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Carbonara M, Iatta R, Miró G, Montoya A, Benelli G, Mendoza-Roldan JA, Papadopoulos E, Lima C, Bouhsira E, Nachum-Biala Y, Decaro N, Schunack B, Baneth G, Otranto D. Feline leishmaniosis in the Mediterranean Basin: a multicenter study. Parasit Vectors 2024; 17:346. [PMID: 39160611 PMCID: PMC11331770 DOI: 10.1186/s13071-024-06419-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/24/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Cats are now recognized as competent hosts for Leishmania infantum and a blood source for sand fly vectors. Although canine leishmaniosis (CanL) is endemic in Mediterranean Basin countries, large-scale epidemiological studies are lacking for feline leishmaniosis (FeL). This study aimed to assess the prevalence of L. infantum infections, associated risk factors, clinical signs, and clinicopathological abnormalities in domestic cat populations from six Mediterranean Basin countries. METHODS From 2019 to 2022, blood and serum samples of cats (n = 2067) living in Italy (n = 300), Greece (n = 297), Portugal (n = 295), France (n = 231), Israel (n = 313), and Spain (n = 631) were collected along with animal data (i.e., age, sex, breed, housing conditions, and geographical origin), clinical signs, and laboratory blood test parameters. Cats were grouped according to their age as kittens (up to 1 year), young (older than 1 and younger than 7 years), mature (between 7 and 10 years), and senior (older than 10 years). Serum samples were tested for L. infantum by immunofluorescence antibody test (IFAT) and enzyme-linked immunosorbent assay (ELISA), and blood samples of seropositive cats were tested for L. infantum kinetoplast deoxyribonucleic acid (kDNA). Viral infection by feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) was molecularly addressed in all cats enrolled. Statistical analysis was performed to evaluate the association between the risk of L. infantum infection and independent variables, and among co-infection of L. infantum with FIV and/or FeLV, clinical signs, and clinicopathological abnormalities. RESULTS Overall, 17.3% (358/2067) of cats scored positive for L. infantum by serological tests. Specifically, 24.7% were from Portugal, 23.2% from Greece, 16.6% from Israel, 15% from Spain, 13.3% from France, and 12.6% from Italy. Leishmania infantum DNA was detected in 15 seropositive animals. Housing condition and FIV infection proved to be risk factors for FeL. Leishmania seropositivity was significantly associated with weight loss, lymphadenomegaly, gingivostomatitis, and oral ulcers, as well as with reduced albumin and albumin/globulin ratio, increased total globulins and total proteins, leukocytosis, and thrombocytosis. CONCLUSIONS This study provides, for the first time, a large-scale epidemiological survey on FeL and its clinical presentation, revealing that L. infantum circulates among domestic cats, especially shelter/free-roaming and FIV-infected animals, living in CanL endemic countries of the Mediterranean Basin.
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Affiliation(s)
| | - Roberta Iatta
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Guadalupe Miró
- Animal Health Department, Veterinary Faculty, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana Montoya
- Animal Health Department, Veterinary Faculty, Universidad Complutense de Madrid, Madrid, Spain
| | - Giovanni Benelli
- Department of Agriculture, Food and Environment, University of Pisa, Pisa, Italy
| | | | - Elias Papadopoulos
- Department of Infectious and Parasitic Diseases and Pathology, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Clara Lima
- Department of Biological Sciences, Microbiology Laboratory, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Emilie Bouhsira
- InTheres, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | | | - Nicola Decaro
- Department of Veterinary Medicine, University of Bari, Bari, Italy
| | | | - Gad Baneth
- School of Veterinary Medicine, Hebrew University, Rehovot, Israel
| | - Domenico Otranto
- Department of Veterinary Medicine, University of Bari, Bari, Italy.
- Department of Veterinary Clinical Sciences, City University of Hong Kong, Hong Kong SAR, China.
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Long-term follow-up of a case of feline leishmaniosis treated with a combination of allopurinol and meglumine antimoniate. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2023; 64:239-244. [PMID: 36874537 PMCID: PMC9979727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
A 9-year-old domestic cat, positive for antibodies to feline immunodeficiency virus (FIV), was brought to a veterinary clinic with alopecia, ulcerative skin lesions, and upper respiratory tract (URT) signs. This was after being treated for suspected allergic dermatitis, without clinical improvement, for 2 y. Biopsy of the skin and fine-needle aspirates of the spleen and of the lymph nodes were taken which detected the presence of Leishmania amastigotes. Leishmania infection was further confirmed by detection of a high titer of anti-Leishmania antibodies (≥ 3200) with an indirect fluorescent antibody technique (IFAT) serology. After the diagnosis of feline leishmaniosis (FeL) was made, allopurinol and meglumine antimoniate were started and led to quick and complete clinical improvement. After 7 mo, allopurinol administration was briefly interrupted but was resumed following relapse of the skin lesions. One month later, the cat was treated for suspected acute kidney injury, which prompted reduction of the total daily dose of allopurinol by 50%. The cat remained clinically well, with complete resolution of the cutaneous and URT signs, for nearly 24 mo after the diagnosis of FeL; at which point it was euthanized for worsening cardiac disease. To our knowledge, this represents a rare case of successful treatment of FeL with a suspected nephrotoxic effect associated with long-term use of allopurinol. Further studies are required to clarify the relationship, if any, between leishmaniosis and congestive heart failure in cats.
