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Lazzeroni M, Reato S, Antinori S, Milazzo L, Pignataro L, Cantarella G. Laryngeal Leishmaniasis: A Neglected, Emerging Disease in Northern Italy. J Voice 2024:S0892-1997(24)00124-3. [PMID: 38658203 DOI: 10.1016/j.jvoice.2024.04.006] [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: 02/20/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
Leishmaniasis represents an emerging public health issue in Mediterranean countries. The incidence of this condition has progressively risen in Northern Italy due to the growing number of immunocompromised people and probably due to climate changes. We hereby describe a case of relapsing laryngeal leishmaniasis in a female immunocompetent patient, presenting as aspecific chronic laryngitis. She was affected by severe asthma treated by inhaled steroid therapy, likely responsible for the parasite's diffusion through a locus minori resistentiae. The aspecific clinical presentation led to a delayed diagnosis and the lack of guidelines for the treatment caused multiple relapses. Biopsies of laryngeal lesions in the follow-up were performed by operative flexible videolaryngoscopy, thus avoiding general anesthesia and reducing associated healthcare costs. The aim of this report is to underline the diagnostic and therapeutic challenges that patients with this condition face and to present what is, to the best of our knowledge, the first application of prophylactic aerosolized pentamidine for relapsing laryngeal leishmaniasis.
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Affiliation(s)
- Matteo Lazzeroni
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Serena Reato
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Dipartimento di Malattie Infettive, ASST-FBF-Sacco, Milan, Italy
| | - Spinello Antinori
- Dipartimento di Malattie Infettive, ASST-FBF-Sacco, Milan, Italy; Dipartimento di Scienze Biomediche e Cliniche Luigi Sacco, Università degli Studi di Milano, Milan, Italy
| | - Laura Milazzo
- Dipartimento di Malattie Infettive, ASST-FBF-Sacco, Milan, Italy
| | - Lorenzo Pignataro
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giovanna Cantarella
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Zakariaei Z, Fakhar M, Bari S, Derakhshani M, Banimostafavi ES, Soleymani M. Nasal Leishmaniasis Misdiagnosed With Intranasal Polyp in a Patient Candidate for Rhinoplasty. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2023; 16:11795476231186913. [PMID: 37799763 PMCID: PMC10548795 DOI: 10.1177/11795476231186913] [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: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 10/07/2023]
Abstract
Mucosal leishmaniasis (ML) is a chronic and rare form of leishmaniasis that causes malignant lesions in the mucosa of the nasal, pharyngeal, and laryngeal regions. We describe a 29-year-old woman who had been suffering from an intranasal polyp for 3 years. The polyp recurred annually after surgical removal, and was diagnosed as nasal leishmaniasis.
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Affiliation(s)
- Zakaria Zakariaei
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
- Toxicology and Forensic Medicine Division, Mazandaran Registry Center for Opioids Poisoning, Antimicrobial Resistance Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Fakhar
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Simin Bari
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Derakhshani
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elham Sadat Banimostafavi
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Radiology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mostafa Soleymani
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
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Ibrahim H, Hamid KAE, Aziz TAE, Samir El bahwashy A, Khattab H, Aaref B, Elsayed E. Nasal mucocutaneous leishmaniasis (MCL) with necrotizing granulomatous inflammation inducing cytotoxic T-cell lymphoma in a male Yemeni patient. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2023; 35:37. [DOI: 10.1186/s43162-023-00219-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/19/2023] [Indexed: 09/01/2023] Open
Abstract
AbstractLeishmaniasis is a protozoal infection transmitted by sandfly vector; there are three main types of leishmaniasis: cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL), and visceral leishmaniasis (VL). Herein, we present a case of endonasal mucocutaneous leishmaniasis in a 34-year-old Yemeni patient who presented with disfiguring nasal swelling associated with fever, a swab from the lesion and direct microscopic examination proved to have mucocutaneous leishmaniasis; he was successfully treated with intravenous antimonial stibogluconate, 1 month after treatment biopsy from the lesion revealed cytotoxic T-cell lymphoma, the purpose is to alert the physicians and otolaryngologists to consider leishmaniasis in the differential diagnosis of nasal granulomas and also to highlight the importance of early diagnosis of cancer in survivors of cutaneous leishmaniasis, especially in areas where cutaneous leishmaniasis is still highly prevalent, as the chronic local inflammation may disfigure the face if not recognized early and adequately treated; also, early cancer diagnosis can prevent mortality
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Bajgai GP, Tshering S, Pradhan B, Pradhan AR, Yangzom P. Oral mucosal leishmaniasis presenting as a nonhealing chronic oral growth: A case report. Clin Case Rep 2023; 11:e7234. [PMID: 37155420 PMCID: PMC10122684 DOI: 10.1002/ccr3.7234] [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: 12/13/2022] [Revised: 03/21/2023] [Accepted: 04/05/2023] [Indexed: 05/10/2023] Open
Abstract
Oral mucosal leishmaniasis is a rare finding posing challenges in the diagnosis and treatment in a nonendemic setting. This disease is present in dental clinics as nonhealing chronic growth. Timely diagnosis and appropriate treatment are crucial to prevent further complications and death.
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Affiliation(s)
- Gyan Prasad Bajgai
- Department of DentistryJigme DorjiWangchuck National Referral HospitalThimphuBhutan
| | - Sangay Tshering
- Department of Obstetrics & GynecologyJigme Dorji Wangchuck National Referral HospitalThimphuBhutan
| | - Birendra Pradhan
- Department of Laboratory MedicineJigme Dorji Wangchuck National Referral HospitalThimphuBhutan
| | - Ambika Rani Pradhan
- Department of DermatologyJigme Dorji Wangchuck National Referral HospitalThimphuBhutan
| | - Pema Yangzom
- Department of DentistryJigme DorjiWangchuck National Referral HospitalThimphuBhutan
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Bahrami S, Oryan A, Bemani E. Anti-leishmanial, immunomodulatory and anti-oxidative activity of quercetin against cutaneous leishmaniasis caused by Leishmania major. Asian Pac J Trop Biomed 2023. [DOI: 10.4103/2221-1691.367689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Laboratory diagnostics for human Leishmania infections: a polymerase chain reaction-focussed review of detection and identification methods. Parasit Vectors 2022; 15:412. [PMID: 36335408 PMCID: PMC9636697 DOI: 10.1186/s13071-022-05524-z] [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: 07/28/2022] [Accepted: 10/02/2022] [Indexed: 11/08/2022] Open
Abstract
Leishmania infections span a range of clinical syndromes and impact humans from many geographic foci, but primarily the world's poorest regions. Transmitted by the bite of a female sand fly, Leishmania infections are increasing with human movement (due to international travel and war) as well as with shifts in vector habitat (due to climate change). Accurate diagnosis of the 20 or so species of Leishmania that infect humans can lead to the successful treatment of infections and, importantly, their prevention through modelling and intervention programs. A multitude of laboratory techniques for the detection of Leishmania have been developed over the past few decades, and although many have drawbacks, several of them show promise, particularly molecular methods like polymerase chain reaction. This review provides an overview of the methods available to diagnostic laboratories, from traditional techniques to the now-preferred molecular techniques, with an emphasis on polymerase chain reaction-based detection and typing methods.
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Bhowate RR, Bhargava PA, Badki SD, Meshram M. Mucosal Leishmaniasis Involving the Nostril and Maxillary Sinus: A Case Report. Cureus 2022; 14:e30289. [PMID: 36381698 PMCID: PMC9650962 DOI: 10.7759/cureus.30289] [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: 09/22/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022] Open
Abstract
An eight-year-old child presented with nasal discharge, stuffiness, and whitish polypoid swelling in the left nostril with Bitot’s spot. Computed tomography (CT) evaluation showed complete involvement of the left nostril and maxillary sinus. Blood investigations revealed leukocytosis, raised absolute eosinophils, increased alkaline phosphatase, and reduced vitamin A levels. Histopathological examination revealed inflammatory infiltrate with Leishman-Donovan bodies, which confirms the diagnosis of mucosal leishmaniasis (ML). In the present case, the recording of demographic data is important as the child was a migrant from the leishmaniasis-endemic area of Bihar state, India. Nasal polypoid growth was removed by endoscopic surgery, followed by a combination of allopathic and polyherbal preparation. The child responded well to these therapeutic measures, and there was no recurrence of nasal discharge, stuffiness, and crustation at six-month follow-up.
