Cutaneous parasitism in patients with American visceral leishmaniasis in an endemic area

Moura, Carla Riama Lopes de Pádua; Costa, Carlos Henrique Nery; Moura, Rafael de Deus; Braga, Aline Reis Ferro; Silva, Vladimir Costa; Costa, Dorcas Lamounier

doi:10.1590/0037-8682-0446-2019

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…Patched presence of parasites in the skin of experimentally infected mice determines that the skin is not a homogenous system, opening PLOS NEGLECTED TROPICAL DISEASES a new dimension of the problem [21]. In addition, the proportion of VL patients harboring parasites in healthy skin is relatively low as recently published [23]. In this paper none of the 22 patients with VL (7 of them being HIV-coinfected) showed parasites through histopathology or immunochemistry, excluding one among the 7 coinfected.…”

Section: Discussionmentioning

confidence: 62%

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Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context

Molina¹,

Jiménez²,

García‐Martínez³

et al. 2020

PLoS Negl Trop Dis

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Background In the Mediterranean basin, Leishmania infantum is the causative agent of visceral leishmaniasis (VL), a zoonosis in which the dog is the primary domestic reservoir, although wildlife may have a leading role in the sylvatic cycle of the disease in some areas. Infections without disease are very frequent. There is limited information regarding the role that VL patients and asymptomatic infected individuals could be playing in the transmission of L. infantum. Xenodiagnosis of leishmaniasis has been used in this descriptive study to explore the role of symptomatic and asymptomatic infected individuals as reservoirs in a recent focus of leishmaniasis in southwestern Madrid, Spain. Methodology and main findings Asymptomatic blood donors (n = 24), immunocompetent patients who were untreated (n = 12) or treated (n = 11) for visceral leishmaniasis (VL), and immunocompromised patients with VL (n = 3) were enrolled in the study. Their infectivity to Phlebotomus perniciosus was studied by indirect xenodiagnosis on peripheral blood samples. Quantitative polymerase chain reaction of blood samples from immunocompetent patients untreated for VL and immunocompromised untreated, treated and under secondary prophylaxis for VL was performed. Antibodies against Leishmania were studied by indirect fluorescent antibody and rK39-immunochromatographic tests. A lymphoproliferative assay with a soluble Leishmania antigen was used to screen for leishmaniasis infection in the healthy population. Sixty-two xenodiagnostic tests were carried out and 5,080 sand flies were dissected. Positive xenodiagnosis was recorded in four patients, with different sand fly infection rates: 1 immunosuppressed HIV / L. infantum coinfected asymptomatic patient, 1 immunosuppressed patient PLOS NEGLECTED TROPICAL DISEASES

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Section: Discussionmentioning

confidence: 62%

“…A total of 899 female sand flies were dissected. The rK39-ICT performed the same day that the IXDs were carried out was positive in 9 out of 11 (81.8%) patients (13,(15)(16)(17)(18)(19)(20)(21)23).…”

Section: Patients Treated For Vlmentioning

confidence: 91%

Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context

Molina¹,

Jiménez²,

García‐Martínez³

et al. 2020

PLoS Negl Trop Dis

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“…longipalpis [40]. A study of VL patients coinfected with L. infantum/HIV found significant cutaneous parasitism in non-lesional skin of one patient, but none of the other patients had detectable skin parasites by immunohistochemistry [41]. Immunosuppressed individuals may develop significantly high parasite levels in peripheral blood, allowing this tissue to serve as an important viable parasite source for vector transmission.…”

Section: Discussionmentioning

confidence: 99%

Leishmania infantum xenodiagnosis from vertically infected dogs reveals significant skin tropism