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A Case of Feline Leishmaniosis with Panniculitis. Case Rep Vet Med 2023; 2023:8864790. [PMID: 36685018 PMCID: PMC9848784 DOI: 10.1155/2023/8864790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/10/2022] [Accepted: 12/26/2022] [Indexed: 01/13/2023] Open
Abstract
Leishmaniases are a group of diseases caused by protozoa of the genus Leishmania and transmitted mainly by the bite of sand fly vectors. Cats are infected with at least 6 species of Leishmania. Significant associations have been found between feline leishmaniosis and coinfections mainly with FIV and/or FeLV. A 7-year-old castrated male, domestic short-haired cat was presented with unknown history and cutaneous and ocular lesions. A raised, semifirm swelling on the forehead was observed along with periocular hypotrichosis and conjunctival and third eyelid edema. The indications for pursuing a diagnosis of leishmaniosis are variable, and differing presentations may require the use of different tests. Diagnosis of feline leishmaniosis with panniculitis caused by Leishmania infantum was made by cytology, histopathology, and PCR and Leishmania antibodies (IFA). The cat responded to therapy with meglumine antimoniate and allopurinol.
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Mestrinho LA, Travancinha J, Sobral C. A case report of leishmaniosis with primary oral manifestation in a cat. Front Vet Sci 2022; 9:1059803. [DOI: 10.3389/fvets.2022.1059803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 11/11/2022] [Indexed: 12/03/2022] Open
Abstract
A case of leishmaniosis with primary oral manifestations was reported in a 10-year-old neutered domestic shorthair cat. The primary lesion was a maxillary nodular lesion, painful with spontaneous bleeding associated with advanced periodontal disease, which did not resolve with tooth extraction or periodontal treatment. Biopsy revealed chronic neutrophilic and macrophagic infections and amastigote forms of Leishmania sp and molecular tests were able to identify Leishmania infantum. Oral signs resolved after the initiation of etiologic treatment with allopurinol. Distinguishing oral signs of leishmaniosis from other oral inflammatory diseases is important, especially in endemic areas, and co-infections must be considered with any oral manifestations of this disease.
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Hemogram Findings in Cats from an Area Endemic for Leishmania infantum and Feline Immunodeficiency Virus Infections. Vet Sci 2022; 9:vetsci9090508. [PMID: 36136724 PMCID: PMC9504703 DOI: 10.3390/vetsci9090508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Some cats positive for Leishmania infantum (Li) show clinical signs and clinicopathological changes, including hemogram abnormalities. However, co-infections or co-morbidities are often detected in cats with leishmaniosis, and they can have a role in the clinical abnormalities observed. In feline Leishmania infantum infections and in clinical cases of feline leishmaniosis, a significant association with feline immunodeficiency virus (FIV) has been detected, but the role of this co-infection is controversial. The aims of this study were to retrospectively evaluate hemogram changes in cats from areas endemic for Leishmania infantum and feline immunodeficiency virus infections (Sicily and Calabria regions, Southern Italy) and to analyze the role of both pathogens in the abnormalities detected. A retrospective cross-sectional study was carried out on 496 cats. Hematological changes in cats positive for Leishmania infantum were found, particularly abnormalities compatible with chronic inflammation including moderate anemia, monocytosis, and morphologically activated monocytes. Moreover, some abnormalities, such as thrombocytosis, seem to arise when cats are co-infected with FIV. Feline leishmaniosis should be considered when some hemogram abnormalities compatible with chronic inflammation are detected. Abstract In feline Leishmania infantum (Li) infection and in clinical cases of feline leishmaniosis, co-infection with feline immunodeficiency virus (FIV) has been reported. However, the role of the retroviral co-infection in the impairment of feline clinical health is still controversial. The aim of this study was to evaluate hemogram changes in cats from regions endemic for both Li and FIV infection. Four hundred and ninety-six cats tested for Li (EDTA blood polymerase chain reaction and immunofluorescence antibody test) and for FIV infection (enzyme-linked immune assay) were retrospectively evaluated. Hemogram results including blood smear morphological evaluation were statistically compared considering four infection patterns: Li+FIV+, Li+FIV−, Li−FIV+, and Li−FIV−. Significantly lower values of erythrocytes (Li+FIV−: p = 0.0248; Li−FIV+: p = 0.0392) and hemoglobin (Li+FIV: p = 0.0086; Li−FIV+: p = 0.0249) were found in both infections when compared to Li−FIV− cats, and severity of anemia was more frequently moderate in Li-positive cats (p = 0.0206) and severe in FIV infection (p = 0.024). Li infection was associated with monocytosis (p = 0.0013) and morphologically activated monocytes (p = 0.0209). Moreover, FIV infection was associated with the presence of inflammatory leukogram (p = 0.023), and an association between thrombocytosis and the co-infection was found (p = 0.0347). Li infection in cats induces hematological changes compatible with chronic inflammation, some of which are due to co-infection with FIV.
