per year, that are distributed across 98 countries throughout the Old México, Mexico World and the New World1-3. Most of the Old World cases are caused by Leishmania 3Instituto Nacional de Medicina Genómica, aethiopica, Leishmania infantum, Leishmania major and Leishmania
    [Show full text]
  • Characterization of a Leishmania Tropica Antigen That Detects Immune Responses in Desert Storm Viscerotropic Leishmaniasis Patients
    Proc. Natl. Acad. Sci. USA Vol. 92, pp 7981-7985, August 1995 Medical Sciences Characterization of a Leishmania tropica antigen that detects immune responses in Desert Storm viscerotropic leishmaniasis patients (parasite/diagnosis/repetitive epitope/subclass) DAVIN C. DILLON*t, CRAIG H. DAY*, JACQUELINE A. WHITTLE*, ALAN J. MAGILLt, AND STEVEN G. REED*t§ *Infectious Disease Research Institute, Seattle, WA 98104; and tWalter Reed Army Institute of Research, Washington, DC 20307 Communicated by Paul B. Beeson, Redmond, WA, April 5, 1995 ABSTRACT A chronic debilitating parasitic infection, An alternative diagnostic strategy is to identify and apply viscerotropic leishmaniasis (VTL), has been described in immunodominant recombinant antigens to increase assay sen- Operation Desert Storm veterans. Diagnosis of this disease, sitivity and specificity. We report herein the cloning, expres- caused by Leishmania tropica, has been difficult due to low or sion, and evaluation of an immunodominant L. tropica anti- absent specific immune responses in traditional assays. We genT capable ofboth specific antibody detection and elicitation report the cloning and characterization of two genomic frag- of interferon y (IFN-y) production in peripheral blood mono- ments encoding portions of a single 210-kDa L. tropica protein nuclear cells (PBMCs) from VTL patients. These results useful for the diagnosis ofVTL in U.S. military personnel. The demonstrate the danger of relying on crude immunological recombinant proteins encoded by these fragments, recombi- assays for the diagnosis of subtle, albeit serious, VTL in Desert nant (r) Lt-1 and rLt-2, contain a 33-amino acid repeat that Storm patients. reacts with sera from Desert Storm VTL patients and with sera from L.
    [Show full text]
  • Leishmaniasis Gap Analysis Report and Action Plan
    30 December 2015 Leishmaniasis Gap Analysis Report and Action Plan Strengthening the Epidemiologial Surveillance, Diagnosis and Treatment of Visceral and Cutaneous Leishmaniasis in Albania, Jordan and Pakistan Connecting Organisations for Regional Disease Key Contributors: Surveillance (CORDS) Immeuble le Bonnel 20, Rue de la Villette 69328 LYON Dr Syed M. Mursalin EDEX 03, FRANCE Dr Sami Adel Sheikh Ali Tel. +33 (0)4 26 68 50 14 Email: [email protected] Dr James Crilly SIRET No 78948176900014 Dr Silvia Bino Published 30 December 2015 Editor: Ashley M. Bersani MPH, CPH List of Acronyms ACL Anthroponotic Cutaneous Leishmaniasis AIDS Acquired Immunodeficiency Syndrome CanL Canine Leishmaniasis CL Cutaneous Leishmaniasis CORDS Connecting Organisations for Regional Disease Surveillance DALY Disability-Adjusted Life Year DNDi Drugs for Neglected Diseases initiative IMC International Medical Corps IRC International Rescue Committee LHW Lady Health Worker MECIDS Middle East Consortium on Infectious Disease Surveillance ML Mucocutaneous Leishmaniasis MoA Ministry of Agriculture MoE Ministry of Education MoH Ministry of Health MoT Ministry of Tourism MSF Médecins Sans Frontières/Doctors Without Borders ND Neglected Disease NGO Non-governmental Organisation NTD Neglected Tropical Disease PCR Polymerase Chain Reaction PKDL Post Kala-Azar Dermal Leishmaniasis POHA Pak (Pakistan) One Health Alliance PZDD Parasitic and Zoonotic Diseases Department RDT Rapid Diagnostic Test SECID Southeast European Centre for Surveillance and Control of Infectious
    [Show full text]
  • Leishmaniasis in the United States: Emerging Issues in a Region of Low Endemicity
    microorganisms Review Leishmaniasis in the United States: Emerging Issues in a Region of Low Endemicity John M. Curtin 1,2,* and Naomi E. Aronson 2 1 Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA 2 Infectious Diseases Division, Uniformed Services University, Bethesda, MD 20814, USA; [email protected] * Correspondence: [email protected]; Tel.: +1-011-301-295-6400 Abstract: Leishmaniasis, a chronic and persistent intracellular protozoal infection caused by many different species within the genus Leishmania, is an unfamiliar disease to most North American providers. Clinical presentations may include asymptomatic and symptomatic visceral leishmaniasis (so-called Kala-azar), as well as cutaneous or mucosal disease. Although cutaneous leishmaniasis (caused by Leishmania mexicana in the United States) is endemic in some southwest states, other causes for concern include reactivation of imported visceral leishmaniasis remotely in time from the initial infection, and the possible long-term complications of chronic inflammation from asymptomatic infection. Climate change, the identification of competent vectors and reservoirs, a highly mobile populace, significant population groups with proven exposure history, HIV, and widespread use of immunosuppressive medications and organ transplant all create the potential for increased frequency of leishmaniasis in the U.S. Together, these factors could contribute to leishmaniasis emerging as a health threat in the U.S., including the possibility of sustained autochthonous spread of newly introduced visceral disease. We summarize recent data examining the epidemiology and major risk factors for acquisition of cutaneous and visceral leishmaniasis, with a special focus on Citation: Curtin, J.M.; Aronson, N.E.