et al. 2021

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Background Dogs are the primary reservoir for human visceral leishmaniasis due to Leishmania infantum. Phlebotomine sand flies maintain zoonotic transmission of parasites between dogs and humans. A subset of dogs is infected transplacentally during gestation, but at what stage of the clinical spectrum vertically infected dogs contribute to the infected sand fly pool is unknown. Methodology/Principal findings We examined infectiousness of dogs vertically infected with L. infantum from multiple clinical states to the vector Lutzomyia longipalpis using xenodiagnosis and found that vertically infected dogs were infectious to sand flies at differing rates. Dogs with mild to moderate disease showed significantly higher transmission to the vector than dogs with subclinical or severe disease. We documented a substantial parasite burden in the skin of vertically infected dogs by RT-qPCR, despite these dogs not having received intradermal parasites via sand flies. There was a highly significant correlation between skin parasite burden at the feeding site and sand fly parasite uptake. This suggests dogs with high skin parasite burden contribute the most to the infected sand fly pool. Although skin parasite load and parasitemia correlated with one another, the average parasite number detected in skin was significantly higher compared to blood in matched subjects. Thus, dermal resident parasites were infectious to sand flies from dogs without detectable parasitemia. Conclusions/Significance Together, our data implicate skin parasite burden and earlier clinical status as stronger indicators of outward transmission potential than blood parasite burden. Our studies of a population of dogs without vector transmission highlights the need to consider canine vertical transmission in surveillance and prevention strategies.

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“…They are usually surrounded by a hypochromic halo and are commonly disseminated over the face, trunk and limbs (upper and lower), evolving over months or even years and associated, until then, to the infection by L. (L.) chagasi (Figure 1) [12,13,15]. This clinical picture clearly differs from that of AVL, although in some occasions AVL patients may simultaneously present with skin lesions (sometimes even with an ulcerative character) that seem to represent a dermal manifestation of the systemic infection by L. (L.) chagasi [16,17]. Another condition worth mentioning here refers to what was considered the first case of "active cutaneous leishmaniasis" caused by Leishmania donovani chagasi in the New World [18].…”

Section: Introductionmentioning

confidence: 99%

An integrative taxonomic analysis of Honduran Central America parasite isolated from non-ulcerated cutaneous leishmaniasis points to Leishmania (Leishmania) poncei n. sp. (Kinetoplastea: Trypanosomatidae)

Silveira,

Vasconcelos dos Santos,

Flores

et al. 2023

Preprint

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Non-ulcerated cutaneous leishmaniasis (NUCL) is an atypical and peculiar clinical form of the disease that was first described by Ponce et al. (1988) in Honduras (Central America), where iso-lated or disseminated popular and/or nodular skin lesions are commonly seen in adolescents and young adults. Leishmania (L.) chagasi was then incriminated as the causal agent of the disease, as well as of American visceral leishmaniasis (AVL), although NUCL has been shown to be more prevalent than AVL in the region. Considering, however, the dubious taxonomic character of the causal agent of NUCL, as there is no evidence of this form of disease associated with L. (L.) cha-gasi in South America, this study aimed to carry out a retrospective taxonomic analysis on a se-ries of studies on the diagnostic approach to the Honduran parasite in loco (El Tigre island, Amapala municipality, west coast of Honduras), where taxonomic characters of a biological (in vitro and in vivo), epidemiological (vector and canine reservoir), clinical-immunological (im-munopathological features of in situ skin lesion and systemic infection) and molecular (ge-nomic/phylogenetic analyses) nature were considered. The findings, particularly those of mo-lecular nature, such as: the Honduran parasite showed to be more ancestral (molecular clock analysis of the DNA polymerase alpha subunit gene) than all viscerotropic ones [L. (L.) chagasi, L. (L.) donovani and L. (L.) infantum], as well as presenting an absolutely unprecedented structural variation on chromosome 17 and the highest frequency of genomic SNPs (more than twice the number seen in the Brazilian parasite), in addition to representing a different phylogenetic lin-eage (mainly in the NJ - RNA Pol II tree) from those viscerotropic ones, have pointed to the characterization of a new leishmanine parasite, Leishmania (Leishmania) poncei n. sp. (Kinetoplas-tea: Trypanosomatidae), in honor of Professor Ponce, who was the first researcher to describe NUCL in Honduras.

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Cutaneous parasitism in patients with American visceral leishmaniasis in an endemic area

Cited by 4 publications

References 18 publications

Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context

Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context

Leishmania infantum xenodiagnosis from vertically infected dogs reveals significant skin tropism

An integrative taxonomic analysis of Honduran Central America parasite isolated from non-ulcerated cutaneous leishmaniasis points to Leishmania (Leishmania) poncei n. sp. (Kinetoplastea: Trypanosomatidae)

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