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Clinical Case of Feline Leishmaniosis: Therapeutic Approach and Long-Term Follow-Up. Vet Sci 2022; 9:vetsci9080400. [PMID: 36006315 PMCID: PMC9416418 DOI: 10.3390/vetsci9080400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary In the present report, clinical, diagnostic, and therapeutical findings observed in a case of feline leishmaniosis (FeL) along with its long-term follow-up data are reported with the aim to provide more evidence-based data on the treatment of this important zoonotic vector-borne disease of cats. The present study represents one of the few reports of FeL with a 28-month follow-up period. This case underlines the effectiveness of allopurinol and highlights how the interruption of treatment frequently leads to relapse, impairing the animal’s health condition and prognosis. Abstract The response to allopurinol treatment and survival time of a case of feline leishmaniosis in a FIV co-infected cat is herein reported. In May 2019, a 13-year-old neutered European Shorthair male was referred due to weight loss and exfoliative dermatitis. Lymphadenomegaly and splenomegaly were detected upon clinical inspection, while the presence of several Leishmania infantum amastigotes were detected on splenic and lymphonodal fine needle aspiration (FNA). Allopurinol (10 mg/kg PO q 12 h) was administered. After two months, the cat’s clinical symptoms disappeared, and the owners decided to interrupt the therapy. In February, two reddish nodular fleshy neoformations appeared in both eyes, and amastigotes of Leishmania were detected by cytology on conjunctival swabs. Allopurinol treatment was re-started at the same rate; the ocular lesions regressed in two weeks, and the owner again decided to interrupt the therapy. In July, the patient had a new relapse, but the owner, tired of continuous relapses, refused further treatment of the disease. The cat’s health condition continued to worsen: in October 2021, the ocular lesions appeared again, and in November the patient died. This case underlines the effectiveness of allopurinol and highlights how interruption of treatment frequently leads to relapse, impairing the animal’s health condition and prognosis.
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Garcia-Torres M, López MC, Tasker S, Lappin MR, Blasi-Brugué C, Roura X. Review and statistical analysis of clinical management of feline leishmaniosis caused by Leishmania infantum. Parasit Vectors 2022; 15:253. [PMID: 35818075 PMCID: PMC9272864 DOI: 10.1186/s13071-022-05369-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/08/2022] [Indexed: 12/02/2022] Open
Abstract
Background There is limited information about feline leishmaniosis (FeL) management in clinical practice. Leishmania infantum is the species of Leishmania most frequently reported in both dogs and cats in countries of the Mediterranean region (henceforth ‘Mediterranean countries’), Central and South America, and Iran. This study was conducted to provide veterinary clinicians with an updated overview of evidence-based information on leishmaniosis in cats. Methods A review was performed using PubMed, Science Direct, Google Scholar and Web of Science. Case reports of FeL caused by L. infantum were sought for the period 1912 to 1 June 2021. Results Sixty-three case reports are included in this review. Fifty-nine out of the 63 cats were from Europe, mostly from Mediterranean countries (88.9%). Most of them were domestic short-haired cats (90%) with a mean age of 7.9 years, and had access to the outdoors (77.3%). Sixty-six percent of the cats had comorbidities, of which feline immunodeficiency virus infection was the most frequent (37.7%). Dermatological lesions (69.8%) was the most frequent clinical sign, and hyperproteinemia (46.3%) the most frequent clinicopathological abnormality. Serology was the most performed diagnostic method (76.2%) and was positive for 93.7% of cats. Medical treatment was applied in 71.4% of cats, and allopurinol was the most used drug (74.4%). Survival time was greater for treated cats (520 days; 71.4% of cats) than non-treated cats (210 days; 25.4%). Conclusions The majority of the cats had comorbidities, of which feline immunodeficiency virus was the most frequent. Dermatological lesions were frequently reported, and systemic clinical signs and clinicopathological abnormalities were also common. Serology may be useful for the diagnosis of FeL in clinical practice, and a positive titer of ≥ 1/40 may be a useful cut-off for sick cats. The reported treatments and dosages varied, but there was a good clinical response and longer survival in most of the cats treated with allopurinol monotherapy. Graphical abstract ![]()
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Affiliation(s)
- Maria Garcia-Torres
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Séverine Tasker
- Bristol Veterinary School, University of Bristol, Langford, Bristol, UK.,Linnaeus Veterinary Limited, Shirley, Solihull, UK
| | - Michael Rex Lappin
- Department of Clinical Sciences, Colorado State University, Fort Collins, USA
| | - Carles Blasi-Brugué
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Roura
