Atypical Manifestations of Cutaneous Leishmaniasis in a Region Endemic for Leishmania braziliensis: Clinical, Immunological and Parasitological Aspects

Guimarães, Luiz Henrique; Queiroz, Adriano; Silva, Juliana Almeida; Silva, Silvana C.; Magalhães, Viviane; Lago, Ednaldo; Machado, Paulo Roberto Lima; Bacellar, Olı́via; Wilson, Mary E.; Beverley, Stephen M.; Carvalho, Edgar M.; Schriefer, Albert

doi:10.1371/journal.pntd.0005100

Cited by 57 publications

(80 citation statements)

References 44 publications

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“…Specifically, it has been shown that there are six haplotypes presented in four loci of the chromosome 28 of L. (V.) braziliensis that are associated with DL . It has been also documented that some haplotypes in the chromosome 28 are also associated with failure to antimony therapy, indicating the importance of differences intraspecies not only in the presentation of the disease, but also in failure to therapy . However, there is a lack of data about the biological behaviour of isolates from DL on phagocytic cells.…”

Section: Introductionmentioning

confidence: 99%

“…10 It has been also documented that some haplotypes in the chromosome 28 are also associated with failure to antimony therapy, indicating the importance of differences intraspecies not only in the presentation of the disease, but also in failure to therapy. 12,13 However, there is a lack of data about the biological behaviour of isolates from DL on phagocytic cells. Neutrophils migrate quickly to the sites of infection and are the main phagocytic cells in the initial phase of L. (V.) braziliensis infection.…”

Section: Introductionmentioning

confidence: 99%

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Leishmania braziliensis isolated from disseminated leishmaniasis patients downmodulate neutrophil function

Cardoso

Bezerra

Medina

et al. 2019

Parasite Immunology

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Summary Aims The polymorphism observed in Leishmania braziliensis is associated with different clinical forms of leishmaniasis. Neutrophils ( PMN s) participate in the pathogenesis of leishmania infection, and here, we evaluate neutrophil function after infection with isolates of L. braziliensis from cutaneous leishmaniasis ( CL ) or disseminated leishmaniasis ( DL ) patients. Methods and results Neutrophils from 30 healthy subjects ( HS ) were infected with isolates of L . ( V .) braziliensis obtained from three CL and three DL patients. They were infected at the ratio of 3:1 parasites per neutrophil, and leishmania uptake was evaluated by microscopy. The neutrophil activation markers and oxidative burst by expression of dihidrorhodamine ( DHR ) were evaluated by flow cytometry and cytokine production by ELISA . The frequency of infected cells and the number of amastigotes were higher in neutrophils infected with CL isolates compared to DL isolates ( P < 0.05). The DHR and CD 66b expression after infection with DL isolate was lower than with CL isolates. There was no difference regarding chemokine production. Conclusion The L. (V.) braziliensis isolates of DL induced lower respiratory burst and neutrophils activation markers compared with CL isolates which may contribute to parasite survival and dissemination in DL patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Leishmania braziliensis isolated from disseminated leishmaniasis patients downmodulate neutrophil function

Cardoso

Bezerra

Medina

et al. 2019

Parasite Immunology

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“…The Brazilian Ministry of Health defines therapeutic failure as an unsatisfactory response to two regular and sequential courses of treatment 2 . Although the therapeutic response to MA may present regional differences 6,7,8 resistance to antimonials is not a national public health problem, and 50 to 100% of the patients with an unfavorable response to the initial treatment respond satisfactorily to a second course of treatment with the same therapeutic scheme 2,9 . If a therapeutic failure ensues, the use of a secondchoice drug such as amphotericin B (desoxycholate or liposomal forms) or pentamidine isethionate 2 is suggested.…”

Section: Introductionmentioning

confidence: 99%

Favorable responses to treatment with 5 mg Sbv/kg/day meglumine antimoniate in patients with American tegumentary leishmaniasis acquired in different Brazilian regions

Cataldo

Conceição-Silva

Antônio

et al. 2018

Rev. Soc. Bras. Med. Trop.