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Oranges T, Veraldi S, Granieri G, Fidanzi C, Janowska A, Dini V, Romanelli M. Parasites causing cutaneous wounds: Theory and practice from a dermatological point of view. Acta Trop 2022; 228:106332. [PMID: 35092728 DOI: 10.1016/j.actatropica.2022.106332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 11/27/2022]
Abstract
A wide range of parasites can infest open wounds, or cause wounds due to the effects of the infestation. Parasitic infestations can involve the skin and subcutaneous tissues, with various clinical manifestations. In case of cutaneous wounds related to infestations, protozoa, helminths and arthropods are the main groups of parasites involved and emerging new aspects have been recently reported. Treating the wound correctly is fundamental in these patients in order to reduce the development of pathological scars and prevent complications. In particular, a gentle debridement for devitalized/infested tissue removal, the appropriate use of topical antiseptics and dressings such as hydrogel, hydrocolloids and antimicrobial dressings can be useful to control superinfections, moisture balance, inflammation and to promote edge proliferation.
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Affiliation(s)
- Teresa Oranges
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy; Department of Pediatrics, Dermatology Unit, Meyer Children's University Hospital, Florence, Italy
| | - Stefano Veraldi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giammarco Granieri
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Cristian Fidanzi
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Agata Janowska
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Valentina Dini
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Marco Romanelli
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy.
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Histological evaluation of skin lesions induced by Leishmania braziliensis treated by PACT using Laser light and 1.9 dimethyl-methylene blue. Photodiagnosis Photodyn Ther 2022; 38:102815. [DOI: 10.1016/j.pdpdt.2022.102815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/22/2022]
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Botelho MCB, Ferreira LL, Fikaris S, Prado-Ribeiro AC, Soubhia AMP, Biasoli ER, Miyahara GI, Bernabé DG. Tongue Nodule as Primary Manifestation of American Cutaneous Leishmaniasis in an Immunocompetent Patient. Head Neck Pathol 2021; 15:1069-1073. [PMID: 33372239 PMCID: PMC8384968 DOI: 10.1007/s12105-020-01253-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 11/17/2020] [Indexed: 01/01/2023]
Abstract
Leishmaniasis is a parasitic disease considered an endemic public health problem in developing countries, where it is a reportable disease. Isolated oral manifestation is rare, and its clinical manifestations are variable. In this paper we describe an unusual case of an immunocompetent patient, 57-year-old man with a painless reddish submucosal nodule located on the tongue dorsum. Microscopical analysis showed chronic inflammatory infiltrate with macrophages containing leishmania in cytoplasmic vacuoles. PCR assays confirmed the diagnosis and patient was treated with meglumine antimoniate for 30 days. Absence of the parasite was confirmed by PCR. Thirteen years after treatment, a scar fibrosis persisted on the tongue dorsum. The case reported reveals that leishmaniasis should be considered in the diagnosis of tongue nodules in immunocompetent patients.
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Affiliation(s)
- Maria Clara Bertolini Botelho
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Lígia Lavezo Ferreira
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Stelios Fikaris
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Ana Carolina Prado-Ribeiro
- Dental Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), University of São Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Ana Maria Pires Soubhia
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Eder Ricardo Biasoli
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Glauco Issamu Miyahara
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Daniel Galera Bernabé
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil.
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil.
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Silveira HA, Panucci BZM, Silva EV, Mesquita ATM, León JE. Microscopical Diagnosis of Oral Leishmaniasis: Kinetoplast. Head Neck Pathol 2021; 15:1085-1086. [PMID: 33599946 PMCID: PMC8385019 DOI: 10.1007/s12105-021-01304-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Heitor Albergoni Silveira
- grid.11899.380000 0004 1937 0722Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, SP Brazil
| | - Beatriz Zamboni Martins Panucci
- grid.11899.380000 0004 1937 0722Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, SP Brazil
| | - Evanio Vilela Silva
- grid.11899.380000 0004 1937 0722Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, SP Brazil
| | - Ana Terezinha Marques Mesquita
- Department of Dentistry, Clinical Stomatology, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, MG Brazil
| | - Jorge Esquiche León
- grid.11899.380000 0004 1937 0722Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, SP Brazil
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Pinheiro ABS, Kurizky PS, Ferreira MDF, Mota MADS, Ribeiro JS, Oliveira Filho EZD, Souza CA, Barroso DH, Sampaio RNR, Gomes CM. The accuracy of the Montenegro skin test for leishmaniasis in PCR-negative patients. Rev Soc Bras Med Trop 2020; 53:e20190433. [PMID: 32348430 PMCID: PMC7198066 DOI: 10.1590/0037-8682-0433-2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/11/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION As highly specific molecular biology-based techniques may not be sensitive enough for the diagnosis of American tegumentary leishmaniasis (ATL), clinicians frequently rely on immunological tests before treatment initiation. Hence, the correct combination of diagnostic tests is imperative for ATL diagnosis. We aimed to evaluate the accuracy of the Montenegro (Leishmanin) skin test (MST) in polymerase chain reaction (PCR)-negative patients to accurately detect ATL. METHODS Patients with a clinical picture compatible with ATL were divided into ATL (confirmed by lesion smear, culture indirect immunofluorescence, and/or histopathology) and no-ATL (diseases that can mimic leishmaniasis) groups. Conventional PCR for the minicircle kDNA of Leishmania was performed, and the MST was carried out for PCR-negative patients. RESULTS Ninety-nine patients were included in this study, including 79 diagnosed with ATL (6 with mucocutaneous leishmaniasis) and 20 without ATL (no-ATL group). The MST showed a high sensitivity of 90.0% (95% confidence interval [CI] = 69.90-97.21) in PCR-negative patients that was 10% higher than the sensitivity reported in PCR-positive population (79.66%; 95% CI = 67.73-87.96). CONCLUSIONS One of the most important reasons for PCR negativity among patients with active ATL is the presence of a strong cellular immunological response, especially in chronic and mucocutaneous leishmaniasis. This reinforces the considerable utility of the tests that detect cellular responses against Leishmania antigens such as the MST in PCR-negative patients when the performance in screening situations is questionable.
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Affiliation(s)
| | - Patricia Shu Kurizky
- Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil
| | | | | | | | | | - Carlos Augusto Souza
- Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil
| | - Daniel Holanda Barroso
- Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil
| | | | - Ciro Martins Gomes
- Núcleo de Medicina Tropical, Universidade de Brasília, Brasília, DF, Brasil
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Sabzevari S, Mohebali M, Hashemi SA. Mucosal and mucocutaneous leishmaniasis in Iran from 1968 to 2018: a narrative review of clinical features, treatments, and outcomes. Int J Dermatol 2020; 59:606-612. [PMID: 31943166 DOI: 10.1111/ijd.14762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 11/12/2019] [Accepted: 12/02/2019] [Indexed: 12/12/2022]
Abstract
Leishmaniases are worldwide zoonotic infectious diseases caused by different types of intracellular protozoan species of the genus Leishmania. Leishmaniasis as an important vector-borne parasitic disease is transmitted between mammalian hosts by female sandflies. There are three main clinical forms of disease with varied severity: visceral leishmaniasis (VL), cutaneous leishmaniasis (CL), and mucocutaneous leishmaniasis (MCL). MCL is the most uncommon form of this syndrome in the Old World. Accordingly, the reports have characterized that patients with the involvement of mucous membranes are rare even in endemic areas. It is well-known that MCL is a rare clinical manifestation in Iran, but there have been several different cases of patients with mucosal (ML) or MCL in some parts of Iran during the past 50 years. Therefore, we aimed to report and present clinical and epidemiological features of ML or MCL in different regions of the country. Also, we demonstrated specified Leishmania species causing the ML in some cases. The present narrative review indicates that ML or MCL is not unexpected in Iran. Based on the findings of the recent studies, it is concluded that diagnosis of ML should be considered by physicians in Iran.