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Villanueva-Saz S, Giner J, Fernández A, Alcover MM, Riera C, Fisa R, Yzuel A, González A, Marteles D, Verde M. Serum protein electrophoretogram profile detected in apparently healthy cats infected with Leishmania infantum - Short communication. Acta Vet Hung 2022. [PMID: 35258480 DOI: 10.1556/004.2021.00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022]
Abstract
The information about the clinical features of Leishmania infantum infection in cats is scarce. In this study, we evaluated the serum protein electrophoresis of samples from 19 infected but apparently healthy cats. To detect L. infantum infection, two serological tests, i.e. western blot (WB) and enzyme-linked immunosorbent assay (ELISA) as well as quantitative polymerase chain reaction (qPCR) on the blood samples were performed. Eventual infection by several selected bacterial and viral pathogens was also tested. All but one of the cats were found positive with WB. The WB-negative cat was positive by ELISA only. From the 18 WB-positive cats, only three were positive also by ELISA and eight with qPCR, including the only animal which was positive in all the three tests. No concomitant infections were detected in any of the cats. The main alteration of the proteinogram was characterised by an increase of the α-2 fraction. In the five cats with hypergammaglobulinaemia, the pattern detected was polyclonal. None of the cats were seropositive to any other pathogens tested. The presence of polyclonal gammopathy and elevation of the α-2 fraction could suggest the presence of active infection. In contrast, the only detection of an increase of the α-2 fraction alone with the presence of positive serological result could be associated by immune response activation against L. infantum.
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Affiliation(s)
- Sergio Villanueva-Saz
- 1 Animal Pathology Department, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
- 2 Clinical Immunology Laboratory, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
| | - Jacobo Giner
- 1 Animal Pathology Department, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
- 2 Clinical Immunology Laboratory, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
| | - Antonio Fernández
- 1 Animal Pathology Department, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
- 2 Clinical Immunology Laboratory, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
| | - María Magdalena Alcover
- 3 Department de Biologia, Salut i Medi Ambient, Facultat de Farmacia, Universitat de Barcelona, Av. de Joan XXIII 27-31, 08028, Barcelona, Spain
| | - Cristina Riera
- 3 Department de Biologia, Salut i Medi Ambient, Facultat de Farmacia, Universitat de Barcelona, Av. de Joan XXIII 27-31, 08028, Barcelona, Spain
| | - Roser Fisa
- 3 Department de Biologia, Salut i Medi Ambient, Facultat de Farmacia, Universitat de Barcelona, Av. de Joan XXIII 27-31, 08028, Barcelona, Spain
| | - Andrés Yzuel
- 2 Clinical Immunology Laboratory, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
| | - Ana González
- 1 Animal Pathology Department, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
- 2 Clinical Immunology Laboratory, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
| | - Diana Marteles
- 2 Clinical Immunology Laboratory, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
| | - Maite Verde
- 1 Animal Pathology Department, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
- 2 Clinical Immunology Laboratory, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013, Zaragoza, Spain
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Tabar MD, Naranjo C, Dehesa A, Rodríguez MC. Leishmaniosis in a cat with chronic diarrhea as the only clinical manifestation. J Vet Intern Med 2022; 36:753-757. [PMID: 35037701 PMCID: PMC8965267 DOI: 10.1111/jvim.16347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Abstract
A 10‐year‐old male domestic shorthaired cat was presented with chronic diarrhea unresponsive to treatment. Laboratory testing identified hyperglobulinemia and mild nonregenerative anemia, and nongastrointestinal causes of diarrhea were ruled out. Gastrointestinal endoscopy and biopsy were performed and disclosed diffuse generalized granulomatous and lymphoplasmocytic inflammatory reaction in all segments of gastrointestinal tract evaluated, with numerous Leishmania spp. amastigotes within the cytoplasm of macrophages. The organism also was detected in spleen and bone marrow and Leishmania spp. serology was positive (immunofluorescence assay 1 : 160). A diagnosis of granulomatous enteritis secondary to leishmaniosis was made. Gastrointestinal signs resolved after treatment with allopurinol and a dietary supplement of nucleotides and active hexose‐correlated compounds (N‐AHCC), but seropositivity and gammopathy persisted 8 months later. The cat died of unrelated causes after an additional 3 months and permission for necropsy was not granted. Leishmaniosis as a cause of chronic diarrhea has not been reported previously in cats and should be considered in endemic areas in cats with chronic gastrointestinal signs.
