Leishmaniose cutânea disseminada produzida por Leishmania viannia braziliensis no Estado do Maranhão - Brasil

Abstract

A leishmaniose dérm ica pós-calazar foi a prim eira form a disseminada da doença, descrita como seqüela do calazar indiano, caracterizandose por m últiplas lesões de pele atribuídas à Leishmania donovani610. Existe ainda outra forma d is s e m in a d a d a d o e n ç a , c o n h e c id a com o leishmaniose cutânea difusa ou anérgica, relatada inicialmente por Silva7 no Brasil e Convit2 na Venezuela.A forma abordada no presente trabalho não se refere às anteriores, e sim a uma outra manifestação clín ic a da le ish m a n io se c a ra c teriz a d a pela disseminação de lesões cutâneas, a partir de uma le sã o in ic ia l, p o d e n d o ou n ão h a v e r co m p ro m etim en to m ucoso4 5. E stas lesões apresentam os mais variados aspectos e a via de dissem in ação é, a in d a , d iscu tív el sendo a hematogênica a mais aceita. O agente etiológico responsável pela m aioria dos casos descritos pertence ao complexo brasiliensis3 4 5 9.

Disseminated cutaneous leishmaniasis caused by Leishmania braziliensis in Southern Brazil

“…The current case draws attention to the number of lesions compared to other cases described in Brazil and in the Southern region, given that the cases of CL have been reported almost exclusively in the North and Northeast of Brazil 4,5,11 . In Maranhão State , Galvão et al 5 reported a patient with 58 lesions; Carvalho et al 8 , in the State of Bahia, found in eight patients, a number of lesions ranging from 75 to 800.…”

“…In Maranhão State , Galvão et al 5 reported a patient with 58 lesions; Carvalho et al 8 , in the State of Bahia, found in eight patients, a number of lesions ranging from 75 to 800. Turetz et al .…”

“…Usually, the finding of amastigote forms of Leishmania on DS for the diagnosis of DL is low 2,13 , but in this case, the number of amastigote forms of Leishmania detected on DS was abundant, although the disease had appeared 150 days before being confirmed. The patient’s weight loss (15 kg) is not something new, given that fever, general malaise, muscle pain and especially weight loss-are reported among the various systemic manifestations of DL 2,5,11 .…”

“…Since then, just a few cases 5 of DL, with additional research on the parasites characteristics, their immunological behavior and response of patients to treatment 2,5 have been reported. DL is characterized by expressing multiple papular acneiform lesions, compromising exposed areas, such as limbs, and frequently face and trunk 2,4,5 . The number of lesions can reach hundreds, according to the Ministry of Health 2 .…”

Disseminated cutaneous leishmaniasis, an emerging form of cutaneous leishmaniasis: report of two cases

“…The immunological aspects are also distinct, as there is an abnormality in cellular immunity which is restored after treatment. On the other hand, in the diffuse form there is always a lack of T‐cell response, which is represented by a negative Montenegro skin test 3–5 …”