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Affiliation(s)
- Sadaf Sabzevari
- Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ahmad Hashemi
- Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Sánchez-Romero C, Júnior HM, Matta VLRD, Freitas LM, Soares CDM, Mariano FV, de Almeida OP, Nascimento de Aquino S. Immunohistochemical and Molecular Diagnosis of Mucocutaneous and Mucosal Leishmaniasis. Int J Surg Pathol 2019; 28:138-145. [PMID: 31566041 DOI: 10.1177/1066896919876706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Leishmaniasis is a parasitic infection transmitted by the bite of infected female sandflies. It principally affects the skin, and the frequency of mucosal involvement is about 5% to 20%. Considering the rarity of leishmaniasis affecting the upper aerodigestive tract mucosa, we evaluated the characteristics of mucocutaneous leishmaniasis and mucosal leishmaniasis and the diagnostic difficulty when the parasites are scarce in tissue samples. The clinical, histopathological, histochemical, immunohistochemical, and molecular features of 17 cases of mucocutaneous leishmaniasis and mucosal leishmaniasis were assessed. Mucosal disease was principally found in the soft palate, oropharynx, and nose, manifesting mainly as a solitary ulcer. In hematoxylin and eosin-stained sections, 10 cases revealed abundant amastigotes within the macrophages. Giemsa staining was not shown to be helpful to confirm the diagnosis in 6 cases with scarce or nondetectable amastigotes. Immunohistochemistry (IHC) showed high sensitivity by positive staining in 14 out of 17 cases (82.3%). Polymerase chain reaction was shown to be more sensitive than IHC with 13 out of 14 (92.8%) positive cases, including the 3 IHC negative cases; however, this technique is not available in many endemic regions. In summary, we suggest that the IHC is a simple technique with rapid results and relatively low cost, when compared with other laboratorial procedures; thus, IHC is a helpful tool that should be implemented in the routine diagnosis of leishmania.
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Affiliation(s)
- Celeste Sánchez-Romero
- University of Campinas (UNICAMP), Piracicaba, Brazil.,Universidad de la República, Montevideo, Uruguay
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Fekri-SoofiAbadi M, Fekri M, Moradabadi A, Vahidi R, Shamsi-Meymandi S, Dabiri D, Dabiri S. Ability of real-time PCR for differential diagnosis of various forms of cutaneous leishmaniasis: a comparative study with histopathology. BMC Res Notes 2019; 12:615. [PMID: 31547842 PMCID: PMC6757515 DOI: 10.1186/s13104-019-4666-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/18/2019] [Indexed: 11/30/2022] Open
Abstract
Objective Histopathological studies suggest that parasite load is different between acute and chronic forms of cutaneous leishmaniasis (CL). However, highly sensitive detection methods are still needed to distinguish different forms of leishmaniasis. In the present study, we developed a quantitative real-time polymerase chain reaction (PCR) to detect and quantify Leishmania tropica parasites in paraffin-embedded tissue samples. Results The ability of real-time PCR for leishmania detection was higher than histopathological evaluation. The quantitative real-time PCR (qPCR) quantified parasite loads were highly correlated with microscopic results (r = 0.598; P < 0.001). Among patients, the parasite load was inversely correlated with disease duration (acute CL lesions had very higher parasite load than chronic CL lesions), but there was no difference in the parasite load according to the patients’ age and sex as well as location of the lesions. In contrast to Ridley scoring system (P < 0.001), there were no statistically significant differences in the relative number of parasites among the lupoid and non-lupoid forms of chronic lesions in real-time PCR (P = 0.549), which indicates the superiority of histopathological evaluation for chronic forms differentiation.
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Affiliation(s)
- Maryam Fekri-SoofiAbadi
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour Medical School, Kerman University of Medical Sciences, 22 Bahman Blvd, 7616913555, Kerman, Iran
| | - Meisam Fekri
- Department of Medicine, Montefiore New Rochelle Hospital, Albert Einstein College of Medicine, New York, USA
| | - Alireza Moradabadi
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour Medical School, Kerman University of Medical Sciences, 22 Bahman Blvd, 7616913555, Kerman, Iran
| | - Reza Vahidi
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour Medical School, Kerman University of Medical Sciences, 22 Bahman Blvd, 7616913555, Kerman, Iran
| | - Simin Shamsi-Meymandi
- Dermatology Department, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Donya Dabiri
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour Medical School, Kerman University of Medical Sciences, 22 Bahman Blvd, 7616913555, Kerman, Iran
| | - Shahriar Dabiri
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour Medical School, Kerman University of Medical Sciences, 22 Bahman Blvd, 7616913555, Kerman, Iran.
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Bemani E, Oryan A, Bahrami S. Effectiveness of amiodarone in treatment of cutaneous leishmaniasis caused by Leishmania major. Exp Parasitol 2019; 205:107747. [PMID: 31442454 DOI: 10.1016/j.exppara.2019.107747] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/17/2019] [Accepted: 08/19/2019] [Indexed: 01/19/2023]
Abstract
Development of new chemotherapeutic agents is an essential issue in the treatment and control of a disease. This study aimed to evaluate the anti-leishmanial activity of amiodarone, an antiarrhythmic class III drug, against Leishmania major, the most prevalent etiological agent of cutaneous leishmaniasis in the old world. The proliferation of promastigotes and intracellular amastigotes in the absence or presence of amiodarone was estimated, in an in vitro study. For in vivo study, five weeks after infection of BALB/c mice with L. major, when the lesions appeared at the injection site, the mice were divided into four groups (n = 6 each); treatment was conducted for 28 consecutive days with vehicle, amiodarone at 40 mg/kg orally and glucantime at 60 mg/kg intraperitoneally. Therapy with amiodarone reduced the size of lesions compared to the untreated group after 12 days. Amiodarone decreased the parasite load and inflammatory responses, particularly the macrophages containing amastigotes, and enhanced granulation tissue formation in the dermis and subcutaneous area. The Tumor necrosis factor-α and Interleukin-6 levels were significantly lower in the cell culture supernatants of the inguinal lymph node in the amiodarone treated group compared to the vehicle and untreated groups. Amiodarone significantly increased the activity of glutathione peroxidase in comparison to the vehicle and untreated groups but did not affect the plasma levels of superoxide dismutase, malondialdehyde, adiponectin, and ferric reducing ability of plasma. Therefore, the anti- L. major activity and immunomodulatory effects of amiodarone reduced the parasitic load and enhanced wound healing in cutaneous leishmaniasis in BALB/c mice. Amiodarone reduced the lesion surface area, but it did not cure it completely.
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Affiliation(s)
- E Bemani
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - A Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
| | - S Bahrami
- Department of Parasitology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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17
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Jayasena Kaluarachchi TD, Weerasekera MM, McBain AJ, Ranasinghe S, Wickremasinghe R, Yasawardene S, Jayanetti N, Wickremasinghe R. Diagnosing Cutaneous leishmaniasis using Fluorescence in Situ Hybridization: the Sri Lankan Perspective. Pathog Glob Health 2019; 113:180-190. [PMID: 31429388 DOI: 10.1080/20477724.2019.1650228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Cutaneous leishmaniasis (CL) caused by Leishmania donovani MON-37 is becoming a major public health problem in Sri Lanka, with 100 new cases per month being reported in endemic regions. Diagnosis of CL is challenging for several reasons. Due to relative specificity and rapidity we propose Fluorescence in Situ Hybridization as a diagnostic tool for CL. The objective was to evaluate the potential of Fluorescence in Situ Hybridization as a diagnostic method for Cutaneous leishmaniasis in Sri Lanka. Literature on current laboratory tests used to diagnose Cutaneous leishmaniasis in Sri Lanka and globally was reviewed. Sri Lankan data were reviewed systematically following the PRISMA guidelines. A narrative of the results is presented. There is currently no gold standard diagnostic method for Cutaneous leishmaniasis. Fluorescence in Situ Hybridization has been previously applied to detect dermal pathologies including those involving infectious agents, and its use to detect the Leishmania parasite in human cutaneous lesions reported in small number of studies, generally with limited numbers of subjects. Advantages of FISH has been specificity, cost and ease-of-use compared to the alternatives. Based on the available literature and our current work, FISH has potential for diagnosing CL and should now be evaluated in larger cohorts in endemic regions. FISH for CL diagnosis could find application in countries such as Sri Lanka, where laboratory facilities may be limited in rural areas where the disease burden is highest.
