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vol.17 issue4Cardiopathy and parasitism in patients with chronic chagas' diseaseHuman mucocutaneous leishmaniasis in Três Braços, Bahia - Brazil: an area of Leishmania braziliensis braziliensis transmission. II. Cutaneous disease. Presentation and evolution author indexsubject indexarticles search
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Revista da Sociedade Brasileira de Medicina Tropical

Print version ISSN 0037-8682

Rev. Soc. Bras. Med. Trop. vol.17 no.4 Uberaba Oct./Dec. 1984

http://dx.doi.org/10.1590/S0037-86821984000400002 

ARTICLES

 

Human mucocutaneous leishmaniasis in Três Braços, Bahia - Brazil. An area of Leishmania braziliensis braziliensis transmission. I. Laboratory diagnosis

 

 

César C. CubaI; Elmer A. Llanos-CuentasI; Air C. BarretoI; Albino V. MagalhãesI; Edinaldo L. LagoII; Steven G. ReedIII; Philip D. MarsdenI

INúcleo de Medicina Tropical e Nutrição, University of Brasília, 70910, Brasília, DF, Brazil
IISUCAM, Ministry of Health Brazil
IIICornell Medical Center, New York

 

 


ABSTRACT

Leishmanial parasites were detected in 71.2% of patients with cutaneous disease and 48% of patients with mucosal disease, using principally scanning of imprints mears and histological sections and hamster inoculation.
Parasites were more frequent in early cutaneous lesions (p < 0.005) o fless than two month duration. Also they were more common in multiple than single mucosal lesions (p < 0.02) in spite of considerable prior glucan time therapy in the former group. 93% of cutaneous lesions had a positive leishmanin skin test and most of the negatives occurred in patients with lesions of less than one month duration. 97% of patients with single mucosal lesion and 79% with multiple mucosal lesions had a positive skin test. 86% of cutaneous disease and 90% of mucosal disease was associated with a positive indirect immunofluorescent antibody test at a ≥ 1/20 dilution. In both groups multiple lesions were associated with higher titres and titres were significantly higher in patients with mucosal disease compared with cutaneous disease (p < 0.01).

Keywords: Leishmania braziliensis braziliensis. Parasite isolation. Immunodiagnosis.


RESUMO

O emprego de esfregaços por aposição (imprint), cortes histológicos e inóculo em hamster foram, em conjunto, capazes de detectar Leishmania em 71,2% de pacientes com acometimento cutâneo e 48% com acometimento da mucosa.
Os parasitos eram mais freqüentes em lesões cutâneas recentes (p. < 0,005) do que após dois meses de duração. Também eram mais freqüentes em lesões múltiplas da mucosa do que naquelas isoladas (p < 0,02) embora o primeiro grupo tivesse recebido anteriormente terapia por glucantime. 93% dos pacientes com lesões cutâneas tiveram o teste de leishmania positivo sendo que a maioria dos casos negativos ocorreu em pacientes cujas lesões tinham menos de um mês de duração. 97% dos pacientes com uma única lesão da mucosa e 79% daqueles com múltiplas lesões foram positivos para o teste de leishmanina.
O teste de imunofluorescência indireta apresentou positividade em diluições de 1:20 em 86% dos casos de acometimento cutâneo e 90% daqueles de acometimento da mucosa. Nos dois grupos as lesões múltiplas estavam associadas com os títulos mais altos e estes eram significativamente mais altos nos pacientes com acometimentos da mucosa quando comparados com os casos de compromentimento cutâneo p^0,01).

Palavras-chave: Leishmania braziliensis braziliensis. Isolamento de parasito. Imunodiagnóstico.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

REFERENCES

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4. Cuba CC, Marsden PD, Barreto AC, Roitman I, Vexenat A, De Lima L, de Sá MH. Identification of human stocks of Leishmania spp isolated from patients with mucocutaneous leishmaniasis in Três Braços, Bahia-Brazil. Transactions of the Royal Society of Tropical Medicine and Hygiene, 78: 708-710, 1984.         [ Links ]

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Recebido para publicação em 16/8/84.

 

 

This work was supported by the Brazilian Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq - Grants No. 403682/82 and 403690/82), the Brazilian Ministry of Health (SUCAM), UNDP/World Bank/W.H.O. Special Programme for Research and Traíning in Tropical Diseases and a United States Public Service grant (AI 16282-04) administered by the Department of International Medicine, Cornell Medical College, New York.

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