First Case of Diffuse Leishmaniasis Associated With Leishmania panamensis

Freites, Christian Olivo; Gundacker, Nathan; Pascale, Juan Miguel; Saldaña, Azäel; Diaz-Suarez, Rosendo; Jiménez, Gabriela; Sosa, Néstor; García, Eyra; Jiménez, Ana I.; Suárez, José Antonio

doi:10.1093/ofid/ofy281

Cited by 9 publications

(8 citation statements)

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“…panamensis has been associated to diverse cutaneous forms of the disease, a behavior that might be the result of local interplay between L. panamensis variants and human populations with different genetic backgrounds. (16,17,18,19) Little is known about the population structure of L. panamensis in Panama. Local studies focus mainly on discriminating Leishmania species on vectors, hosts, and humans rather than inferring their genetic diversity.…”

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confidence: 99%

Evaluation of cytochrome b sequence to identify Leishmania species and variants: the case of Panama

Davila

Pineda

Calzada

et al. 2021

Mem. Inst. Oswaldo Cruz

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BACKGROUND The genetic heterogeneity of Leishmania parasites is a major factor responsible for the wide variety of Leishmania-associated manifestations. Consequently, understanding the genetic make-up of Leishmania species using suitable molecular markers is an important component of realising local and regional scale disease risk. The cytochrome b (cytb) is frequently used to type New World Leishmania species. However, its potential to discriminate Leishmania species and variants requires further evaluation.OBJECTIVES To explore the capacity of cytb gene to identify New World Leishmania species and variants and to develop an approach able to type local Leishmania species and variants.METHODS We retrieved 360 partial and complete Leishmania cytb gene sequences publicly available in GenBank database to study all single nucleotide polymorphisms (SNPs) across the cytb gene that differentiate New World Leishmania species. This information was used to develop an approach based upon the polymorphisms found in a DNA segment of 948bp. We also compared the typing results found with this technique with the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) profiling obtained using HSP70 gene as target. One hundred Panamanian isolates were used to both typed Leishmania species and assess local genetic variability.FINDINGS We found complete agreement between our cytb approach and the PCR-RFLP profiling method based on HSP70 for Leishmania species identification. Ninety-two isolates were identified as L. panamensis, although other Viannia species were found circulating at a lower frequency. Three L. panamensis haplotypes were identified in Panamanian provinces. We also provide an initial report of L. guyanensis haplotypes circulating in Panama.MAIN CONCLUSIONS Cytb gene sequence encompasses key main SNPs that aid to identify Leishmania species. The cytb approach developed with this information was able to identify and assess genetic variability of local Leishmania species found in this study. Key words: leishmaniasis -cytochrome b gene -haplotypes -Leishmania panamensis -Leishmania guyanensis -PanamaLeishmaniasis, a neglected tropical disease transmitted by female sandflies and caused by kinetoplastic protozoa parasites of the genus Leishmania, is endemic in 98 countries worldwide. Due to the high number of cases and its geographical expansion, the World Health Organization (WHO) considers leishmaniasis as an emerging/ reemerging vector borne parasitic disease. (1) Regarding its impact on public health, leishmaniasis has an estimated annual incidence of 2.0 million cases and an approximated prevalence of 12,000,000 cases. (2) In addition, this disease is responsible for 20,000 to 40,000 deaths occurring in rural and suburban populations all year round. (1,2) Visceral and tegumentary leishmaniasis are the main clinical forms of the disease which show different clinical expressions depending upon the species of Leishmania responsible for the disease, the genetic background and immunological status of ...

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Evaluation of cytochrome b sequence to identify Leishmania species and variants: the case of Panama

Davila

Pineda

Calzada

et al. 2021

Mem. Inst. Oswaldo Cruz

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“…4 The spectrum of cutaneous manifestations associated with CL in the New World includes ulcerative, diffuse, disseminated, and atypical forms (psoriasiform, verrucous, zosteriform, or nodular). 6,9 The Pan American Health Organization recommends assessing the annual CL transmission index to identify the locations within the Americas with the highest risk of transmission. Used to prioritize and control interventions, this index is constituted by the annual incidence of CL and the density of transmission which is defined as the total annual number of CL cases in a defined geographic area by municipalities, regions, and subregions of countries with existing leishmaniasis transmission.…”

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“…However, local or systemic treatment is recommended for individuals with complex CL defined as the presence of subcutaneous nodules; area greater than 5 cm; regional adenopathy; lesions on the face, fingers, toes, or genitalia; location or size not amenable to localized treatment; immunocompromised host; previous clinical failure; infection due to a Leishmania species potentially associated with mucosal disease; or diffuse CL. 9,10 In these clinical scenarios, treatment accelerates the healing process and reduces the chances of relapse and dissemination (mucosal or visceral).…”

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confidence: 99%

Case Report: Cutaneous Leishmaniasis due to Leishmania (Viannia) panamensis in Two Travelers Successfully Treated with Miltefosine

Mann

Phupitakphol

Davis

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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We present two cases of Leishmania (V) panamensis in returning travelers from Central America successfully treated with miltefosine. The couple presented with ulcerative skin lesions nonresponsive to antibiotics. Skin biopsy with polymerase chain reaction (PCR) revealed L. (V) panamensis. To prevent the development of mucosal disease and avoid the inconvenience of parental therapy, we treated both patients with oral miltefosine. We suggest that miltefosine represents an important therapeutic alternative in the treatment of cutaneous lesions caused by L. panamensis and in preventing mucosal involvement.

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“…There are a variety of atypical cutaneous manifestations, however, including nodular, sporotrichoid, disseminated, psoriasiform, verrucous, zosteriform, eczematous, and/or erysipeloid (Figs. 3 and 4 ) [ 4 •, 22 ]. Other atypical presentations include small satellite lesions outside of the plaque/ulcer (nodular lymphangitis) (Fig.…”

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confidence: 99%

A Review of Leishmaniasis: Current Knowledge and Future Directions

et al. 2021

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Purpose of Review The goal of this review is to summarize the current knowledge of the epidemiology, clinical manifestations, diagnosis, and treatment of cutaneous, mucosal, and visceral leishmaniasis. We will describe the most recent findings and suggest areas of further research in the leishmaniasis field. Recent Findings This article reviews newer leishmaniasis tests (including rapid diagnostic tests using rK39 antibodies), vaccine candidates, and updated treatment recommendations. Summary While leishmaniasis is a complex disease, learning the prominent clinical manifestations and major parasite species can guide the recommendations for diagnosis and treatment.

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First Case of Diffuse Leishmaniasis Associated With Leishmania panamensis

Cited by 9 publications

References 13 publications

Evaluation of cytochrome b sequence to identify Leishmania species and variants: the case of Panama

Evaluation of cytochrome b sequence to identify Leishmania species and variants: the case of Panama

Case Report: Cutaneous Leishmaniasis due to Leishmania (Viannia) panamensis in Two Travelers Successfully Treated with Miltefosine

A Review of Leishmaniasis: Current Knowledge and Future Directions

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