Evidence for Leishmania (Viannia) parasites in the skin and blood of patients before and after treatment

Carolina Vergel, Ricardo Palacios, Horacio Cadena, Claudia Jimena Posso, Liliana Valderrama, Mauricio Perez, John Walker, Bruno Luis Travi, Nancy Gore Saravia

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Background. American cutaneous leishmaniasis is considered to be a zoonotic disease transmitted by sand flies that feed on infected sylvatic mammals. However, the "domestication" of transmission and the increase in treatment failure with antimonial drugs have raised the suspicion of anthroponotic transmission of American cutaneous leishmaniasis. Methods. The objective of the present study was to explore the potential of humans as a source of infection for sand flies. Biological (xenodiagnosis and culture) and molecular (polymerase chain reaction/Southern blot) detection methods were used to evaluate peripheral-blood monocytes and tissue fluids from sites accessible to sand flies from 59 adult patients with parasitologically confirmed American cutaneous leishmaniasis. Results. Overall, 44.1% of patients (26/59) presented biological and/or molecular evidence of Leishmania parasites in normal skin, peripheral-blood monocytes, lesion scars, or lesion border (by xenodiagnosis) before (18/59 [30.5%]) or after (10/27 [37.0%]) treatment. Leishmania parasites were cultured from the unaffected skin of 2 (3.6%) of 55 patients, and xenodiagnosis gave positive results for 5 (8.8%) of 57 patients before treatment. Conclusions. The presence of Leishmania parasites in the unaffected skin and peripheral-blood monocytes of a high proportion of patients even after treatment and the acquisition of infection by sand flies support the plausibility of anthroponotic transmission of American cutaneous leishmaniasis.

Original languageEnglish (US)
Pages (from-to)503-511
Number of pages9
JournalJournal of Infectious Diseases
Volume194
Issue number4
DOIs
StatePublished - Aug 15 2006
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Vergel, C., Palacios, R., Cadena, H., Posso, C. J., Valderrama, L., Perez, M., Walker, J., Travi, B. L., & Saravia, N. G. (2006). Evidence for Leishmania (Viannia) parasites in the skin and blood of patients before and after treatment. Journal of Infectious Diseases, 194(4), 503-511. https://doi.org/10.1086/505583