Atypical presentation of Old‐World cutaneous leishmaniasis, diagnosis and species identification by PCR

Karamian, Mehdi; Motazedian, MH; Fakhar, Mahdi; Pakshir, Keyvan; Jowkar, Farideh; Rezanezhad, Hassan

doi:10.1111/j.1468-3083.2008.02674.x

Cited by 39 publications

(44 citation statements)

References 21 publications

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“…Tanıda gecikmeler, yanlış medikal tedavi veya gereksiz cerrahi müdaheleler sonucu istenmeyen skar oluşumuna yol açabilmektedir (8,9).…”

Section: Discussionunclassified

A cutaneous leishmania case left a deep scar on the face and delayed at diagnosis

Alan¹,

Başsorgun²

2015

Turk J Bioch

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Kutanöz leishmaniasis (KL), enfekte tatarcıkların deriden kan emerken bulaştırdıkları leishmania türlerinin memeli konaklarda oluşturdukları bir hastalık grubudur. Kutanöz morfolojideki çeşitlilikten dolayı KL sık görülen pek çok dermatozu taklit edebilmekte ve endemik olmayan bölgelerde tanı ve tedavide yanılgılara yol açabilmektedir. Gereksiz cerrahi müdaheleler hastalığın alevlenmesine neden olmaktadır. KL lezyonları sıklıkla kendiliğinden gerileme eğiliminde olsa da tedavisiz bırakılan olgular bulaş açısından kaynak ve risk oluşturduğundan ve kozmetik öneme sahip bölgelerde kötü görünümde deriden çökük skar oluşumuna yol açabileceğinden dolayı erken tanı ve tedavi büyük önem taşımaktadır. Bunun yanı sıra skar zemininde nadir de olsa bazal hücreli karsinom (BHK) ve skuamoz hücreli karsinom (SHK) gelişme riskinin olması da erken tanı ve tedavinin önemini arttırmaktadır.Cutaneous leishmaniasis (CL) is a disease group created by leishmania species which are transmitted by infected sandflies while sucking blood from the skin in mammal hosts. Due to the variety in cutaneous morphology, CL can imitate several frequent dermatosis, and cause a fallacy in diagnosis and treatment in non-endemic regions. Unnecessary surgical interventions cause the disease to inflame. Cutaneous leishmania lesions deprived of the treatment pose a risk and source for infection. Moreover, untreated CL lesions can cause cutaneously pitted scar formation. Due to these reasons, early diagnosis and treatment have a great importance. Moreover, the risk of BCC and SCC development even rarely on scare basis increases the importance of early diagnosis and treatment.Anahtar Kelimeler: Demir eksikliği anemisi, tiroid.

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“…Tanıda gecikmeler, yanlış medikal tedavi veya gereksiz cerrahi müdaheleler sonucu istenmeyen skar oluşumuna yol açabilmektedir (8,9).…”

Section: Discussionunclassified

A cutaneous leishmania case left a deep scar on the face and delayed at diagnosis

Alan¹,

Başsorgun²

2015

Turk J Bioch

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“…[10][11][12][13][14][49][50][51] Different assays may use different targets for amplification (such as the ribosomal RNA gene, mini-exon gene, internal transcribed spacer regions, or kinetoplast DNA). [10][11][12][13][14][49][50][51] Although these targets offer accurate taxonomic data for amplification, they vary in their specificities and species-discriminating capabilities. Clinicians using PCR-based assays must be familiar with their strengths and limitations.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, molecular speciation by polymerase chain reaction (PCR) has been increasingly cited as a rapid and reliable method, with greater sensitivity than microscopic methods. 10,11 PCR can be performed directly on the clinical specimen, with results processed in a few hours, thus providing timely information to the clinician. [10][11][12][13] In this single-center prospective case series, we used a species-specific treatment approach based on molecular identification of the infecting species by PCR in 10 patients with CL.…”