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Affiliation(s)
| | | | - Alexandra Dehesa
- Hospital Veterinario San Vicente-Vetsum, San Vicente del Raspeig, Spain
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Nascimento LFJ, Cirilo TM, Gomes DS, Gomes ACA, Lima VFS, Scher R, Jain S, Fujiwara RT, Dolabella SS. Epidemiological and diagnostic aspects of feline leishmaniasis with emphasis on Brazil: a narrative review. Parasitol Res 2021; 121:21-34. [PMID: 34761278 PMCID: PMC8580739 DOI: 10.1007/s00436-021-07372-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022]
Abstract
The leishmaniases are a group of diseases caused by the protozoan parasite belonging to the genus Leishmania. In the New World, although dogs are considered the main parasite reservoir, in the last two decades, several studies have confirmed the role of cats (Felis catus) in the epidemiology of the disease and feline leishmaniasis (FeL) is now considered to be an emerging disease. The present review summarizes the current knowledge about FeL, focusing on important immunopathological aspects, epidemiology, and diagnostic methods applied for felines in Brazil. Cats are infected with the same species of Leishmania found in dogs (i.e., Leishmania infantum). Like dogs, skin lesions are the most common in cats with clinical FeL, mainly affecting the cephalic region and less frequently the legs which may be accompanied by generalized signs or visceral involvement. Information on the immune response of cats to Leishmania infection is scarce; however, efficient infection control is seen in most cases. For diagnosis, generally, the same methods as those in dogs are used, mainly serological tools. But there is a lack of studies focusing the performance of these methods for diagnosing FeL. The estimated overall prevalence of FeL in Brazil is 8%, with L. infantum being the most prevalent species. However, infections with Leishmania braziliensis and Leishmania amazonensis have also been reported. In conclusion, although there has been an increase in the publication related to FeL in Brazil in recent years, there is a lack of research relating immune response and diagnosis of these animals. Cats have been shown to be competent hosts for Leishmania parasites, and their role in the epidemiology of the disease cannot be underestimated, especially in areas of Brazil where the disease is historically endemic.
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Affiliation(s)
- Luiz F J Nascimento
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Tatyane M Cirilo
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Dharliton S Gomes
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Ana Carolina A Gomes
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Victor F S Lima
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - R Scher
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, SE, 49100-000, Brazil
- Departamento de Morfologia, Instituto de Ciências Biológicas e da Saúde, Universidade Federal de Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - S Jain
- Programa de Pós-Graduação em Biotecnologia Industrial, Universidade Tiradentes, Aracaju, SE, 49032-490, Brazil
| | - Ricardo T Fujiwara
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, SE, 49100-000, Brazil.
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil.
| | - Silvio S Dolabella
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, SE, 49100-000, Brazil.
- Departamento de Morfologia, Instituto de Ciências Biológicas e da Saúde, Universidade Federal de Sergipe, São Cristóvão, SE, 49100-000, Brazil.
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11
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Dos Santos NS, de Pinho FA, Hlavac NRC, Nunes TL, Almeida NR, Solcà MS, Varjão BM, Portela RW, Rugani JN, Rêgo FD, Barrouin-Melo SM, Soares RP. Feline Leishmaniasis Caused by Leishmania infantum: Parasite Sequencing, Seropositivity, and Clinical Characterization in an Endemic Area From Brazil. Front Vet Sci 2021; 8:734916. [PMID: 34513979 PMCID: PMC8424124 DOI: 10.3389/fvets.2021.734916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
Zoonotic leishmaniasis caused by Leishmania infantum is a disease of One Health concern since human and animal cases and environmental damage are interconnected. L. infantum has a complex epidemiological cycle with multiple hosts, including mammals-humans, domestic, and wild animals-and arthropod vectors. Knowledge on mammal infections in endemic areas is crucial for developing control strategies. This work aimed to detect and characterize L. infantum infection in domestic cats from areas where human and canine leishmaniasis cases occur. No cases of feline leishmaniasis (FeL) had been previously reported in those areas. Five municipalities from Bahia state were chosen, comprising 2,480.8 km2 with 1,103,866 inhabitants. Ninety domiciliated and/or sheltered cats underwent clinical examination and serology by a rapid reference test recommended by the Brazilian government. Cytology, PCR, and parasite DNA sequencing were performed in bone marrow samples. Rapid tests detected antibodies in 5.6% (5/90) of the cats. Leishmania infantum infection was confirmed in 7.8% (7/90) of the cats by PCR, sequencing, and parasite isolation. Three out of the five municipalities (60%) had infected cats, and PCR positivity varied from 6.9 to 29%. One cat was categorized as harboring active L. infantum infection with amastigote forms in bone marrow smears. No clinical signs were detected at the first clinical exam, but 1 month later the cat developed severe FeL. The cat isolate was grown in culture, typed and its DNA sequence was homologous to the L. infantum reference strain (PP75). In conclusion, cats are potential hosts and may acquire L. infantum in endemic areas where canine and human cases occur. For cats, the need for surveillance, differential diagnosis and clinical care is highly recommended since a fast clinical progression of FeL developed in a subclinical animal. An accurate standardized immunodiagnostic assay for FeL is warranted.