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Affiliation(s)
| | - Manjula Manoji Weerasekera
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura , Nugegoda , Sri Lanka
| | - Andrew J McBain
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura , Nugegoda , Sri Lanka.,Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester , Manchester
| | - Shalindra Ranasinghe
- Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura , Colombo , Sri Lanka
| | - Renu Wickremasinghe
- Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura , Colombo , Sri Lanka
| | - Surangi Yasawardene
- Department of Anatomy, Faculty of Medical Sciences, University of Sri Jayewardenepura , Colombo , Sri Lanka
| | - Nisal Jayanetti
- Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura , Colombo , Sri Lanka
| | - Rajitha Wickremasinghe
- Department of Public Health, Faculty of Medicine, University of Kelaniya , Kelaniya , Sri Lanka
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18
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Oryan A, Bemani E, Bahrami S. Emerging role of amiodarone and dronedarone, as antiarrhythmic drugs, in treatment of leishmaniasis. Acta Trop 2018; 185:34-41. [PMID: 29689189 DOI: 10.1016/j.actatropica.2018.04.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 04/18/2018] [Accepted: 04/19/2018] [Indexed: 12/14/2022]
Abstract
Leishmaniasis is a group of human and animal diseases causing 20,000-40,000 annual deaths and its etiological agents belong to the Leishmania genus. The most current treatment against leishmaniasis is chemotherapy. Pentavalent antimonials such as glucantime and pentostam have been administrated as the first-line drugs in treatment of various forms of leishmaniasis. The second-line drugs such as amphotericin B, liposomal amphotericin B, miltefosine, pentamidine, azole drugs and paromomycin are used in resistant cases to pentavalent antimonials. Because of drawbacks of the first-line and second-line drugs including adverse side effects on different organs, increasing resistance, high cost, need to hospitalization and long-term treatment, it is necessary to find an alternative drug for leishmaniasis treatment. Several investigations have reported the effectiveness of amiodarone, the most commonly used antiarrhythmic drug, against fungi, Trypanosomes and Leishmania spp. in vitro, in vivo and clinical conditions. Moreover, the beneficial effects of dronedarone, amiodarone analogues, against Trypanosoma cruzi and Leishmania mexicana have recently been demonstrated and such treatment regimens resulted in lower side effects. The anti- leishmanial and anti- trypanosomal effectiveness of amiodarone and dronedarone has been attributed to destabilization of intracellular Ca2+ homeostasis, inhibition of sterol biosynthesis and collapse of mitochondrial membrane potential. Because of relative low cost, excellent pharmacokinetic properties, easy accessibility and beneficial effects of amiodarone and dronedarone on leishmaniasis, they are proper candidates to replace the current drugs used in leishmaniasis treatment.
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Affiliation(s)
- A Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
| | - E Bemani
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - S Bahrami
- Department of Parasitology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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19
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Abstract
A variety of arthropods, protozoa, and helminths infect the skin and subcutaneous tissues and may be identified by anatomic pathologists in standard cytology and histology preparations. The specific organisms seen vary greatly with the patient's exposure history, including travel to or residence in endemic countries. Arthropods are the most commonly encountered parasites in the skin and subcutaneous tissues and include Sarcoptes scabei, Demodex species, Tunga penetrans, and myiasis-causing fly larvae. Protozoal parasites such as Leishmania may also be common in some settings. Helminths are less often seen, and include round worms (eg, Dirofilaria spp.), tapeworms (eg, Taenia solium, Spirometra spp.), and flukes (eg, Schistosoma spp.). This review covers the epidemiologic and histopathologic features of common parasitic infections of the skin and subcutaneous tissues.
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Gonzalez-Olivares M, Moreno-Torres A, Navarro-Vidal B, Cordoba S, Garrido-Rios AA, Ruiz-Giardin JM, Borbujo J. A patient with chronic labial oedema and nodular palatal lesions. Clin Exp Dermatol 2018; 43:481-484. [PMID: 29344972 DOI: 10.1111/ced.13388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 11/26/2022]
Affiliation(s)
- M Gonzalez-Olivares
- Department of Dermatology, Hospital Universitario de Fuenlabrada Ringgold, Fuenlabrada, Madrid, Spain
| | - A Moreno-Torres
- Department of Pathology, Hospital Universitario de Fuenlabrada Ringgold, Fuenlabrada, Madrid, Spain
| | - B Navarro-Vidal
- Department of Dermatology, Hospital Universitario de Fuenlabrada Ringgold, Fuenlabrada, Madrid, Spain
| | - S Cordoba
- Department of Dermatology, Hospital Universitario de Fuenlabrada Ringgold, Fuenlabrada, Madrid, Spain
| | - A A Garrido-Rios
- Department of Dermatology, Hospital Universitario de Fuenlabrada Ringgold, Fuenlabrada, Madrid, Spain
| | - J M Ruiz-Giardin
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - J Borbujo
- Department of Dermatology, Hospital Universitario de Fuenlabrada Ringgold, Fuenlabrada, Madrid, Spain
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21
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Lu F, Huang S. The Roles of Mast Cells in Parasitic Protozoan Infections. Front Immunol 2017; 8:363. [PMID: 28428784 PMCID: PMC5382204 DOI: 10.3389/fimmu.2017.00363] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 03/14/2017] [Indexed: 12/26/2022] Open
Abstract
Protozoan parasites such as Plasmodium spp., Leishmania spp., Trypanosoma spp., and Toxoplasma gondii are major causes of parasitic diseases in both humans and animals. The immune system plays a critical role against protozoa, but their immune mechanism remains poorly understood. This highlights the need to investigate the function of immune cells involved in the process of parasite infections and the responses of host immune system to parasite infections. Mast cells (MCs) are known to be central players in allergy and anaphylaxis, and it has been demonstrated that MCs have crucial roles in host defense against a number of different pathogens, including parasites. To date, there are many studies that have examined the interaction of helminth-derived antigens and MCs. As one of the major effector cells, MCs also play an important role in the immune response against some parasitic protozoa, but their role in protozoan infections is, however, less well characterized. Herein, we review the current knowledge about the roles of MCs and their mediators during infections involving highly pathogenic protozoa including Plasmodium spp., Leishmania spp., Trypanosoma spp., and T. gondii. We offer a general review of the data from patients and experimental animal models infected with the aforementioned protozoa, which correlate MCs and MC-derived mediators with exacerbated inflammation and disease progression as well as protection against the parasitic infections in different circumstances. This review updates our current understanding of the roles of MCs during parasitic protozoan infections, and the participation of MCs in parasitic protozoan infections could be of a potential therapeutic target.
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Affiliation(s)
- Fangli Lu
- Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Disease Control Sun Yat-sen University, Ministry of Education, Guangzhou, China
| | - Shiguang Huang
- School of Stomatology, Jinan University, Guangzhou, China
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Abstract
The sinonasal tract is frequently affected by nonneoplastic inflammatory diseases. Inflammatory lesions of the sinonasal tract can be divided into 3 main categories: chronic rhinosinusitis, which encompasses a heterogeneous group of entities, all of which result in mucosal inflammation with or without polyps-eosinophils; infectious diseases; and autoimmune diseases and vasculitides, which can result in midline necrosis and facial deformities. This article reviews the common inflammatory lesions of the sinonasal tract with emphasis on infectious diseases, vasculitis, iatrogenic, and diseases of unknown cause. Many of these lesions can result in midline destruction and result in facial deformity.
