Dissemination in Cutaneous Leishmaniasis I. Subcutaneous Nodules

Kubba, Raj; Elhassan, Ahmed M.; Al-Gindan, Yussuf; Omer, Awad; Kutty, Methil Kannan; Saeed, Mahmoud B. M.

doi:10.1111/j.1365-4362.1987.tb00193.x

Cited by 62 publications

(59 citation statements)

References 11 publications

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“…major infection is variable and includes nodular, ulcerative, and satellite lesions, lymph node enlargement, and lymphadenitis and lymphangitis with sporotrichoid spread. [12][13][14][15] The picture differs in various parts of the world in relation to the locally circulating L . major strain.…”

Section: Discussionmentioning

confidence: 99%

“…Reports from Saudi Arabia on L. major infections suggested that development of satellite lesions and lymphatic involvement may be related to treatment. 12,13,22 Treatments reported in these studies are local therapies (cryotherapy, ilSb v ) and systemic treatments, both oral (ketoconazole, rifampicin) and parenteral (antimony), but numbers of patients treated and specific relationships and associations of lymphatic involvement with respective treatments are not given. In a Cochrane analysis on treatment of Old World CL 19 and in a large series of ilSb v treatments of patients infected with L. tropica in Turkey, 23,24 lymphatic involvement during treatment is not mentioned.…”

Section: Discussionmentioning

confidence: 99%

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Cutaneous Leishmaniasis (Leishmania major Infection) in Dutch Troops Deployed in Northern Afghanistan: Epidemiology, Clinical Aspects, and Treatment

Thiel¹,

Leenstra²,

Vries³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. Cutaneous leishmaniasis caused by Leishmania major infection affected 172 (18.3%) of 938 Dutch military troops deployed in northern Afghanistan in 2005. The high attack rate was a result of initial insufficient availability of means of prevention and insufficient adherence to preventive measures. At presentation, the lymphatic system was involved in 24.8%. Treatment with intralesional injections of antimony with or without cryotherapy was satisfactory, but 19.5% of patients received secondary treatment with miltefosine. Six months after treatment, 128 (77.1%) of 166 treated patients were cured, 16 (9.6%) were lost to follow-up, and 22 (13.3%) already experienced cure at six weeks but were not seen at six months. Natural evolution played a role in this observational study, which showed cure of all patients seen at six months. In general, management of cutaneous leishmaniasis was feasible under field conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cutaneous Leishmaniasis (Leishmania major Infection) in Dutch Troops Deployed in Northern Afghanistan: Epidemiology, Clinical Aspects, and Treatment

Thiel¹,

Leenstra²,

Vries³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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“…Thus, all strains from the Middle East were classified as expressing high (n ϭ 5) or intermediate (n ϭ 2) virulence whereas the majority of those from Tunisia were expressing low (n ϭ 4) or intermediate (n ϭ 6) virulence, with only two strains from this country expressing high virulence. Whether these differences in the experimental pathogenicity, induced by strains from North Africa or the Middle East, are germane to differences in the clinical severity of disease in humans is unknown; however, it is worth noting that ZCL due to L. major has globally a more benign evolution in Tunisia than in the Middle East (3,21). Thus, at El Guettar, where almost all Tunisian strains used in this study were collected, a prospective follow-up of ZCL previously showed that 65% of cutaneous lesions had spontaneously improved after 2 weeks and almost all of them had completely healed after 15 weeks (28).…”

Section: Discussionmentioning

confidence: 99%

Heterogeneity of WildLeishmania majorIsolates in Experimental Murine Pathogenicity and Specific Immune Response

Kébaïer¹,

Louzir²,

Chenik³

et al. 2001

Infect Immun

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Virulence variability was investigated by analyzing the experimental pathogenicity of 19 Leishmania major strains in susceptible BALB/c mice. Twelve strains were isolated from Tunisian patients with zoonotic cutaneous leishmaniasis; seven strains were isolated in Syria (n ‫؍‬ 1), Saudi Arabia (n ‫؍‬ 2), Jordan (n ‫؍‬ 2), or Israel (n ‫؍‬ 2). BALB/c mice were injected in the hind footpad with 2 ؋ 10 6 amastigotes of the various isolates, and lesion progression was recorded weekly for 9 weeks. Interleukin-4 (IL-4) and gamma interferon (IFN-␥) production of lymph node mononuclear cells activated in vitro with parasite antigens were evaluated 5 weeks after infection. We show that disease progression induced by different L. major isolates was largely heterogeneous although reproducible results were obtained when using the same isolate. Interestingly, isolates from the Middle East induced a more severe disease than did the majority of Tunisian isolates. Strains with the highest virulence tend to generate more IL-4 and less IFN-␥ in vitro at week 5 postinfection as well as higher levels of early IL-4 mRNA in the lymph node draining the inoculation site at 16 h postinfection. These results suggest that L. major isolates from the field may differ in virulence, which influences the course of the disease induced in mice and the type of immune response elicited by the infected host.

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“…Failure of the immune system to control parasite multiplication might lead to infection in the superficial layer of the papillary dermis in the eczematoid, erysipeloid, and psoriasiform forms or in the reticular dermis in sporotrichoid forms of CL (2). Multiple lesions of LCL can occur because of multiple inoculations by infected sand flies but can also result from parasite dissemination (130). A chronic form of LCL develops in cases where the protective response is insufficient and lesions persists for over 1 year (2).…”

Section: Cl-hiv Coinfectionmentioning

confidence: 99%

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

et al. 2008

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SUMMARY To date, most Leishmania and human immunodeficiency virus (HIV) coinfection cases reported to WHO come from Southern Europe. Up to the year 2001, nearly 2,000 cases of coinfection were identified, of which 90% were from Spain, Italy, France, and Portugal. However, these figures are misleading because they do not account for the large proportion of cases in many African and Asian countries that are missed due to a lack of diagnostic facilities and poor reporting systems. Most cases of coinfection in the Americas are reported in Brazil, where the incidence of leishmaniasis has spread in recent years due to overlap with major areas of HIV transmission. In some areas of Africa, the number of coinfection cases has increased dramatically due to social phenomena such as mass migration and wars. In northwest Ethiopia, up to 30% of all visceral leishmaniasis patients are also infected with HIV. In Asia, coinfections are increasingly being reported in India, which also has the highest global burden of leishmaniasis and a high rate of resistance to antimonial drugs. Based on the previous experience of 20 years of coinfection in Europe, this review focuses on the management of Leishmania-HIV-coinfected patients in low-income countries where leishmaniasis is endemic.

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Dissemination in Cutaneous Leishmaniasis I. Subcutaneous Nodules

Cited by 62 publications

References 11 publications

Cutaneous Leishmaniasis (Leishmania major Infection) in Dutch Troops Deployed in Northern Afghanistan: Epidemiology, Clinical Aspects, and Treatment

Cutaneous Leishmaniasis (Leishmania major Infection) in Dutch Troops Deployed in Northern Afghanistan: Epidemiology, Clinical Aspects, and Treatment

Heterogeneity of WildLeishmania majorIsolates in Experimental Murine Pathogenicity and Specific Immune Response

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

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