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Affiliation(s)
- Nara Santos Dos Santos
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Flaviane Alves de Pinho
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia (UFBA), Salvador, Brazil.,Department of Veterinary Anatomy, Pathology and Clinics of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Nicole Regina Capacchi Hlavac
- Department of Veterinary Anatomy, Pathology and Clinics of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Talyta Lins Nunes
- Department of Veterinary Anatomy, Pathology and Clinics of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Nádia Rossi Almeida
- Department of Veterinary Preventive Medicine and Animal Production of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Manuela Silva Solcà
- Department of Veterinary Preventive Medicine and Animal Production of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Bruno Milen Varjão
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Ricardo Wagner Portela
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | | | - Felipe Dutra Rêgo
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Stella Maria Barrouin-Melo
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia (UFBA), Salvador, Brazil.,Department of Veterinary Anatomy, Pathology and Clinics of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
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12
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Feline Leishmaniosis: An Emerging Public Health Problem. Vet Sci 2021; 8:vetsci8090173. [PMID: 34564567 PMCID: PMC8473070 DOI: 10.3390/vetsci8090173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 11/17/2022] Open
Abstract
Leishmaniosis is the third most important vector-borne disease in humans, preceded by malaria and lymphatic filariasis, and it is considered endemic in tropical and subtropical areas, where higher temperatures favor development of its vector, sandflies. This zoonotic disease is caused by infection of protozoa Leishmania spp. and the most serious mucocutaneous and visceral form is produced by Leishmania infantum, which predominates in the Mediterranean region. The usual hosts for this parasite are dogs and humans, but an increment in cases of L. infantum infection has been observed in cats in the last years. This increase could be due to the use of sandflies repellents in dogs, obligating the parasite to looking for other hosts. The role of cats in the epidemiology of this disease is unknown, although increase of prevalence of feline leishmaniosis has been observed in endemic areas in the last years. Diagnostic techniques and treatments in cats are not standardized, which makes it difficult to establish prevalence and epidemiology of feline leishmaniosis. Furthermore, the clinical signs and immune response against Leishmania in cats are different to those in dogs, with an observed increment of drug resistance. It is necessary to increase our knowledge about L. infantum infection in cats, including clinical signs, transmission, treatments, and the role of cats in the increasing of zoonoses. Finally, new alternative treatments are required for controlling the spread of this disease in all species of mammals.
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Pereira A, Maia C. Leishmania infection in cats and feline leishmaniosis: An updated review with a proposal of a diagnosis algorithm and prevention guidelines. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2021; 1:100035. [PMID: 35284863 PMCID: PMC8906079 DOI: 10.1016/j.crpvbd.2021.100035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/27/2021] [Indexed: 04/15/2023]
Abstract
Leishmaniosis is a vector-borne disease caused by protozoans of the genus Leishmania, which are transmitted to vertebrates, including cats, through the bites of female phlebotomine sand flies. An increasing number of epidemiological and experimental studies concerning Leishmania infection in cats, as well as case reports of clinical leishmaniosis in these felids, have been published in recent years. In the present study, a comprehensive review was made by sourcing the National Library of Medicine resources to provide updated data on epidemiology, immunopathogenesis, diagnosis, treatment, and prevention of feline leishmaniosis. Cats were found infected with Leishmania parasites worldwide, and feline leishmaniosis appears as an emergent disease mostly reported in countries surrounding the Mediterranean Sea and in Brazil. Cats with impaired immunocompetence seem to have a higher risk to develop clinical disease. The main clinical and clinicopathological findings are dermatological lesions and hypergammaglobulinemia, respectively. Diagnosis of feline leishmaniosis remains a challenge for veterinarians, in part due to the lack of diagnosis support systems. For this reason, a diagnostic algorithm for clinical decision support is herein proposed. No evidence-based treatment protocols are currently available, and these remain empirically based. Control measures are limited and scarce. Thus, a set of prevention guidelines are herein suggested.
