DNA was isolated from 92 Giemsa-stained smears of lesions from suspected cases of cutaneous leishmaniasis and used for PCR-based diagnosis of Leishmania infection. Each smear had been examined under a light microscope at x 1,000 and scored for amastigote numbers. Although the smears had been stored for up to 4 years, all the microscopy-positive slides were also positive by PCR and four of the 14 smears that were negative by microscopy (although of lesions that were clinically consistent with leishmaniasis) were also PCR-positive. PCR-based investigations therefore appear to offer an effective method to confirm suspected cases of cutaneous leishmaniasis using (even archived) samples that have been collected, from humans (and reservoir hosts) in the field, by simple methods.
Myiasis is a condition resulting from the invasion of tissues or organs of man or animals by the larvae of dipterous flies. The distribution of myiasis is worldwide, with more cases being reported from tropical, subtropical, and warm temperate areas. The various forms of myiasis may be classified from an entomological or a clinical point of view. This report describes a rare case of vulvar myiasis due to Wohlfahrtia magnifica in an otherwise healthy 20-year-old Iranian female. To our knowledge, this is the first report of cutaneous myiasis of the vulva due to W. magnifica from Iran and the Middle East region.
Skin biopsies from 117 cases of acute and 23 cases of lupoid leishmaniasis were studied. Of the 117 acute cases, anergic macrophage response were seen in 44, diffuse necrosis in 9 and focalized necrosis in 11 biopsies; the remaining 53 biopsies showed scanty or no parasites with a few to abundant epithelioid cells probably representing post necrotic changes before complete healing of the lesions. The 23 biopsies of lupoid leishmaniasis showed rather well organized epithelioid granulomata surrounded by lymphocytes, inconspicuous plasma cells, no amastigotes and no necrosis. Lupoid cases showed strong delayed hypersensitivity with leishmanin and low serum antibody titres. It appears that the lesions of urban cutaneous leishmaniasis spend a long time in the anergic phase. Partial destruction of parasites by activated macrophages together with gradual elevation of antibody levels prepares the appropriate antigen-antibody ratio for optimum development of necrosis at PI3 leading to effective elimination of parasites. Plasma cells appear to be important in the induction of necrosis and inhibition of epithelioid granulomata. A significant inverse relationship has been found between plasma cells and epitheloid cells. The delayed hypersensitivity observed in lupoid leishmaniasis is probably the result of a poor humoral response evidenced by inconspicuous plasma cells and low serum antibody titres.
Urine samples from 21 patients with visceral leishmaniasis were examined for the presence of Leishmania donovani soluble antigen and antibody by double counter-current immunoelectrophoresis. 19 samples revealed both antigen and antibody (IgM in 5 and IgG in all samples). 2 urine samples collected 10 and 13 days after Glucantime treatment revealed only antibody (IgG), not soluble antigen.
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