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Affiliation(s)
- Kathleen T Montone
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, 6 Founders, Philadelphia, PA 19104, USA.
| | - Virginia A LiVolsi
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, 6 Founders, Philadelphia, PA 19104, USA
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Field Validation of SYBR Green- and TaqMan-Based Real-Time PCR Using Biopsy and Swab Samples To Diagnose American Tegumentary Leishmaniasis in an Area Where Leishmania (Viannia) braziliensis Is Endemic. J Clin Microbiol 2016; 55:526-534. [PMID: 27927916 DOI: 10.1128/jcm.01954-16] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 11/24/2016] [Indexed: 11/20/2022] Open
Abstract
The precise diagnosis of American tegumentary leishmaniasis (ATL) is an essential task due to the disease's associated morbidity. A noninvasive, extremely sensitive, and highly specific exam is critical, particularly for mucosal leishmaniasis (ML), in which a low parasite quantity is expected. We aimed to compare the diagnostic accuracy of swab and biopsy sample analysis using SYBR Green- and TaqMan-based real-time PCR (qPCR) assays with that of a composite reference standard consisting of the Montenegro skin test, serology, histopathology, smears, culture, and conventional PCR. In total, 55 patients with ATL (ML, 18 patients; cutaneous leishmaniasis [CL], 37 patients) and 36 patients without ATL were studied. qPCR analysis of swabs was more accurate when using SYBR Green (87.88%; 95% confidence interval [CI], 77.86 to 93.73 patients) than when using TaqMan (78.79%; 95% CI, 67.49 to 86.92%) (P = 0.031). SYBR Green (84.72%; 95% CI, 74.68 to 91.25%) was also more accurate than TaqMan (73.61%; 95% CI, 62.42 to 82.41%) for biopsy samples (P = 0.008). All qPCR methods were 100% specific. Swabs and biopsy specimens had similar sensitivity when using the same chemistry (P = 0.125 for SYBR Green and P = 0.625 for TaqMan). Moreover, qPCR achieved better performance than most existing techniques used for the diagnosis of ATL and also detected the Leishmania parasite in a greater proportion of patients than the associated histopathology, smear, culture, and conventional PCR techniques did. Swabs therefore represent a useful diagnostic tool because they not only are noninvasive but also can achieve an accuracy similar to that of biopsy samples. The high accuracy of SYBR Green-based qPCR may also reduce the requirement for associated parasitological tests for ATL diagnosis.
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Ostad M, Shirian S, Pishro F, Abbasi T, Ai A, Azimi F. Control of Cutaneous Leishmaniasis Using Geographic Information Systems from 2010 to 2014 in Khuzestan Province, Iran. PLoS One 2016; 11:e0159546. [PMID: 27467509 PMCID: PMC4965128 DOI: 10.1371/journal.pone.0159546] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 07/04/2016] [Indexed: 12/21/2022] Open
Abstract
Background Cutaneous leishmanisis (CL) is found worldwide and is considered to be endemic in 88 countries such as Iran. Geographic information system (GIS) is a method that can create, archive, analyze traditional map and place data of the disease distribution. The aim of this study was to produce distributional maps of CL over five years and evaluate the role of GIS in control of CL in Khuzestan province where an endemic area of CL in Iran is. Methods CL epidemiological data on the District and village levels for the period 2010–2013 were provided as census by health surveillance system in all counties and in control diseases center (CDC) of Khuzestan province. After collection of CL data, the collected data of CL from 2010 to 2013 were analyzed using GIS. The collected data of CL from 2010 to 2013 was analyzed using GIS. The endemic areas of CL during 2010–2013 were recognized using GIS maps and the control programs of CL were done in these regions based on epidemiological situation and the stratification of risk areas. Results During the study period, there were 4672 recorded cases of clinical cases of CL by Khuzestan Health Center. Data of GIS referring to CL patients showed that center and eastern districts of Khuzestan had a significant number of cases. In 2014 that control program was done, ten distinct of Khuzestan Province didn’t show any cases of the disease. Conclusion In conclusion, analyses of data distributed in the geographic spaces are increasingly appreciated in leishmaniasis control management. GIS tools promoted greater efficiency in making decisions and planning activities in the control of vector born disease such as leishmaniasis.
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Affiliation(s)
- Mojdeh Ostad
- Department of Geography, Ahvaz Islamic Azad University, Ahvaz, Iran
| | - Sadegh Shirian
- Department of Pathology, School of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Science, Tehran, Iran
- Shiraz Molecular Pathology Research Center, Dr Daneshbod Lab, Shiraz, Iran
- * E-mail: (SS); (FA)
| | - Fatemeh Pishro
- Department of Geography, Ahvaz Islamic Azad University, Ahvaz, Iran
| | - Tahereh Abbasi
- Shiraz Molecular Pathology Research Center, Dr Daneshbod Lab, Shiraz, Iran
- Department of Water Resource Engineering, Shiraz Islamic Azad University, Shiraz, Iran
| | - Armin Ai
- Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Azimi
- Department of Geography, Ahvaz Islamic Azad University, Ahvaz, Iran
- * E-mail: (SS); (FA)
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25
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Machado-Alba JE, García-Betancourt S, Medina-Morales DA. Leishmaniasis mucosa en un lactante. Una presentación inusual de una enfermedad olvidada. INFECTIO 2016. [DOI: 10.1016/j.infect.2015.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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26
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Abstract
CONTEXT A number of entities may result in necrosis in the sinonasal tract and lead to significant morbidity and mortality. These include infections, necrotizing vasculitis, neoplastic processes, and drug dependency. This review will concentrate on the differential diagnosis of sinonasal necrotizing lesions. OBJECTIVE To review the differential diagnoses of necrotizing destructive lesions of the sinonasal tract. DATA SOURCES The current literature was reviewed to provide updated information regarding the differential diagnosis of sinonasal necrotizing lesions, including infectious disease processes; antineutrophilic cytoplasmic antibody-associated vasculitides; neoplastic processes, particularly natural killer/T-cell lymphomas; and drug abuse. CONCLUSIONS The differential diagnosis of necrotizing sinonasal lesions is broad, with often overlapping diagnostic features that lead to diagnostic challenges. Ancillary tests such as special stains and immunohistochemical studies can offer significant assistance.
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Affiliation(s)
- Kathleen T Montone
- From the Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia
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27
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Handler MZ, Patel PA, Kapila R, Al-Qubati Y, Schwartz RA. Cutaneous and mucocutaneous leishmaniasis: Clinical perspectives. J Am Acad Dermatol 2016; 73:897-908; quiz 909-10. [PMID: 26568335 DOI: 10.1016/j.jaad.2014.08.051] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 08/11/2014] [Accepted: 08/22/2014] [Indexed: 10/22/2022]
Abstract
Leishmaniasis is endemic in 98 countries and territories, with 1.2 million new cases per year, making it a worldwide concern. The deadly visceral form is a leading cause of death from tropical parasitic infections, second only to malaria. Leishmaniasis appears to be increasing in many countries because of extended urbanization. The disease reservoir includes small mammals; parasite transmission occurs via bite of the female phlebotomine sandfly. Disease manifestations vary and largely depend upon the Leishmania species acquired. It may be first evident with a range of findings-from a localized cutaneous ulcer to diffuse painless dermal nodules-or, in the mucocutaneous form, ulceration of the oropharynx. In the potentially deadly visceral form, the internal organs and bone marrow are affected.
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Affiliation(s)
- Marc Z Handler
- Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Parimal A Patel
- Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Rajendra Kapila
- Infectious Diseases, Rutgers New Jersey Medical School, Newark, New Jersey; Medicine, Rutgers New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, New Jersey
| | | | - Robert A Schwartz
- Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey; Medicine, Rutgers New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, New Jersey; Rutgers School of Public Affairs and Administration, Newark, New Jersey.
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28
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Bafghi AF, Jebali A, Daliri K. Silica nanowire conjugated with loop-shaped oligonucleotides: A new structure to silence cysteine proteinase gene in Leishmania tropica. Colloids Surf B Biointerfaces 2015; 136:323-8. [PMID: 26432619 DOI: 10.1016/j.colsurfb.2015.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 09/12/2015] [Accepted: 09/16/2015] [Indexed: 10/23/2022]
Abstract
The main aim of this study was to evaluate the capability of silica nanowire conjugated with loop-shaped oligonucleotides (SNWCLSOs) to silence cysteine proteinase b (Cpb) gene in Leishmania (L) tropica. On the other hand, its toxicity on amastigotes and mouse peritoneal macrophages was evaluated by 5-diphenyl-tetrazolium bromide (MTT) assay. For control, two loop-shaped oligonucleotides (LSO) were considered. LSO1 and LSO2 were 5'-NH2-cccccaaaaaaaaaaaaaaaaaaaaaaaaaggggg-COOH-3' and LSO2: 5'-NH2-cccccttttttttttttttttttttttttttttttttttttttggggg-COOH-3', respectively. After 72 h incubation at 37 °C, AMSNW, LSO1, and LSO2 had no remarkable toxicity on L. tropica amastigote (2 × 10(5)/mL) and mouse peritoneal macrophages (2 × 10(5)/mL). In case of SNWCLSOs, they had high toxicity on L. tropica amastigote, but they had no effect on mouse peritoneal macrophages. At concentrations of 1, 10, and 25 μg/mL, AMSNW, LSO1 and LSO2 had no effect on the gene expression. But, at concentration of 50 and 100 μg/mL, decrease of gene expression was observed. In case of SNWCLSOs, they could dramatically decrease the gene expression. It could be concluded that since SNWCLSOs could silence Cpb gene with no remarkable toxicity, they are good choice for treat cutaneous leishmaniasis in future. As a new agent, it must be checked in vivo.