Section: Introductionmentioning

confidence: 99%

A Species-Specific Approach to the Use of Non-Antimony Treatments for Cutaneous Leishmaniasis

Ramanathan

Talaat

Fedorko

et al. 2011

The American Society of Tropical Medicine and Hygiene

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We used a species-specific approach to treat 10 patients with cutaneous leishmaniasis diagnosed using polymerase chain reaction. Non-antimony treatments (oral miltefosine, ketoconazole, and liposomal amphotericin B) were chosen as an alternative to pentavalent antimony drugs based on likely or proven drug efficacy against the infecting species. Leishmania Viannia panamensis was diagnosed in three patients and treated successfully with oral ketoconazole. Miltefosine treatment cured two patients with L. infantum chagasi. A wide variety of Leishmania responded to liposomal amphotericin B administered for 5–7 days. Three patients with L. V. braziliensis, one patient with L. tropica, and two patients with L. infantum chagasi were treated successfully. One person with L. V. braziliensis healed slowly because of a resistant bacterial superinfection, and a second patient with L. infantum chagasi relapsed and was retreated with miltefosine. These drugs were reasonably well-tolerated. In this limited case series, alternative non-antimony–based regimens were convenient, safe, and effective.

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“…Two Leishmania species produced the amplified fragments of about 750 bp for L. tropica f and 560 bp for L. major (10). Amplification reactions visualized in 1.5 % Agarose Gel Electrophoresis, using a 100 bp DNA ladder (11) ( Figure 2 ).…”

Section: Nested-pcrmentioning

confidence: 99%

Identification of Cutaneous Leishmaniasis Agents in Four Geographical Regions of Khuzestan Province Using Nested PCR

Maraghi¹,

Mardanshah²,

Rafiei³

et al. 2013

Jundishapur J Microbiol

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Background: Leishmania tropica and Leishmania major are the main causes of cutaneous leishmaniasis in endemic regions of Iran. Objectives: The aim of this study was the identification of cutaneous leishmaniasis agents in Khuzestan province located southwest of Iran. Patients and Methods: 146 samples were collected from the lesions of 146 individuals including 67 (59.59% ) male and 59 ( 40.41% ) female with cutaneous leishmaniasis. The samples were then delivered to Iran-Zamin diagnostic laboratory and smeared on slides, stained with Wright's eosin methylene blue stain and examined microscopically and graded from 1+ to 4+. DNA was extracted from the slides and the identification of cutaneous leishmaniasis agents was performed using Nested PCR with the primers of CSB1XR, CSB2XF, LIR and 13Z. Results: 138 (94.5%) out of 146 cases of four regions were L. major and 8 (5.5%) were L. tropica. 57.97% of L. major cases were male and 42.03% were female. 87.5% of L. tropica were male and 12.5% were female. The maximum number of L. tropica cases was found in the northern region (8.16%) and the minimum was found in the western region (3.22%). 96.78% of L. major cases belonged to the western region of Khuzestan. Conclusions: L. major is the main species responsible for cutaneous leishmsniasis in four geographical regions of Khuzestan province southwestern of Iran and Nested PCR can be used for diagnosis and Leishmania species identification.

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Atypical presentation of Old‐World cutaneous leishmaniasis, diagnosis and species identification by PCR

Abstract: The results showed that KDNA PCR methods have a higher sensitivity compared with microscopic method. Moreover, PCR could identify the parasite species for specific therapy. Microscopic method had low sensitivity and less value in chronic and atypical CL cases.

Cited by 39 publications

References 21 publications

A cutaneous leishmania case left a deep scar on the face and delayed at diagnosis

A cutaneous leishmania case left a deep scar on the face and delayed at diagnosis

A Species-Specific Approach to the Use of Non-Antimony Treatments for Cutaneous Leishmaniasis

Identification of Cutaneous Leishmaniasis Agents in Four Geographical Regions of Khuzestan Province Using Nested PCR

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