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Affiliation(s)
- André Pereira
- Global Health and Tropical Medicine (GHMT), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa, 1349-008 Lisboa, Portugal
| | - Carla Maia
- Global Health and Tropical Medicine (GHMT), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa, 1349-008 Lisboa, Portugal
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14
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Abramo F, Albanese F, Gattuso S, Randone A, Fileccia I, Dedola C, Ibba F, Ottaiano P, Brianti E. Skin Lesions in Feline Leishmaniosis: A Systematic Review. Pathogens 2021; 10:472. [PMID: 33924616 PMCID: PMC8070508 DOI: 10.3390/pathogens10040472] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
Feline leishmaniosis (FeL) is increasingly reported throughout the world and skin lesions predominate in the clinical picture. There are, however, few evidence-based data on cutaneous feline leishmaniosis and directions are strongly needed for a better management of the disease. In this study, we systematically reviewed what is currently known about the clinical dermatological presentation of FeL through analysis of the literature and, further, by adding unpublished cases managed by Italian veterinary dermatologists. Sixty-six feline cases of cutaneous leishmaniosis published in 33 articles between 1990 and 2020 met the inclusion criteria and were analyzed. Six unpublished cases of cutaneous FeL managed by Italian dermatologists were also reviewed. The majority of cases were reported from South America, followed by Europe and North America. Nodules were the most frequently reported clinical signs and the presence of Leishmania in lesioned skin was assessed mainly by cytology. A total of six Leishmania species have been identified as being responsible for skin lesions. Coinfections by FIV or FeLV were reported in 12.1% and 9.1% of the cases, respectively. Clinical data including treatment have been analyzed and discussed to provide directives for proper management of the disease for which cats may also serve as domestic reservoirs for human infections.
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Affiliation(s)
- Francesca Abramo
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy
| | - Francesco Albanese
- Private Veterinary Laboratory “LaVallonea”, 20017 Passirana di Rho, Italy;
| | | | | | - Ivan Fileccia
- Ambulatorio Veterinario Preneste, Centro Veterinario Specialistico, 00137 Rome, Italy;
| | - Carla Dedola
- Centro Veterinario Ichnos, 09131 Cagliari, Italy;
| | - Fabrizio Ibba
- Clinica Veterinaria Animal House, 09012 Capoterra, Italy;
| | | | - Emanuele Brianti
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy;
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15
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Hopke K, Meyers A, Auckland L, Hamer S, Florin D, Diesel A, Patterson A. Leishmania mexicana in a central Texas cat: clinical presentation, molecular identification, sandfly vector collection and novel management. JFMS Open Rep 2021; 7:2055116921999595. [PMID: 33815814 PMCID: PMC7995465 DOI: 10.1177/2055116921999595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Case summary This case report documents the clinical appearance, diagnosis and novel treatment of a central Texas cat with cutaneous leishmaniosis. The cat presented with a linear erosion on the right pinnal margin, an ulcerated exophytic nodule on the right hock and a swelling in the right nostril. Cytological and histopathological findings were consistent with leishmaniosis. PCR confirmed the presence of Leishmania mexicana, a species endemic to Texas. An epidemiological investigation was conducted by trapping sandflies from the cat’s environment. Sandflies collected were identified as Lutzomyia species, known vectors of Leishmania species. Given the lack of validated medical therapies for L mexicana in cats, treatments typically prescribed for canine leishmaniosis were administered. Allopurinol achieved clinical success but was discontinued due to suspected drug-related neutropenia. Topical imiquimod also improved lesional skin but was not sustainable due to application difficulty. Oral administration of artemisinin resulted in significant clinical improvement of cutaneous lesions without reported adverse events. Nearly 8 months after the initiation of artemisinin therapy, the cat remained systemically healthy with stable lesions. Relevance and novel information This case report demonstrates endemic feline leishmaniosis in central Texas and provides the clinician with alternative therapeutic options for medical management.
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Affiliation(s)
- Kaitlin Hopke
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, USA
| | - Alyssa Meyers
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, USA
| | - Lisa Auckland
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, USA
| | - Sarah Hamer
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, USA
| | | | - Alison Diesel
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, USA
| | - Adam Patterson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, USA
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Cardoso L, Schallig H, Persichetti MF, Pennisi MG. New Epidemiological Aspects of Animal Leishmaniosis in Europe: The Role of Vertebrate Hosts Other Than Dogs. Pathogens 2021; 10:pathogens10030307. [PMID: 33800782 PMCID: PMC8000700 DOI: 10.3390/pathogens10030307] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 12/20/2022] Open
Abstract
Infection with Leishmania parasites can lead to severe disease in humans and dogs, which act as a reservoir in zoonotic transmission. An increasing number of reports suggest that leishmaniosis is not restricted to dogs, but also affects many other mammalian and avian species. Consequently, this expands the potential reservoir and is of great public and veterinary health concern. The present study reviews, based on a comprehensive search of scientific literature published from 1 January 2001 to 31 December 2020, the currently available information on animal leishmaniosis in vertebrates in Europe, other than dogs and humans. This review provides an exhaustive list of mammals and birds in which infections with or exposure to Leishmania parasites have been detected in European countries. Most cases are reported from the Mediterranean region. Domestic animals, in particular cats, pose a concern because of close contact with humans. The wildlife reservoir is less likely to contribute to zoonotic transmission, with the exception of hares. This potentially large reservoir needs to be taken into account when developing control measures for zoonotic leishmaniosis. From a veterinary point of view, it is important that veterinarians are better aware of leishmaniosis and trained in its management.
