Detection ofLeishmaniain Unaffected Mucosal Tissues of Patients with Cutaneous Leishmaniasis Caused byLeishmania (Viannia)Species

Abstract

Background Leishmania (Viannia) species are the principal cause of mucosal leishmaniasis. The natural history and pathogenesis of mucosal disease are enigmatic. Parasitological evaluation of mucosal tissues has been constrained by the invasiveness of conventional sampling methods. Methods We evaluated the presence ofLeishmania in the mucosa of 26 patients with cutaneous leishmaniasis and 2 patients with mucocutaneous leishmaniasis. Swab samples of the nasal mucosa, tonsils, and conjunctiva were analyzed using polymerase chain reaction with LV-B1 primers and Southern blot hybridization. Results Two patients with mucocutaneous leishmaniasis and 21 (81%) of 26 patients with cutaneous leishmaniasis had Leishmania kinetoplast minicircle DNA (kDNA) in mucosal tissues. kDNA was amplified from swab samples of nasal mucosa from 14 (58%) of 24 patients, tonsils from 13 (46%) of 28 patients, and conjunctiva from 6 (25%) of 24 patients. kDNA was detected in the mucosa of patients with cutaneous disease caused by Leishmania panamensis, Leishmania guyanensis, and Leishmania braziliensis. Conclusion The asymptomatic presence of parasites in mucosal tissues may be common in patients with Leishmania (Viannia) infection.

Clinical and Epidemiologic Profile of Cutaneous Leishmaniasis in Colombian Children: Considerations for Local Treatment

“…In the Americas, risk of mucosal involvement has driven the recommendation and acceptance of toxic systemic treatment. However, the indefinite persistence of Leishmania after treatment and the asymptomatic presence of parasites in mucosal tissues of patients with active cutaneous disease, [18][19][20][21][22] a history of CL, or even asymptomatic infection prompted reassessment of the pathogenesis and risk of mucosal disease. 22 The therapeutic goal of clinical resolution of cutaneous lesions is accompanied by reduction of parasite burden but now recognized to be independent of elimination of infection.…”

Phlebotomine Vector Ecology in the Domestic Transmission of American Cutaneous Leishmaniasis in Chaparral, Colombia

“…( V. ) species. 29,30 The thermal profile was 95°C for 5 minutes, 35 cycles at 92°C for 1 minute, 66°C for 40 seconds, 72°C for 30 seconds, and a final extension at 72°C for 1 minute.…”

“…To improve the sensitivity and specificity of PCR, a chemoluminescent Southern blot was performed. 29,30 Briefly, agarose gels were processed in denaturation (1.5 M NaCl, 0.5 M NaOH) and neutralization (1 M Tris, pH 8.0, 1.5 M NaCl) buffer for 20 minutes each and blotted onto a nylon membrane (Hybond N+; Amersham Bioscience). The transfer was carried out by capillary action overnight using 10× sodium chloridesodium citrate (1.5 mol/L NaCl and 0.15 mol/L sodium citrate).…”

“…40,41 Furthermore, individuals in endemic areas without clinical symptoms have been observed to harbor parasites. 30 The presence of Le. ( V. ) guyanensis in the area suggested that it has recently expanded its range using an anthropophilic phlebotomine vector very different from the vector in its natural enzootic foci, such as L. umbratilis and L. antunesi .…”

Diagnostic Performance of Filter Paper Lesion Impression PCR for Secondarily Infected Ulcers and Nonulcerative Lesions Caused by Cutaneous Leishmaniasis

“…Optimization of noninvasive strategies in nonulcerative lesions is warranted. Noninvasive diagnostic testing for CL is novel, with a dearth of published studies supporting its utility (5,8,13). FPLI PCR reduces the risks of bleeding and infection, diminishes the costs of testing by obviating the need for anesthesia, needles, syringes, and sharps biohazard disposal, and provides clinicians with an expedient, low-tech alternative to the operator-dependent collection of aspirates and scrapings.…”