    [Show full text]
  • Drugs for Amebiais, Giardiasis, Trichomoniasis & Leishmaniasis
    Antiprotozoal drugs Drugs for amebiasis, giardiasis, trichomoniasis & leishmaniasis Edited by: H. Mirkhani, Pharm D, Ph D Dept. Pharmacology Shiraz University of Medical Sciences Contents Amebiasis, giardiasis and trichomoniasis ........................................................................................................... 2 Metronidazole ..................................................................................................................................................... 2 Iodoquinol ........................................................................................................................................................... 2 Paromomycin ...................................................................................................................................................... 3 Mechanism of Action ...................................................................................................................................... 3 Antimicrobial effects; therapeutics uses ......................................................................................................... 3 Leishmaniasis ...................................................................................................................................................... 4 Antimonial agents ............................................................................................................................................... 5 Mechanism of action and drug resistance ......................................................................................................
    [Show full text]
  • Mucosal Leishmaniasis with Primary Oral Involvement: a Case Series and a Review of the Literature
    Oral Diseases (2014) doi:10.1111/odi.12268 © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd All rights reserved www.wiley.com REVIEW ARTICLE Mucosal leishmaniasis with primary oral involvement: a case series and a review of the literature MD Mignogna1, A Celentano1, S Leuci1, M Cascone1, D Adamo1, E Ruoppo1, G Favia2 1Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples; 2Head Oral Surgery Unit, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy OBJECTIVE: To analyze retrospectively a case series of Introduction primary oral leishmaniasis and to review the literature on head–neck primary mucosal leishmaniasis (ML) in Leishmaniasis is a parasitic disease caused by several pro- immunocompetent patients. tozoan species of the genus Leishmania, belonging to the SUBJECTS AND METHODS: A PUBMED search was family Trypanosomatidae. After malaria and African try- ‘ ’ carried out from 1950 to 2013. Clinical records of panosomiasis ( sleeping sickness ), the leishmaniases are patients with primary head–neck mucosal manifesta- the third most important group of vectorborne diseases tions of leishmaniasis were analyzed. In addition, clinical and are ranked ninth in terms of the global burden of dis- records between 2001 and 2012 of patients with pri- ease of all infectious and parasitic diseases (Prabhu et al, mary oral manifestations were collected in two indepen- 1992; Stockdale and Newton, 2013). dent hospitals. The leishmaniases are widely dispersed, with transmis- fi RESULTS: Our multicenter case series revealed seven sion to humans on ve continents, and are endemic in 98 patients with oral leishmaniasis. The most commonly countries.
    [Show full text]
  • Semi-Quantitative, Duplexed Qpcr Assay for the Detection of Leishmania Spp
    Tropical Medicine and Infectious Disease Article Semi-Quantitative, Duplexed qPCR Assay for the Detection of Leishmania spp. Using Bisulphite Conversion Technology Ineka Gow 1,2,*, Douglas Millar 2 , John Ellis 1 , John Melki 2 and Damien Stark 3 1 School of Life Sciences, University of Technology, Sydney, NSW 2007, Australia; [email protected] 2 Genetic Signatures Ltd., Sydney, NSW 2042, Australia; [email protected] (D.M.); [email protected] (J.M.) 3 Microbiology Department, St. Vincent’s Hospital, Sydney, NSW 2010, Australia; [email protected] * Correspondence: [email protected]; +61-466263511 Received: 6 October 2019; Accepted: 28 October 2019; Published: 1 November 2019 Abstract: Leishmaniasis is caused by the flagellated protozoan Leishmania, and is a neglected tropical disease (NTD), as defined by the World Health Organisation (WHO). Bisulphite conversion technology converts all genomic material to a simplified form during the lysis step of the nucleic acid extraction process, and increases the efficiency of multiplex quantitative polymerase chain reaction (qPCR) reactions. Through utilization of qPCR real-time probes, in conjunction with bisulphite conversion, a new duplex assay targeting the 18S rDNA gene region was designed to detect all Leishmania species. The assay was validated against previously extracted DNA, from seven quantitated DNA and cell standards for pan-Leishmania analytical sensitivity data, and 67 cutaneous clinical samples for cutaneous clinical sensitivity data. Specificity was evaluated by testing 76 negative clinical samples and 43 bacterial, viral, protozoan and fungal species. The assay was also trialed in a side-by-side experiment against a conventional PCR (cPCR), based on the Internal transcribed spacer region 1 (ITS1 region).
