Follow-Up of a Human Accidental Infection by Leishmania (Viannia) braziliensis Using Conventional Immunologic Techniques and Polymerase Chain Reaction

Evaluation of antigens from various Leishmania species in a Western blot for diagnosis of American tegumentary leishmaniasis.

“…21 The use of this test has been assayed in following chemotherapy and cure. 13 Our results showed that some proteins were specific for the serum samples from patients with Chagas' disease ( Table 2). The major bands with apparent molecular weight of 30 kD for L. (V.) braziliensis, 35 kD for L. (L.) amazonensis, 28 kD for (L.) tropica, and 28 kD for strain 268T were recognized by these sera at a high frequency of 78.30%, 90.00%, 90.00% and 80.00%, respectively (Table 4).…”

“…The delayed intradermal Montenegro test is the best method for evaluation, 11,12 but present infections are not distinguished from past infections. 1,13 The humoral immune response occurs only during the active phase of infection, with the appearance of low titers of antibodies, representing a temporary response. 14,15 Several techniques have been developed for the serologic diagnosis of leishmaniasis.…”

Persistent Infections by Leishmania (Viannia) braziliensis

“…As mentioned above, we were able to detect L. braziliensis DNA in blood samples from patients cured many years ago (Guevara et al 1993) or in asymptomatic subjects coming from endemic areas for L. braziliensis (Guevara et al 1994). In these cases, the higher PCR signal intensities are registered in purified monocytic fraction (Delgado et al 1996). In patients with recent lesions we rarely detected L. braziliensis in blood samples, suggesting that at the beginning of the infection the parasites are restricted mostly to the primary lesion where the insect bite occurred (Guevara et al 1994); later, when they are being challenged (naturally or artificially), they metastasize and either reach an equilibrium with the host or are eliminated (Padilha-Gonçalves 1988, Guevara et al 1994).…”

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“…This raises important questions related to blood donors and the risk of transmission via blood transfusions. There is evidence that patients cure and that their blood can become parasite positive again after 1 to 30 years (Guevara et al 1993, Delgado et al 1996 as well as the reactivation by immunosuppressive drugs (Scatena et al 2003). Similarly the fact that there is strong evidence that transmission of visceral leishmaniasis (VL) amongst HIV positive drug users in Europe (Desjeux & Alvar 2003) is by contaminated syringes again indicates the danger of contaminated blood.…”