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Affiliation(s)
- Ali Fatahi Bafghi
- Department of Medical Parasitology & Mycology, The School of Medicine, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Jebali
- Department of Laboratory Sciences, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Karim Daliri
- Department of Medical Nanotechnology, Pajoohesh Lab, Yazd, Iran
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Gomes CM, Paula NAD, Morais OOD, Soares KA, Roselino AM, Sampaio RNR. Complementary exams in the diagnosis of American tegumentary leishmaniasis. An Bras Dermatol 2015; 89:701-9. [PMID: 25184908 PMCID: PMC4155947 DOI: 10.1590/abd1806-4841.20142389] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 02/25/2013] [Indexed: 01/04/2023] Open
Abstract
The diagnosis of American Tegumentary Leishmaniasis is a difficult but essential task when considering the high toxicity profile of the drugs available. Since the discovery of its etiologic agent, numerous diagnostic tests have been developed. None of the tests available today can be considered as the gold standard, since they do not add enough accuracy for the disease detection. Good epidemiological and clinical knowledge of the disease are fundamental precepts of the dermatology practice and precede the rational use of existing diagnostic tests. In this article we aim, through extensive literature review, to recall fundamental concepts of any diagnostic test. Subsequently, based on this information, we will weave important comments about the characteristics of existing diagnostic tests, including immunological tests such as Montenegro's skin test, serology and detection of parasites by direct examination, culture or histopathology. Finally we will discuss the new technologies and options for the diagnosis of Cutaneous Leishmaniasis. The molecular biology technique is considered a promising tool, promoting the rapid identification of the species involved. We also aim to educate dermatologists about a disease with high morbidity and assist in its difficult recognition.
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Jebali A, Anvari-Tafti MH. Hybridization of different antisense oligonucleotides on the surface of gold nanoparticles to silence zinc metalloproteinase gene after uptake by Leishmania major. Colloids Surf B Biointerfaces 2015; 129:107-13. [PMID: 25835145 DOI: 10.1016/j.colsurfb.2015.03.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/06/2015] [Accepted: 03/10/2015] [Indexed: 01/22/2023]
Abstract
The use of antisense oligonucleotides is a novel strategy to treat infectious diseases. In this approach, vital mRNAs are targeted by antisense oligonucleotides. The aim of this study was to evaluate the effects of gold nanoparticles hybridized with different antisense oligonucleotides on Leishmania (L) major. In this project, gold nanoparticles were first synthesized, and then conjugated with primary oligonucleotides, 3'-AAA-5'. Next, conjugated gold nanoparticles (NP1) were separately hybridized with three types of antisense oligonucleotide from coding reign of GP63 gene (NP2), non-coding reign of GP63 gene (NP3), and both coding and non-coding reigns of GP63 (NP4). Then, 1mL of L. major suspension was separately added to 1mL of different hybridized gold nanoparticles at serial concentrations (1-200μg/mL), and incubated for 24, 48, and 72h at 37°C. Next, the uptake of each nanoparticle was separately measured by atomic absorption spectroscopy. After incubation, the cell viability was separately evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay. Also, the expression of GP63 gene was read out by quantitative-real-time PCR. This study showed that NP2 and NP3 had higher (5-fold) uptake than NP1 and NP4. Moreover, NP2 and NP3 led to less cell viability and gene expression, compared with NP1 and NP4. It could be concluded that both sequence and size of antisense oligonucleotide were important for transfection of L. major. Importantly, these antisense oligonucleotides can be obtained from both coding and non-coding reign of GP63 gene. Moreover, hybridized gold nanoparticles not only could silence GP63 gene, but also could kill L. major.
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Affiliation(s)
- Ali Jebali
- Department of Laboratory Sciences, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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31
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Nangia A, Sehgal S, Chander R. Scrape cytology in localized oral mucosal leishmaniasis. J Cytol 2014; 31:180-1. [PMID: 25538394 PMCID: PMC4274536 DOI: 10.4103/0970-9371.145668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Anita Nangia
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Shivali Sehgal
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Ram Chander
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
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da Costa DCS, Palmeiro MR, Moreira JS, Martins ACDC, da Silva AF, de Fátima Madeira M, Quintella LP, Confort EM, de Oliveira Schubach A, da Conceição Silva F, Valete-Rosalino CM. Oral manifestations in the American tegumentary leishmaniasis. PLoS One 2014; 9:e109790. [PMID: 25386857 PMCID: PMC4227643 DOI: 10.1371/journal.pone.0109790] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 09/10/2014] [Indexed: 11/27/2022] Open
Abstract
Introduction American tegumentary leishmaniasis (ATL) can affect the skin or mucosa (mucocutaneous leishmaniasis – MCL) including the oral cavity. MCL oral lesions are often confused with other oral diseases, delaying diagnosis and specific treatment, and increasing the likelihood of sequelae. Thus, increasing the knowledge of the evolution of ATL oral lesions can facilitate its early diagnosis improving the prognosis of healing. Objectives Evaluate the frequency of ATL oral lesion and describe its clinical, laboratory and therapeutic peculiarities. Methods A descriptive transversal study was carried out, using data from medical records of 206 patients with MCL examined at the outpatient clinics-IPEC-Fiocruz between 1989 and 2013. Proportions were calculated for the categorical variables and the association among them was assessed by the Pearson's chi-square test. Measures of central tendency and dispersion were used for the continuous variables and their differences were assessed by both parametric (t test) and non parametric (Mann-Whitney) tests. P-values <0.05 were considered as significant. Results The most affected site was the nose, followed by the mouth, pharynx and larynx. Seventy eight (37.9%) have oral lesions and the disease presented a lower median of the evolution time than in other mucous sites as well as an increased time to heal. The presence of oral lesion was associated with: the presence of lesions in the other three mucosal sites; a smaller median of the leishmanin skin test values; a longer healing time of the mucosal lesions; a higher recurrence frequency; and a smaller frequency of treatment finishing and healing. When the oral lesion was isolated, it was associated with an age 20 years lower than when the oral lesion was associated with other mucosal sites. Conclusion Considering the worst therapy results associated with the presence of oral lesions, we suggest that lesions in this location represent a factor of worse prognosis for MCL.
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Affiliation(s)
- Daniel Cesar Silva da Costa
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro-RJ, Brazil
| | - Mariana Reuter Palmeiro
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro-RJ, Brazil
| | - João Soares Moreira
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro-RJ, Brazil
| | | | - Aline Fagundes da Silva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro-RJ, Brazil
| | - Maria de Fátima Madeira
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro-RJ, Brazil
| | - Leonardo Pereira Quintella
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro-RJ, Brazil
| | - Eliame Mouta Confort
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro-RJ, Brazil
| | | | - Fátima da Conceição Silva
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro-RJ, Brazil
- * E-mail: (CMVR); (FCS)
| | - Cláudia Maria Valete-Rosalino
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro-RJ, Brazil
- Department of Otorhinolaryngology and Ophthalmology, Federal University of Rio de Janeiro, Rio de Janeiro-RJ, Brazil
- * E-mail: (CMVR); (FCS)
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Crovetto-Martínez R, Aguirre-Urizar JM, Orte-Aldea C, Araluce-Iturbe I, Whyte-Orozco J, Crovetto-De la Torre MA. Mucocutaneous leishmaniasis must be included in the differential diagnosis of midline destructive disease: two case reports. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:e20-6. [PMID: 25442251 DOI: 10.1016/j.oooo.2014.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 08/18/2014] [Accepted: 09/09/2014] [Indexed: 01/05/2023]
Abstract
Midline destructive lesions have multiple possible etiologies, which can be grouped into neoplastic, infectious, or vasculitis-associated. The purpose of these case reports and literature review was to highlight the need to include mucocutaneous leishmaniasis in the diagnosis of midfacial lesions in any patient who has lived in Leishmania-endemic areas because this entity meets all of the clinical criteria to be considered a form of midline destructive lesion. We present two cases of mucocutaneous leishmaniasis that occurred in a Bolivian male immigrant and a European male traveler to Panama, in whom lesions were misdiagnosed as different midline destructive lesions with different causes (Wegener, vasculitis, and natural killer or T-cell lymphoma [NKTL]). The conclusion of our work is that all patients with midline destructive lesions should undergo histologic and molecular studies to be evaluated for mucosal leishmaniasis, particularly patients whose clinical history suggests this possibility. In cases of uvular involvement, biopsy of this region might be a possible alternative to nasal biopsy.