    [Show full text]
  • Louisiana Morbidity Report
    Louisiana Morbidity Report Office of Public Health - Infectious Disease Epidemiology Section P.O. Box 60630, New Orleans, LA 70160 - Phone: (504) 568-8313 www.dhh.louisiana.gov/LMR Infectious Disease Epidemiology Main Webpage BOBBY JINDAL KATHY KLIEBERT GOVERNOR www.infectiousdisease.dhh.louisiana.gov SECRETARY September - October, 2015 Volume 26, Number 5 Cutaneous Leishmaniasis - An Emerging Imported Infection Louisiana, 2015 Benjamin Munley, MPH; Angie Orellana, MPH; Christine Scott-Waldron, MSPH In the summer of 2015, a total of 3 cases of cutaneous leish- and the species was found to be L. panamensis, one of the 4 main maniasis, all male, were reported to the Department of Health species associated with progression to metastasized mucosal and Hospitals’ (DHH) Louisiana Office of Public Health (OPH). leishmaniasis in some instances. The first 2 cases to be reported were newly acquired, a 17-year- The third case to be reported in the summer of 2015 was from old male and his father, a 49-year-old male. Both had traveled to an Australian resident with an extensive travel history prior to Costa Rica approximately 2 months prior to their initial medical developing the skin lesion, although exact travel history could not consultation, and although they noticed bug bites after the trip, be confirmed. The case presented with a non-healing skin ulcer they did not notice any flies while traveling. It is not known less than 1 cm in diameter on his right leg. The ulcer had been where transmission of the parasite occurred while in Costa Rica, present for 18 months and had not previously been treated.
    [Show full text]
  • ESCMID Online Lecture Library © by Author
    Microscopy and PCR for diagnosis of parasitic infections: a tale of two amazing powerful techniques Tom van Gool MD, PhD, Aldert Bart PhD Section Clinical Parasitology, Department Medical Microbiology, Academic Medical Center, Amsterdam, ESCMID OnlineNetherlands Lecture Library © by author Academic Medical Center (AMC), Amsterdam, Netherlands Patients from routine clinical care large university hospital, Dept. ESCMIDTropical Medicine Online and general practitioners Lecture from surroundings. Library © by author Microscopy: an old, but still extremely useful diagnostic tool in clinical parasitology! Needed: 1: a microscope 2: a well trained technician 3: saline, iodine, or other (cheap) stain…. and… a wealth of information becomes available! ESCMID Online Lecture Library © by author Molecular Diagnosis Acanthamoeba detection and typing Parasitic Infections, Angiostrongylus detection (AMC, NL) Babesia detection and typing Blastocystis detection and typing Cryptosporidium detection Dientamoeba fragilis detection Entamoeba detection and typing Echinococcus detection and typing ….a large variety of Giardia detection and typing protozoa and helminths.... Leishmania detection and typing Malaria detection and typing Microsporidium detection and typing Opisthorchis detection and typing Schistosoma spp detection and typing Toxocara detection TrypanosomaESCMID cruzi detection Online and typing Lecture Library Intestinal helminths i.e. strongyloides © by author Current priorities in diagnostic approaches - Malaria - Leishmania - Intestinal parasites
    [Show full text]
  • Manual for the Diagnosis and Treatment of Leishmaniasis
    Republic of the Sudan Federal Ministry of Health Communicable and Non-Communicable Diseases Control Directorate MANUAL FOR THE DIAGNOSIS AND TREATMENT OF LEISHMANIASIS November 2017 Acknowledgements The Communicable and Non-Communicable Diseases Control Directorate (CNCDCD), Federal Ministry of Health, Sudan, would like to acknowledge all the efforts spent on studying, controlling and reducing morbidity and mortality of leishmaniasis in Sudan, which culminated in the formulation of this manual in April 2004, updated in October 2014 and again in November 2017. We would like to express our thanks to all National institutions, organizations, research groups and individuals for their support, and the international organization with special thanks to WHO, MSF and UK- DFID (KalaCORE). I Preface Leishmaniasis is a major health problem in Sudan. Visceral, cutaneous and mucosal forms of leishmaniasis are endemic in various parts of the country, with serious outbreaks occurring periodically. Sudanese scientists have published many papers on the epidemiology, clinical manifestations, diagnosis and management of these complex diseases. This has resulted in a better understanding of the pathogenesis of the various forms of leishmaniasis and has led to more accurate and specific diagnostic methods and better therapy. Unfortunately, many practitioners are unaware of these developments and still rely on outdated diagnostic procedures and therapy. This document is intended to help those engaged in the diagnosis, treatment and nutrition of patients with various forms of leishmaniasis. The guidelines are based on publications and experience of Sudanese researchers and are therefore evidence based. The guidelines were agreed upon by top researchers and clinicians in workshops organized by the Leishmaniasis Control response at the Communicable and Non-Communicable Diseases Control Directorate, Federal Ministry of Health, Sudan.
    [Show full text]