Anais Brasileiros de Dermatologia
On-line version ISSN 1806-4841
BENICIO, Ednelza de Almeida et al. Combining diagnostic procedures for the management of leishmaniasis in areas with high prevalence of Leishmania guyanensis. An. Bras. Dermatol. [online]. 2011, vol.86, n.6, pp.1141-1144. ISSN 1806-4841. http://dx.doi.org/10.1590/S0365-05962011000600012.
BACKGROUND: The Amazon region corresponds to approximately 40% of the cases of leishmaniasis in Brazil. We report a prospective study with 180 patients conducted in a health care unit that diagnoses 10% of the cases of leishmaniasis in the Brazilian Amazon. The study addresses how a combination of procedures improves diagnosis in areas with high prevalence of Leishmania guyanensis. OBJECTIVES: to evaluate diagnostic methods in areas with high prevalence of Leishmania guyanensis. METHODS: All subjects were amastigote-positive by direct microscopic examination of lesion scarifications. We conducted skin biopsy and histopathology, polymerase chain reaction and parasite cultivation. RESULTS: Polymerase chain reaction detected almost ninety percent of infections when two amplification protocols were used (mini-exon and HSP-70). HSP-70 specific polymerase chain reaction matched the sensitivity of parasite cultivation plus histopathology. CONCLUSION: The best combination was polymerase chain reaction plus histopathology, which increased diagnostic sensitivity to 94%. Species discrimination by polymerase chain reaction disclosed prevalence of human infections with Leishmania guyanensis of 94% and with Leishmania braziliensis of 6% for this region
Keywords : Diagnosis; Leishmania guyanensis; Leishmaniasis.