Case Report: Atypical Cutaneous Leishmaniasis in a Patient with Mixed Leishmania guyanensis and Leishmania amazonensis Infection

Gosch, Carina Scolari; Resende, Bruna Silva; Amorim, Célia Bastos; Marques, Cálita Pollyanna; Pereira, Ledice Inácia de Araújo; Pinto, Sebastião Alves; Uliana, Sílvia Reni Bortolin; Coelho, Adriano C.; Ribeiro‐Dias, Fátima; Dorta, Miriam Leandro

doi:10.4269/ajtmh.17-0760

Cited by 8 publications

(6 citation statements)

References 22 publications

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“…Previous studies have suggested that preceding Leishmania infections may confer protection against reinfection with other homologous or heterologous species ( 31 , 32 ). Multiple studies from Mexico, Perú, Ecuador, Bolivia, Brazil, and more recently Colombia have demonstrated the presence of mixed infection with different Leishmania species in CL patients ( 5 , 6 , 9 , 10 , 12 ). Such findings also raise questions regarding possible synergistic or antagonizing effects between species in the context of coinfections.…”

Section: Discussionmentioning

confidence: 99%

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Development of an Amplicon-Based Next-Generation Sequencing Protocol to Identify Leishmania Species and Other Trypanosomatids in Leishmaniasis Endemic Areas

et al. 2021

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Traditionally, there has been a frequent, yet incorrect assumption that phlebotomine vectors, animal reservoirs, and human hosts are susceptible to Leishmania infection by a single parasite species. However, current evidence supports that these new vector-parasite-reservoir associations lend vectors and reservoirs greater permissiveness to certain Leishmania species, thus promoting the appearance of coinfection events, particularly in disease-endemic regions.

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Section: Discussionmentioning

confidence: 99%

“…More interestingly, the presence of Leishmania guyanensis and Leishmania panamensis hybrid strains causing both CL and MCL has been described in Ecuador ( 10 ). Furthermore, studies from Brazil have revealed the presence of double and triple infections caused by several Leishmania species, both in mammals and humans ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

Development of an Amplicon-Based Next-Generation Sequencing Protocol to Identify Leishmania Species and Other Trypanosomatids in Leishmaniasis Endemic Areas

et al. 2021

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“…A previous screening of PM susceptibility in vitro against a panel of clinical isolates from Instituto de Infectologia Emílio Ribas, a reference center for treatment of leishmaniasis in the city Sao Paulo, allowed us identify a clinical isolate, ER256, highly susceptible to PM. This isolate was typed as L. amazonensis by sequencing the internal transcribed ribosomal DNA (ITS), as previously described ( Gosch et al, 2018 ). Sequence analysis of full sequence of ITS indicated 99% identity with the reference strain L. amazonensis (MHOM/BR/73/M2269) (GenBank accession number AJ000316.1 ), a strain isolated from a patient of the Amazon region ( Miles et al, 1980 ).…”

Section: Resultsmentioning

confidence: 99%

Activity of paromomycin against Leishmania amazonensis: Direct correlation between susceptibility in vitro and the treatment outcome in vivo

Coser

Ferreira

Branco

et al. 2020

International Journal for Parasitology: Drugs and Drug Resistan

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Paromomycin is an aminoglycoside antibiotic approved in 2006 for the treatment of visceral leishmaniasis caused by Leishmania donovani in Southeast Asia. Although this drug is not approved for the treatment of visceral and cutaneous leishmaniasis in Brazil, it is urgent and necessary to evaluate the potential of this drug as alternative for the treatment against species responsible for these clinical forms of the disease. In Brazil, Leishmania amazonensis is responsible for cutaneous and diffuse cutaneous leishmaniasis. The diffuse cutaneous form of the disease is difficult to treat and frequent relapses are reported, mainly when the treatment is interrupted. Here, we evaluated paromomycin susceptibility in vitro of a L. amazonensis clinical isolate from a patient with cutaneous leishmaniasis and the reference strain L. amazonensis M2269, as well as its in vivo efficacy in a murine experimental model . Although never exposed to paromomycin, a significant differential susceptibility between these two lines was found. Paromomycin was highly active in vitro against the clinical isolate in both forms of the parasite, while its activity against the reference strain was less active. In vivo studies in mice infected with each one of these lines demonstrated that paromomycin reduces lesion size and parasite burden and a direct correlation between the susceptibility in vitro and the effectiveness of this drug in vivo was found. Our findings indicate that paromomycin efficacy in vivo is dependent on intrinsic susceptibility of the parasite. Beyond that, this study contributes for the evaluation of the potential use of paromomycin in chemotherapy of cutaneous leishmaniasis in Brazil caused by L. amazonensis .

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“…The detection of coinfection events underscores the importance of accurately identifying the responsible Leishmania species in infections. Such events can significantly impact the natural course of the leishmaniasis, as previously documented [ 80 ], and add complexity to both the diagnosis of and therapeutic approach to the disease.…”

Section: Discussionmentioning

confidence: 99%

Validation of Oxford nanopore sequencing for improved New World Leishmania species identification via analysis of 70-kDA heat shock protein

Patiño,

Ballesteros,

Muñoz

et al. 2023

Parasites Vectors

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Background Leishmaniasis is a parasitic disease caused by obligate intracellular protozoa of the genus Leishmania. This infection is characterized by a wide range of clinical manifestations, with symptoms greatly dependent on the causal parasitic species. Here we present the design and application of a new 70-kDa heat shock protein gene (hsp70)-based marker of 771 bp (HSP70-Long). We evaluated its sensitivity, specificity and diagnostic performance employing an amplicon-based MinION™ DNA sequencing assay to identify different Leishmania species in clinical samples from humans and reservoirs with cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL). We also conducted a comparative analysis between our novel marker and a previously published HSP70 marker known as HSP70-Short, which spans 330 bp. Methods A dataset of 27 samples from Colombia, Venezuela and the USA was assembled, of which 26 samples were collected from humans, dogs and cats affected by CL and one sample was collected from a dog with VL in the USA (but originally from Greece). DNA was extracted from each sample and underwent conventional PCR amplification utilizing two distinct HSP70 markers: HSP70-Short and HSP70-Long. The subsequent products were then sequenced using the MinION™ sequencing platform. Results The results highlight the distinct characteristics of the newly devised HSP70-Long primer, showcasing the notable specificity of this primer, although its sensitivity is lower than that of the HSP70-Short marker. Notably, both markers demonstrated strong discriminatory capabilities, not only in distinguishing between different species within the Leishmania genus but also in identifying instances of coinfection. Conclusions This study underscores the outstanding specificity and effectiveness of HSP70-based MinION™ sequencing, in successfully discriminating between diverse Leishmania species and identifying coinfection events within samples sourced from leishmaniasis cases. Graphical abstract

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Case Report: Atypical Cutaneous Leishmaniasis in a Patient with Mixed Leishmania guyanensis and Leishmania amazonensis Infection

Cited by 8 publications

References 22 publications

Development of an Amplicon-Based Next-Generation Sequencing Protocol to Identify Leishmania Species and Other Trypanosomatids in Leishmaniasis Endemic Areas

Development of an Amplicon-Based Next-Generation Sequencing Protocol to Identify Leishmania Species and Other Trypanosomatids in Leishmaniasis Endemic Areas

Activity of paromomycin against Leishmania amazonensis: Direct correlation between susceptibility in vitro and the treatment outcome in vivo

Validation of Oxford nanopore sequencing for improved New World Leishmania species identification via analysis of 70-kDA heat shock protein

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