Visceral leishmaniasis with duodenal involvement: three immunocompetent cases from southern Iran

Geramizadeh, Bita; Fakhar, Mahdi; Motazedian, MH

doi:10.1179/136485906x112149

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…Furthermore, although patients with VL may have symptoms of mild diarrhea, the presence of severe enteropathy, not accompanied by other classic signs of systemic involvement as the presenting feature, is rare: a literature review revealed only four case reports occurring in nonimmunosuppressed patients [7, 10, 11]. There are at least another five confirmed cases of intestinal involvement following the classical form of visceral leishmaniasis in immunocompetent individuals [12–14]. …”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Dyarrheal Syndrome in a Patient Co-Infected withLeishmania infantumandSchistosoma mansoni

Cota

Gomes

Pinto

et al. 2012

Case Reports in Medicine

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This case report describes an atypical clinical presentation of visceral leishmaniasis affecting the digestive tract and causing malabsorption syndrome in a patient without recognized immunosuppressive condition. After appropriate treatment for the classical visceral form of the disease, diarrhea persisted as the main symptom and massive infection by Leishmania was detected by histopathology analysis of the duodenal mucosa. Schistosoma mansoni coinfection was also confirmed and treated without impact on diarrhea. New course of amphotericin B finally led to complete improvement of diarrhea. Atypical visceral leishmaniasis involving the gastrointestinal tract is well recognized in HIV coinfection but very rare in immunocompetent patients. The factors determining the control or evolution of the Leishmania infection have not been completely identified. This case stresses the importance of atypical symptoms and the unusual location of visceral leishmaniasis, not only in immunodepressed patients, and raises the possible influence of chronic infection by S. mansoni reducing the immune response to Leishmania.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Dyarrheal Syndrome in a Patient Co-Infected withLeishmania infantumandSchistosoma mansoni

Cota

Gomes

Pinto

et al. 2012

Case Reports in Medicine

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“…The PCR products were separated by electrophoresis in a 1.5%-agarose gel, stained with ethidium bromide, visualized under ultra-violet trans-illumination, and sized by comparison with a 100-bp 'ladder'. Each sample found PCR-positive for leishmanial DNA was then investigated using the PCR described by Geramizadeh et al (2006), which is based on the speciesspecific primers LIN4 and LIN17, to confirm that the DNA detected was that of L. infantum.…”

Section: Sample Collection and Testingmentioning

confidence: 99%

“…All 100 were subsequently found positive for L. infantum DNA, using the PCR described by Geramizadeh et al (2006), indicating that they probably had L. infantum amastigotes in their peripheral blood. Although a male subject was more likely to be found PCR-positive than a female subject, the difference was not statistically significant (13.9% v. 11.1%; P50.33).…”

Section: Pcr Screeningmentioning

confidence: 99%

Asymptomatic human carriers ofLeishmania infantum: possible reservoirs for Mediterranean visceral leishmaniasis in southern Iran

Fakhar

Motazedian

Hatam

et al. 2008

Annals of Tropical Medicine & Parasitology

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Over the last decade, the incidence of visceral leishmaniasis (VL) has increased in many districts of the province of Fars, in southern Iran. Recent epidemiological reports indicate that asymptomatic human infections with Leishmania infantum (the causative agent of VL throughout the Mediterranean basin) occur more frequently in Iran than was previously believed. Between 2004 and 2006, blood samples were collected from 802 apparently healthy subjects from communities, in the north-west and south-east of Fars province, where VL cases had been recorded. Each of these samples was tested for anti-Leishmania antibodies, in direct agglutination tests (DAT), and for L. infantum kinetoplast DNA, in PCR-based assays. Of the 426 subjects from north-western Fars, eight (1.9%) were found seropositive and 68 (16.0%) PCR-positive. The corresponding values for the 376 subjects from south-eastern Fars were lower, with five (1.3%) seropositive and 32 (8.5%) PCR-positive. Of the 100 PCR-positive subjects, 18 (18.0%) each lived in a household in which there had been a case of VL, and six (6.0%) had had VL themselves (in each case, more than a year before the blood sampling for the present study). Although 21 of the PCR-positives have now been followed-up for at least 18 months, none has developed symptomatic VL. Since positivity in the PCR-based assay probably indicated the presence of L. infantum amastigotes in the peripheral blood of 12.5% of the subjects, it is clear that asymptomatic human carriers of L. infantum are quite common in the study areas and probably act as reservoirs in the transmission of the parasite, to humans and to dogs, by sandflies.

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“…The main causative agent of VL in Iran is L. infantum , (Mohebali et al 2007) but recently, L. tropica (Viscerotropic strain) has been reported as another aetiological agent for immunocompetent patients infected with VL in Southern Iran (Geramizadeh et al 2006; Alborzi et al 2006). In the present study a viscerotropic strain of L. tropica isolated from southern Iran, was included.…”

Section: Discussionmentioning

confidence: 99%

An integrated pipeline for the development of novel panels of mapped microsatellite markers for Leishmania donovani complex, Leishmania braziliensis and Leishmania major

et al. 2008

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A panel of microsatellites mapped to the Leishmania genome might make it possible to find associations between specific loci and phenotypic traits. To identify such loci, a Perl programme was written that scans the sequence of a genome and writes all loci containing microsatellites to a MySQL database. The programme was applied to the sequences of the L. braziliensis, L. infantum and L. major genomes. The database is publicly available over the internet: http://www.genomics.liv.ac.uk/tryps/resources.html 'Microsatellite Locus Extractor', and allows the selection of mapped microsatellites that meet user-defined criteria from a specified region of the selected genome. The website also incorporates a primer design pipeline that will design primers to amplify the selected loci. Using this pipeline 12 out of 17 primer sets designed against the L. infantum genome generated polymorphic PCR products. A tailed primer protocol was used to label all microsatellite primers with a single set of labelled primers. To avoid the culture of parasites prior to genotyping, sets of nested PCR primers were developed to amplify parasite DNA eluted from microscope slides. The limit of detection was approximately 1.6 parasite equivalents. However, only 6/56 DNA from slides stored at ambient temperature for over 6 months gave positive PCR results.

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Visceral leishmaniasis with duodenal involvement: three immunocompetent cases from southern Iran

Cited by 3 publications

References 18 publications

Dyarrheal Syndrome in a Patient Co-Infected withLeishmania infantumandSchistosoma mansoni

Dyarrheal Syndrome in a Patient Co-Infected withLeishmania infantumandSchistosoma mansoni

Asymptomatic human carriers ofLeishmania infantum: possible reservoirs for Mediterranean visceral leishmaniasis in southern Iran

An integrated pipeline for the development of novel panels of mapped microsatellite markers for Leishmania donovani complex, Leishmania braziliensis and Leishmania major

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