Cutaneous Leishmaniasis Due to Leishmania infantum

Abstract

Background: Leishmania infantum recently has been identified as a possible agent of cutaneous leishmaniasis (CL). This species has been isolated from cutaneous lesions of patients from the Mediterranean Basin. However, little is known about the clinical, biological, or therapeutic features of this newly recognized CL.Observations: Six patients aged 9 months to 85 years in southeastern France were found to have autochthonous leishmaniasis. Parasitological identification showed that the agent was L infantum, zymodemes Montpellier-1 for 2 patients and Montpellier-24 for 1 patient. Five patients who underwent testing with a Western blot assay were found to have antibodies against 4 antigens with molecular masses of 18, 21, 23, and 31 kd. Five patients were successfully treated with local injections of N-methylglucamine, and 1 patient was successfully treated with topical paromomycin sulfate. No patient had visceral disease at diagnosis or after follow-up.Conclusions: Recent data provide increasing evidence that L infantum is an important agent of CL. In southwestern Europe, this species is the only agent that has long been identified from autochthonous CL. Leishmania infantum should be considered an agent of CL in areas in which visceral leishmaniasis is endemic. Western blot assay could be a useful test for the diagnosis, but precise parasitological identification is important to having a better knowledge of the disease. The relationships between CL and the visceral disease have to be explored.

Recurrence of visceral and muco-cutaneous leishmaniasis in a patient under immunosuppressive therapy

“…L. infantum is well recognized as the etiological agent of VL in southern Europe and is much less commonly reported as a cause of CL [2]. Mucosal forms of L. infantum infection are very rare [3–5].…”

Localized Cutaneous Leishmaniasis due to <i>Leishmania infantum</i> in a Patient Treated with Infliximab

“…Endemic areas in France are the regions of Languedoc-Roussillon and Provence-Alpes-Côtes d’Azur [1,2,3]. L. infantum (most frequently zymodeme MON-1 ) is a species responsible for VL, mainly in children or immunocompromised hosts.…”

“…Occasionally, L. infantum (also zymodeme MON-1) can cause localized CL in immunocompetent hosts. In France, autochthonous CL has a very low incidence (estimated as 0.5 per million a year) and VL remains rare [1,2,3]. However, studies based on leishmanin skin testing or serological tests have shown a high seroprevalence for leishmaniasis (from 10 to 60% of healthy carriers depending on age and county) [1,2,3,4].…”

“…In France, autochthonous CL has a very low incidence (estimated as 0.5 per million a year) and VL remains rare [1,2,3]. However, studies based on leishmanin skin testing or serological tests have shown a high seroprevalence for leishmaniasis (from 10 to 60% of healthy carriers depending on age and county) [1,2,3,4]. These data suggest that acquiring immunity is a usual and asymptomatic phenomenon, and that only a few hosts, according to their immune status, develop symptomatic disease.…”

Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin B

“…1 Journal of Infection (2005) Based on the relative tropism of Leishmania and the immune status of the host, Leishmaniases are classified into cutaneous, mucocutaneous and visceral. The cutaneous forms are generally divided into Old World CL, related to Leishmania of the major and donovani complexes, and New World CL, caused by the L. mexicana and L. braziliensis complexes.…”