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Affiliation(s)
- R Crovetto-Martínez
- Department of Stomatology II, University of the Basque Country / EHU, Spain.
| | - J M Aguirre-Urizar
- Department of Stomatology II, University of the Basque Country / EHU, Spain
| | - C Orte-Aldea
- Department of Otorhinolaryngology, Miguel Servet Hospital, Zaragoza, Spain
| | - I Araluce-Iturbe
- Department of Otorhinolaryngology, Basurto University Hospital (UPV/EHU), Bilbao, Vizcaya, Spain
| | - J Whyte-Orozco
- Department of Anatomy and Histology, University of Zaragoza, Spain
| | - M A Crovetto-De la Torre
- Department of Otorhinolaryngology, Basurto University Hospital (UPV/EHU), Bilbao, Vizcaya, Spain
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Eroglu F, Uzun S, Koltas IS. Comparison of clinical samples and methods in chronic cutaneous leishmaniasis. Am J Trop Med Hyg 2014; 91:895-900. [PMID: 25223940 DOI: 10.4269/ajtmh.13-0582] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This study aimed at finding out the most effective clinical samples and methods in chronic cutaneous leishmaniasis (CCL). Smear, aspiration fluid, and filter paper samples were taken from 104 skin lesions of suspected cases with CCL, and they were compared using microscopic examination, culture, and molecular methods. We characterized four different forms of CCL and identified the causative agents in CCL forms using high-resolution melting curve real-time polymerase chain reaction assay. We observed that smear was detected to be the most sensitive (63.5%) among clinical samples, and real-time polymerase chain reaction method was the most sensitive (96.8%) among the methods used in diagnosis of CCL. We identified 68.8% Leishmania tropica and 31.2% L. infantum in papular lesions, 69.2% L. infantum and 30.8% L. tropica in nodular lesions, 57.9% L. tropica and 42.1% L. major in ulcerating plaque lesions, and 55.5% L. tropica and 44.5% L. major in noduloulcerative lesions in CCL patients.
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Affiliation(s)
- Fadime Eroglu
- Emine-Baheddin Nakıboglu Medicine Faculty, Medical Microbiology Department, Zirve University, Gaziantep, Turkey; Medicine Faculty, Dermatology Department, Akdeniz University, Antalya, Turkey; Medicine Faculty, Parasitology Department, Cukurova University, Adana, Turkey
| | - Soner Uzun
- Emine-Baheddin Nakıboglu Medicine Faculty, Medical Microbiology Department, Zirve University, Gaziantep, Turkey; Medicine Faculty, Dermatology Department, Akdeniz University, Antalya, Turkey; Medicine Faculty, Parasitology Department, Cukurova University, Adana, Turkey
| | - Ismail Soner Koltas
- Emine-Baheddin Nakıboglu Medicine Faculty, Medical Microbiology Department, Zirve University, Gaziantep, Turkey; Medicine Faculty, Dermatology Department, Akdeniz University, Antalya, Turkey; Medicine Faculty, Parasitology Department, Cukurova University, Adana, Turkey
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Hamidinia D, Maraghi S, Azimi F, Ai A, Shirian S. The role of climate on prevalence or eradication of vesical schistosomiasis in Khuzestan Province of Iran. J Parasit Dis 2014; 40:387-9. [PMID: 27413310 DOI: 10.1007/s12639-014-0515-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 08/05/2014] [Indexed: 11/28/2022] Open
Abstract
Climate is defined as the combination of climate and air elements of a given region which is usually measured for a period of decades. De-marton climate classification has been established based on many factors, including elements such as temperature and rainfall. Vesicle schistosomiasis is a parasitic disease caused by Schistosoma haematobium. This parasite lives in the blood vessels of the bladder. The parasite can cause hematuria in human and if not treated properly can lead to vesicale carcinoma. The parasite is distributed only in certain parts of the province and it is highly dispersed along the rivers of Dez, Karkheh and Karun with high emissions. In 1970, the prevalence of infection in infected foci was 23.8 %. Campaign against the parasite began in 1958 but it did not encompass all centers of infection. Preventive measures include diagnosis and treatment of patients, public health promotion, health education, drying swamps and ponds, improving the environment, cementing the irrigation canals, and the use of moluscocide eventually leads to changing the ecological and conditions of parasite and snail inhabits. Application of preventive measures resulted in the reduction of infection level to 0.7 % in 1979. By continuing struggle and intensifying preventive measures and changing ecological and climatic environment, in 2008, the examination of 3400 urine samples of students in Andimeshk district revealed no cases of the vesical schistosomiasis. It is concluded that S. haematobium and vesical schistosomiasis is eliminated from Khuzestan province southwest Iran, but the disease is still prevalent in neighboring Iran's western border country (Iraq) and due to the special conditions of its facilities and the traffic between the two countries, it is necessary to control and eradicate the disease in Iraq by using the experiences of Iran in eliminating the disease.
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Affiliation(s)
| | - Sharif Maraghi
- Department of Parasitology and Mycology, Abadan Arvand International Division, Infectious and Tropical Diseases Research Center, Thalassemia and Hemoglobinopathy Research Center, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran
| | - Farideh Azimi
- Department of Geography, Ahwaz Islamic Azad University, Ahwaz, Iran
| | - Armin Ai
- Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadegh Shirian
- Brain and Spinal Cord Injury Research Center, Tehran University of Medical Scineces, Tehran, Iran
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Shirian S, Oryan A, Hatam GR, Daneshbod Y. Three Leishmania/L. species--L. infantum, L. major, L. tropica--as causative agents of mucosal leishmaniasis in Iran. Pathog Glob Health 2014; 107:267-72. [PMID: 23916336 DOI: 10.1179/2047773213y.0000000098] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Cases of human oro-mucosal leishmaniasis are mainly reported in areas where Leishmania (Viannia) braziliensis perpetuates and the damages are mainly located at the cartilaginous nasal septum and frontal portions of the nasal fossa. In Iran, an area free of any L.(V) braziliensis, three Leishmania species are known to perpetuate through distinct (i) blood-feeding sand flies and (ii) rodents or (iii) canidae. Thus while establishing the diagnosis of any human oro-mucosal lesions, three Leishmania species - L. infantum, L. major, and L. tropica - must be considered as potential etiological agents of these damages. With these objectives in mind, features such as localization, extent, severity of oro-mucosal lesions, and duration of symptoms at the time of diagnosis were recorded from 11 patients with respect to the presence or absence of cutaneous lesions in other body parts. The biopsy samples were collected from the oro-mucosal and cutaneous lesions and were processed for further identification of the Leishmania species. The lesions ranged from mucosal nodules without ulceration, nodules with erosion, and shallow to deep ulcerations. Leishmania major was isolated from six (55%) cases showing lesions or scars. The scars were restricted to upper and lower extremities. For the other five patients who did not display any signs of former or active cutaneous leishmaniasis, L. major, L. tropica, and L. infantum were isolated from their lesions. In conclusion L. major, L. infantum, and L. tropica, regardless of common tropism, can be seen in mucosal tissues. However, L. major was the predominant species detected from the lesions in the nasal, gingival, and hard and soft palates, and L. tropica was isolated from the gingival and lower lip lesions. Leishmania infantum was isolated from two severe cases of deep mucosal damage displayed by the epiglottis, cricoarytenoid muscle, and laryngeal mucosa. One important finding was the association of L. major with active or scarred skin lesions.
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Affiliation(s)
- Sadegh Shirian
- Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Shirian S, Oryan A, Hatam GR, Panahi S, Daneshbod Y. Comparison of Conventional, Molecular, and Immunohistochemical Methods in Diagnosis of Typical and Atypical Cutaneous Leishmaniasis. Arch Pathol Lab Med 2014; 138:235-40. [DOI: 10.5858/arpa.2013-0098-oa] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—Localized cutaneous leishmaniasis (CL) typically presents as papules, crusted nodules, plaques, or noduloulcerative lesions. Atypical CL does not show these features or mimic malignant lesion. In atypical forms, CL may be overlooked because of its similarity to other dermal diseases.