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Introduction: Favorable responses in American tegumentary leishmaniasis (ATL) patients to treatment with 5 mg Sb v /kg/day meglumine antimoniate (MA) has been reported in Rio de Janeiro, but little is known regarding the therapeutic response to low doses in patients from other locations. Methods: A retrospective review of medical records was conducted to compare the therapeutic response to 5 mg Sb v /kg/day MA treatment among 36 patients who acquired ATL in Brazilian states other than Rio de Janeiro (OS group) and 72 patients from Rio de Janeiro (RJ group). Results: One course of 5 mg Sb v /kg/day MA cured 72.8% of 81 cutaneous (CL) and 66.6% of 27 mucosal (ML) leishmaniasis-infected patients: 70% in the CL/RJ group, 81% in the CL/OS group, 50% in the ML/RJ group, and 80% in the ML/OS group. After up to two additional treatment courses at the same dose, 88.9% and 85.2% of the CL and ML patients were cured, respectively. Adverse events were observed in 40% of patients in the CL/RJ group, 57% of the CL/OS group, 58% of the ML/RJ group, and 80% of the ML/OS group. No significant differences were observed in the cure rates or adverse effects between the RJ and OS groups. No patients required permanent discontinuation of treatment due to adverse events. Conclusions: Patients with ATL acquired in both RJ and OS may respond to low-dose MA. While high-dose MA should remain the standard treatment for ATL, low-dose MA might be preferred when toxicity is a primary concern.

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“…The main factors responsible for the delays or difficulties in arriving at the diagnosis of CL were usually clinical presentations mimicking other diseases [17,18]. A high index of suspicion and including CL in the differential diagnosis of granulomatous cutaneous conditions are very important for early diagnosis obecność licznych amastygotów gatunku Leishmania zarówno w monocytach, jak i w macierzy zewnątrzkomórkowej (ryc.…”

Section: Discussionmentioning

confidence: 99%

“…Wśród głównych czynników odpowiedzialnych za opóźnienia lub trudności z ustaleniem rozpoznania CL wymieniano zwykle obraz kliniczny imitujący inne choroby [17,18]. Istotne znaczenie dla odpowiednio wczesnego rozpoznania i szybkiego podjęcia leczenia tej oszpecającej choroby ma duża czujność diagnostyczna oraz uwzględnianie CL w diagnostyce różnicowej ziarniniakowych chorób skóry.…”

Section: Discussionunclassified

Lupoid mucocutaneous leishmaniasis

Yosef¹,

Reszke²,

Szepietowski³

2018

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Introduction.Leishmaniasis is a parasitic infection caused by different species of the intracellular protozoan Leishmania and transmitted through the bite of an infected female sand fly. It occurs in various clinical forms, including cutaneous manifestations. Objective. To present a case of lupoid mucocutaneous leishmaniasis in a patient from Ethiopia. Case report. A 17-year-old man with no significant medical history presented with papular, plaque and ulcerative lesions in the central region of face that had been present for one year. A smear followed by Giemsa stain revealed the presence of amastigotes in monocytes and extracellular matrix. Based on the clinical manifestation and microscopic examination, the diagnosis of mucocutaneous leishmaniasis was established. The treatment was based on N-methylglucamine antimoniate, with subsequent resolution of skin lesions. Conclusions. Mucocutaneous leishmaniasis, including the lupoid subtype, is an important clinical entity in endemic areas. Treatment with antimony derivatives may be beneficial in affected subjects. streszczenie Wprowadzenie. Leiszmanioza jest chorobą pasożytniczą wywołaną przez różne gatunki wewnątrzkomórkowych pierwotniaków z rodzaju Leishmania, przenoszoną przez ukąszenie zakażonej samicy muchówki. Choroba może mieć różne obrazy kliniczne, w tym objawy skórne. Cel pracy. Opis przypadku postaci toczniowej leiszmaniozy skórno--śluzówkowej u pacjenta z Etiopii. Opis przypadku. Mężczyzna 17-letni bez istotnej przeszłości chorobowej zgłosił się ze zmianami grudkowymi, blaszkowymi oraz owrzodzeniami zlokalizowanymi w centralnej części twarzy, które pojawiły się około roku wcześniej. Wykonano wymaz metodą odciskową z następczym barwieniem metodą Giemsy, co uwidoczniło obecność amastygotów w monocytach i macierzy zewnątrzkomórkowej. Na podstawie obrazu klinicznego oraz badania mikroskopowego ustalono rozpoznanie postaci toczniowej leiszmaniozy śluzówkowo-skórnej. W leczeniu zastosowano antymonian N-metyloglukaminy i uzyskano ustąpienie zmian skórnych.

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Atypical Manifestations of Cutaneous Leishmaniasis in a Region Endemic for Leishmania braziliensis: Clinical, Immunological and Parasitological Aspects

Cited by 57 publications

References 44 publications

Leishmania braziliensis isolated from disseminated leishmaniasis patients downmodulate neutrophil function

Leishmania braziliensis isolated from disseminated leishmaniasis patients downmodulate neutrophil function

Favorable responses to treatment with 5 mg Sbv/kg/day meglumine antimoniate in patients with American tegumentary leishmaniasis acquired in different Brazilian regions

Lupoid mucocutaneous leishmaniasis

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