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Affiliation(s)
- Luís Cardoso
- Department of Veterinary Sciences, and Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Correspondence:
| | - Henk Schallig
- Department of Medical Microbiology, Experimental Parasitology Section, Amsterdam University Medical Centres, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Maria Flaminia Persichetti
- Department of Veterinary Sciences, University of Messina, Polo Universitario Annunziata, 98168 Messina, Italy; (M.F.P.); (M.G.P.)
| | - Maria Grazia Pennisi
- Department of Veterinary Sciences, University of Messina, Polo Universitario Annunziata, 98168 Messina, Italy; (M.F.P.); (M.G.P.)
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Feline Leishmania spp . Infection in a Non-Endemic Area of Northern Italy. Animals (Basel) 2020; 10:ani10050817. [PMID: 32397321 PMCID: PMC7278790 DOI: 10.3390/ani10050817] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Leishmaniosis caused by Leishmania infantum is a parasitic disease of people and animals transmitted by sand fly vectors. Although dogs in south and central Italy are most affected, in recent decades feline leishmaniosis (FeL) has become an emerging disease. This study aimed to update information on the presence of FeL in stray cats in Milan, in northern Italy; to compare these results with previous studies performed in the same area; and to report aspects of Leishmania infection in cats. A total of 117 stray cats were included and 10 (8.6%) had L. infantum infection. The parasite was identified in popliteal lymph nodes in five cats and five had antibodies against L. infantum. Most infected cats were from a specific area of Milan. Increased gammaglobulins were seen in infected cats, which also had antibodies against the pathogens Anaplasma phagocytophilum, Chlamydophila felis, and Toxoplasma gondii. There was a high prevalence of FeL in the surveyed area of northern Italy. Further studies are needed to understand if these infected cats are being imported from other areas, or if there is a real Leishmania focus in Milan. Investigation of the presence of sand fly vectors in Milan would be useful. Abstract Feline leishmaniosis (FeL) is an emerging vector-borne feline disease, with increasing numbers of cases reported and studies performed internationally. This study aimed to update the epidemiological status for FeL in stray cats in Milan, northern Italy; compare these results with previous studies in Northern Italy; and report clinicopathologic findings and coinfections in cats infected with Leishmania spp. A total of 117 cats were tested for L. infantum and retrovirus infection, hematological, and biochemical parameters. Demographic and clinical data were collected and FeL affected cats screened for selected coinfections. Overall, 10/117 (8.6%) cats tested positive for L. infantum: in five cats L. infantum DNA was found in popliteal lymph nodes and five were IFAT seropositive at titers from 1:80 to 1:160. Infected cats were concentrated in a specific area of Milan (p = 0.0154). No specific clinicopathologic abnormalities or retroviral infections were significantly linked to the infection, other than hypergammaglobulinemia (p = 0.0127). Seroreactivity to Anaplasma phagocytophilum, Chlamydophila felis, and Toxoplasma gondii was found in some infected cats. A high prevalence of FeL was found in a non-endemic area of northern Italy and future studies should continually monitor this data to understand whether these cases are imported or if Leishmania vectors are present in this area.
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Pereira A, Valente J, Parreira R, Cristovão JM, Azinheira S, Campino L, Maia C. An Unusual Case of Feline Leishmaniosis With Involvement of the Mammary Glands. Top Companion Anim Med 2019; 37:100356. [PMID: 31837752 DOI: 10.1016/j.tcam.2019.100356] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/31/2019] [Accepted: 08/15/2019] [Indexed: 11/19/2022]
Abstract
We report an unusual case of leishmaniosis with the involvement of mammary glands in an old cat with what seems to be a concurrent regressive feline leukemia virus infection. Leishmania donovani complex parasites were identified for the first time in inflammatory breast fluid during a clinical recurrence manifested about 4 years after the first diagnosis of feline leishmaniosis. Combined treatment with allopurinol and meglumine antimoniate resulted in clinical cure of mammary lesion and a concurrent uveitis.
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Affiliation(s)
- André Pereira
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (NOVA), Lisbon, Portugal; Medical Parasitology Unit, IHMT, NOVA, Lisbon, Portugal
| | | | - Ricardo Parreira
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (NOVA), Lisbon, Portugal; Medical Microbiology Unit, IHMT, NOVA, Lisbon, Portugal
| | - José Manuel Cristovão
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (NOVA), Lisbon, Portugal; Medical Parasitology Unit, IHMT, NOVA, Lisbon, Portugal
| | | | - Lenea Campino
- Medical Parasitology Unit, IHMT, NOVA, Lisbon, Portugal
| | - Carla Maia
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (NOVA), Lisbon, Portugal; Medical Parasitology Unit, IHMT, NOVA, Lisbon, Portugal.
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