Objective.—To compare conventional, molecular, and immunohistochemical methods in the diagnosis of typical and atypical CL.
Design.—The kinetoplast DNA, nested, polymerase chain reaction assay and immunohistochemical methods were compared and validated against conventional methods, including cytology and pathology, using 100 specimens of typical and atypical lesions of suspected CL.
Results.—Compared with other methods, polymerase chain reaction of the kinetoplast DNA showed the highest sensitivity (typical positive, 100%, 67 of 67; atypical positive, 94%, 31 of 33) and specificity (100%), followed by immunohistochemistry (typical positive, 97%, 65 of 67, with 100% specificity; atypical positives, 94%, 31 of 33, with 100% specificity), and cytology (typical positive, 79%, 53 of 67, with 100% specificity; atypical positive, 58%, 19 of 33, with 100% specificity), followed by pathology (typical positive, 70%, 47 of 67, with 100% specificity; atypical positive, 42%, 14 of 33, with 100% specificity). In addition, polymerase chain reaction enabled identification of 98% (98 of 100) of the positive samples that included strains of Leishmania major (99% [99 of 100] cases) and Leishmania tropica (1% [1 of 100] cases).
Conclusions.—Because cytology is cheap and easy to perform with high sensitivity, it is the preferred, primary approach for typical CL, but cytology and pathology do not have sufficient sensitivity for diagnosis of atypical CL cases. Nested polymerase chain reaction and immunohistochemistry are sensitive tests for diagnosis of both typical and atypical CL and are recommended as complementary tests in suspected CL with negative conventional microscopy results.
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Affiliation(s)
- Sadegh Shirian
- From the Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Iran (Dr Shirian); the Department of Pathology, School of Veterinary Medicine, Shiraz University, Iran (Drs Shirian, Oryan, and Panahi); Basic Sciences in Infectious Diseases, Research Center, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran (Dr Hatam); and the Department of Cytopathology, Dr Daneshbod Pathology Laboratory, Shiraz, Iran (Dr Daneshbod)
| | - Ahmad Oryan
- From the Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Iran (Dr Shirian); the Department of Pathology, School of Veterinary Medicine, Shiraz University, Iran (Drs Shirian, Oryan, and Panahi); Basic Sciences in Infectious Diseases, Research Center, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran (Dr Hatam); and the Department of Cytopathology, Dr Daneshbod Pathology Laboratory, Shiraz, Iran (Dr Daneshbod)
| | - Gholam-Reza Hatam
- From the Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Iran (Dr Shirian); the Department of Pathology, School of Veterinary Medicine, Shiraz University, Iran (Drs Shirian, Oryan, and Panahi); Basic Sciences in Infectious Diseases, Research Center, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran (Dr Hatam); and the Department of Cytopathology, Dr Daneshbod Pathology Laboratory, Shiraz, Iran (Dr Daneshbod)
| | - Saed Panahi
- From the Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Iran (Dr Shirian); the Department of Pathology, School of Veterinary Medicine, Shiraz University, Iran (Drs Shirian, Oryan, and Panahi); Basic Sciences in Infectious Diseases, Research Center, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran (Dr Hatam); and the Department of Cytopathology, Dr Daneshbod Pathology Laboratory, Shiraz, Iran (Dr Daneshbod)
| | - Yahya Daneshbod
- From the Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Iran (Dr Shirian); the Department of Pathology, School of Veterinary Medicine, Shiraz University, Iran (Drs Shirian, Oryan, and Panahi); Basic Sciences in Infectious Diseases, Research Center, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran (Dr Hatam); and the Department of Cytopathology, Dr Daneshbod Pathology Laboratory, Shiraz, Iran (Dr Daneshbod)
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Oryan A, Shirian S, Tabandeh MR, Hatam GR, Randau G, Daneshbod Y. Genetic diversity of Leishmania major strains isolated from different clinical forms of cutaneous leishmaniasis in southern Iran based on minicircle kDNA. INFECTION GENETICS AND EVOLUTION 2013; 19:226-31. [DOI: 10.1016/j.meegid.2013.07.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 07/11/2013] [Accepted: 07/18/2013] [Indexed: 10/26/2022]
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Strazzulla A, Cocuzza S, Pinzone MR, Postorino MC, Cosentino S, Serra A, Cacopardo B, Nunnari G. Mucosal leishmaniasis: an underestimated presentation of a neglected disease. BIOMED RESEARCH INTERNATIONAL 2013; 2013:805108. [PMID: 23853773 PMCID: PMC3703408 DOI: 10.1155/2013/805108] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 06/06/2013] [Indexed: 11/18/2022]
Abstract
We present a review of current knowledge about mucosal leishmaniasis (ML). Although involvement of mucous membranes is classically admitted in New World leishmaniasis, particularly occurring in infection by Leishmania (L.) braziliensis species complex, ML is also a possible presentation of Old World leishmaniasis, in either L. donovani or L. major species complex infections. Thus, ML has to be considered not only as a Latin American disease but as an Old and New World disease. We describe ML epidemiology, pathogenesis, clinics, diagnosis, and therapy. Considering both its highly disfiguring lesions and its possible lethal outcome, ML should not be underestimated by physicians. Moreover, leishmaniasis is expected to increase its burden in many countries as sandfly vector distribution is widespreading towards non-endemic areas. Finally, the lack of clear understanding of ML pathogenesis and the absence of effective human vaccines strongly claim for more research.
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Affiliation(s)
- Alessio Strazzulla
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Garibaldi Nesima Hospital, University of Catania, 95125 Catania, Italy
| | - Salvatore Cocuzza
- Division of Otorhinolaryngology, Department of Medical-Surgical Specialties, Policlinico-Vittorio Emanuele Hospital, University of Catania, 95125 Catania, Italy
| | - Marilia Rita Pinzone
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Garibaldi Nesima Hospital, University of Catania, 95125 Catania, Italy
| | - Maria Concetta Postorino
- Division of Pathology and Experimental Microbiology, Elie Metchnikoff Department, University of Messina, 98125 Messina, Italy
| | - Stefano Cosentino
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Garibaldi Nesima Hospital, University of Catania, 95125 Catania, Italy
| | - Agostino Serra
- Division of Otorhinolaryngology, Department of Medical-Surgical Specialties, Policlinico-Vittorio Emanuele Hospital, University of Catania, 95125 Catania, Italy
| | - Bruno Cacopardo
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Garibaldi Nesima Hospital, University of Catania, 95125 Catania, Italy
| | - Giuseppe Nunnari
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Garibaldi Nesima Hospital, University of Catania, 95125 Catania, Italy
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Oryan A, Shirian S, Tabandeh MR, Hatam GR, Kalantari M, Daneshbod Y. Molecular, cytological, and immunocytochemical study and kDNA sequencing of laryngeal Leishmania infantum infection. Parasitol Res 2012; 112:1799-804. [DOI: 10.1007/s00436-012-3240-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 12/08/2012] [Indexed: 11/24/2022]
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Teemul TA, Giles-Lima M, Williams J, Lester SE. Laryngeal leishmaniasis: Case report of a rare infection. Head Neck 2012; 35:E277-9. [DOI: 10.1002/hed.23141] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2012] [Indexed: 11/12/2022] Open
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Mixed mucosal leishmaniasis infection caused by Leishmania tropica and Leishmania major. J Clin Microbiol 2012; 50:3805-8. [PMID: 22972819 DOI: 10.1128/jcm.01469-12] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mixed infections with different Leishmania species could explain differences in the clinical courses of these infections. On identification of Leishmania parasites from Iranian patients with mucosal leishmaniasis (ML), a patient with both oral and nasal lesions was found to be concomitantly infected with Leishmania tropica and L. major. Mixed infection was identified by PCR amplification of Leishmania kinetoplast DNA on scraping of cytological smears and histopathological sections. L. major and L. tropica were isolated from the nasal and oral lesions, respectively. These species were also confirmed by immunohistochemistry. This seems to be the first reported case of concurrent ML infection with two Leishmania species. It indicates that, at least in this patient, previous infection with one of these Leishmania species did not protect against infection with the other. This result has important implications for the development of vaccines against leishmaniases and implies careful attention in the treatment of this infectious disease.
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