Geographic distribution and clinical description of leishmaniasis cases in Peru.

Abstract

Studies were conducted from 1986 through 1993 to further define the geographic distribution and relative importance of different species of Leishmania as a cause of leishmaniasis in Peru. Patients with a clinical diagnosis of cutaneous and/or mucosal or diffuse cutaneous leishmaniasis were enrolled at the Naval Medical Research Institute Detachment (NAMRID) Laboratory in Lima, the Tropical Disease Clinic at San Marcos University Daniel A. Carrión, the Central Military Hospital, and a Ministry of Health hospital in Cusco, Peru. Clinical features, lesion aspirates, and biopsy tissue were obtained from each patient. All specimens were collected and assayed separately, including multiple specimens from some of the same patients for Leishmania parasites by inoculating aliquots of either aspirates or biopsy tissue suspensions onto Senekji's blood agar medium. Stocks of Leishmania isolates were used to prepare promastigotes to produce extracts for identifying the Leishmania species by the cellulose acetate electrophoresis enzyme technique. A total of 351 isolates of Leishmania were obtained from 350 patients who were infected primarily in the low and high jungle of at least 15 different Departments of Peru. Of the 351 isolates, 79% were identified as L. (V.) braziliensis, 7% as L. (V.) guyanensis, 10% as L. (V.) peruviana, 2% as L. (V.) lainsoni, and 1.7% as L. (L.) amazonensis. The clinical form of disease varied depending on the species of Leishmania, with L. (V.) braziliensis being associated most frequently with cutaneous, mucosal ulcers and mixed cutaneous and mucosal disease, and L. (V) peruviana, L. (V.) guyanensis, L. (V.) lainsoni with cutaneous lesions.Leishmania (L.) amazonensis was isolated from six patients, three with cutaneous lesions, one with mucosal lesions, and two with diffuse cutaneous lesions. Among all of the leishmaniasis cases, males were affected more frequently, and cases occurred among patients less than 10 to more than 51 years of age. These data further defined the geographic distribution and the relative frequency of Leishmania species associated with different clinical forms of leishmaniasis in Peru.

Natural Leishmania Infection of Lutzomyia auraensis in Madre de Dios, Peru, Detected by a Fluorescence Resonance Energy Transfer–Based Real-Time Polymerase Chain Reaction

“…3,[15][16][17] Capture of sand flies and identification. Peridomiciliary sand fly specimens were captured in September, November, and December of 2009 (before and during the rainy season) in the vicinity of 10 arbitrarily selected houses during 10 consecutive days each month (Figure 1).…”

“…1 In South America, New World tegumentary leishmaniasis (NWTL) is mainly caused by species of the Viannia subgenus, including L. (V.) braziliensis, Leishmania (V.) peruviana, Leishmania (V.) guyanensis, and Leishmania (V.) panamensis. 2,3 In Peru, NWTL is endemic in 74% of the country, 3,4 and there were 6,761 reported cases in 2010. 5 The transmission cycle of Leishmania begins with the bite of an infected phlebotomine sand fly.…”

Leishmaniasis in travelers: A literature review

“…] panamensis infections [13]. In particular, as above-mentioned, three clinical outcomes may derive from L. [V.] braziliensis infection, probably due to the complex interactions with the host's imune system.…”

Simultaneous Infection with Leishmania (Viannia) braziliensis and L. (V.) lainsoni in a Peruvian Patient with Cutaneous Leishmaniasis

“…1,2 Among the subgenus L. (Viannia), different species are widespread in South American regions to which leishmaniasis is endemic, which include areas from the tropical jungle to Andean valleys. It has been previously demonstrated that at 12 months posttreatment, 30% of L. (V.) braziliensis-infected patients showed treatment failure with pentavalent antimony compared with 25% of L. (V.) peruviana-infected patients and 8% of L. (V.) guyanensis-infected patients, thus reiterating a species specificity to treatment response.…”