Cutaneous and mucocutaneous leishmaniasis: experience of a Mediterranean hospital

Autor: Marta Garrido-Jareño, Iván Castro-Hernández, María Dolores Gómez-Ruiz, Javier Pemán-García, Rabab Chouman-Arcas, Miguel Salavert-Lletí, José Miguel Molina-Moreno, José Luis López-Hontangas, Rafael Botella-Estrada, Antonio Sahuquillo-Torralba, Margarita Llavador-Ros
Rok vydání: 2020
Předmět:
Adult
Leishmaniasis
Mucocutaneous
Male
medicine.medical_specialty
Adolescent
030231 tropical medicine
Leishmaniasis
Cutaneous
Biology
Administration
Cutaneous
Giemsa stain
lcsh:Infectious and parasitic diseases
Immunocompromised Host
Young Adult
03 medical and health sciences
0302 clinical medicine
Cutaneous leishmaniasis
Risk Factors
Amphotericin B
Epidemiology
medicine
Humans
lcsh:RC109-216
030212 general & internal medicine
Child
Aged
Retrospective Studies
Leishmania
Meglumine Antimoniate
Research
Immune status
Incidence (epidemiology)
Retrospective cohort study
Leishmaniasis
Nucleic acid amplification technique
Middle Aged
microbiological diagnosis
medicine.disease
Dermatology
Mucocutaneous leishmaniasis
Nucleic acid amplification techniques
Infectious Diseases
Spain
Child
Preschool
Tropical medicine
Female
Parasitology
Zdroj: Parasites & Vectors, Vol 13, Iss 1, Pp 1-7 (2020)
Parasites & Vectors
ISSN: 1756-3305
DOI: 10.1186/s13071-020-3901-1
Popis: Background Leishmaniasis, considered by the World Health Organization as one of the most important tropical diseases, is endemic in the Mediterranean Basin. The aim of this study was to evaluate epidemiological and clinical characteristics of cutaneous (CL) and mucocutaneous leishmaniasis (MCL) in La Fe University Hospital, Valencia, Spain. The particular focus was on diagnosis techniques and clinical differences according to the immunological status of the patients. Methods An eleven-year retrospective observational study of CL and MCL episodes at the hospital was performed. Epidemiological, clinical and therapeutic variables of each case, together with the microbiological and anatomopathological diagnosis, were analyzed. Results A total of 42 patients were included, 30 of them were male and 28 were immunocompetent. Most of the cases (36/42) were diagnosed in the last 5 years (2013–2017). The incidence of CL and MCL increased from 3.6/100,000 (2006–2012) to 13.58/100,000 (2013–2017). The majority of the patients (37/42) exhibited CL, in 30 cases as single lesions (30/37). Ulcerative lesions were more common in immunosuppressed patients (13/14) than in immunocompetent patients (20/28), (P = 0.2302). The length of lesion presence before diagnosis was 7.36 ± 6.72 months in immunocompetent patients and 8.79 ± 6.9 months in immunosuppressed patients (P = 0.1863). Leishmania DNA detection (92.3%) was the most sensitive diagnostic technique followed by Giemsa stain (65%) and histopathological examination (53.8%). Twelve patients (12/42) had close contact with dogs or were living near to kennels, and 10 of them did not present underlying conditions. Intralesional glucantime (21/42) and liposomal amphotericin B (7/42) were the most common treatments administered in monotherapy. All patients evolved successfully and no relapse was reported. Conclusions Some interesting clinical and epidemiological differences were found in our series between immunocompetent and immunosuppressed patients. Future studies can take these results further especially by studying patients with biological therapy. Skin biopsies combining NAAT with histological techniques are the most productive techniques for CL or MCL diagnosis.
Databáze: OpenAIRE
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