DOMESTIC FELINE CUTANEOUS LEISHMANIASIS IN THE MUNICIPALITY OF RIBAS DO RIO PARDO, MATO GROSSO DO SUL STATE, BRAZIL: A CASE REPORT

Cutaneous leishmaniases are anthropozoonoses that involve many species of Leishmania and a wide variety of wild mammalian hosts, thus presenting high importance to public health. This study reports the second case of feline leishmaniasis in Mato Grosso do Sul state, in which Leishmania (Leishmania) amazonensis was found in a domestic cat from Ribas do Rio Pardo. Clinical signs were similar to those observed in other diseases commonly diagnosed in cats, such as cryptococcosis and sporotrichosis. Cutaneous leishmaniasis should, therefore, be added to differential diagnoses by feline veterinary practitioners, and also adequate investigations should be carried out to verify the relevance of domestic cats as L. amazonensis reservoirs.


INTRODUCTION
Cutaneous leishmaniases are important diseases in relation to morbidity, especially in tropical areas throughout the world.Their etiological agents comprise several species of the genus Leishmania that determine different clinical aspects and present diversified epidemiology as well as heterogeneous distribution (1,2).
Leishmaniases are considered anthropozoonoses of wild animals that may infect humans at zoonotic foci.The epidemiological profile of cutaneous leishmaniases in Brazil involves a broad range of domestic and wild hosts and several phlebotomine species (3)(4)(5)(6)(7).
The present study aimed to describe the second case of cutaneous leishmaniasis in the state of Mato Grosso do Sul (MS), attributed to L. (Leishmania) amazonensis, in a domestic feline from the municipality of Ribas do Rio Pardo.

CASE REPORT
An adult domestic feline, from Ribas do Rio Pardo (MS), was referred for clinical assistance at the Veterinary Hospital of UNIDERP, presenting ulcerated lesions in the muzzle and nodules on the borders of both ears.
The animal was submitted to physical examination, hematological assay and serum biochemical tests of urea, creatinine and alanine aminotransferase (ALT).Clinical exams revealed ulcerated and hemorrhagic lesions on the muzzle, which provoked constant sneezing and mild inspiratory dyspnea (Figure 1).Floating nodules of varied sizes were also found in the pinnae.Cat physical examination showed no alteration.
Blood tests presented only a mild leukocytosis with neutrophilia while the results of serum biochemistry (urea, creatinine and ALT) were in compliance with normal values for this species.
Aspiration puncture in the nodules was performed for cytological evaluation.Smears were prepared and stained by the panoptic method.The aspirated material was also

DISCUSSION
Leishmania (L.) amazonensis is the etiological agent of anergic diffuse cutaneous leishmaniasis and is distributed broadly throughout Latin America including several regions of Brazil (1,8,9).
In Mato Grosso do Sul, human cases of Leishmania (L.) amazonensis were reported in Bela Vista city, in the south of the Bodoquena mountain ridge; whereas cat infections were registered in Assentamento Guaicurus, on the western slope of the central portion of the mountain ridge, in the municipality of Bonito (10,11).Its main vector, Bichromomyia flaviscutellata, a phlebotomine that usually does not affect humans, was found in Campo Grande and Bonito, respectively, the south and central areas of the Bodoquena mountain ridge (12)(13)(14).
As already observed by the aforementioned authors, clinical signs of protozoan diseases in cats are unspecific and similar to other infections that affect these animals, especially sporotrichosis and cryptococcosis -fungal diseases manifested through nodules and cutaneous ulcers with frequent nose impairment (23,24).It is noteworthy that the lesions observed in the present case were less severe than those reported in previous cases.
The occurrence, in Mato Grosso do Sul, of a second case of ACL in a cat -though in geographically distinct places -and its similarity to cutaneous manifestations caused by other pathogens reinforces the need to alert veterinarians to include this disease in the differential diagnosis of feline dermatopathy.
Additionally, it is important to note that, although cases reported in felines are scarce, the current situation of ACL reservoirs in Mato Grosso do Sul remains unknown.
Moreover, the lawless occupation of land, very common in the state, with abrupt changes in the original vegetation and weather alterations are factors that force phlebotomine adaptation to urban areas and may, therefore, favor the disease transmission among domestic animals (24).Further studies are necessary to clarify the role of domestic cats, as well as of other animals, in the cycle of leishmanial transmission in this region.
cultured in a McNeal, Novy and Nicole (NNN) medium with an aqueous phase containing brain-heart infusion (BHI) and subcutaneously inoculated into the upper limbs of two hamsters (Mesocricetus auratus).The smear from the lesion aspirate presented a large quantity of extracellular and intracellular amastigotes in macrophages (Figure 2) while numerous promastigotes were observed in the culture, five days post-cultivation.The parasite was identified as Leishmania (Leishmania) amazonensis by indirect immunofluorescence reaction, Souza AI et al.Domestic feline cutaneous leishmaniasis in the municipality of Ribas do Rio Pardo, Mato Grosso do Sul, State, Brazil: A case report.J Venom Anim Toxins incl Trop Dis.2009;15(2):361 employing monoclonal antibodies and the biotin-avidin system, according to Shaw et al. (2).About 15 days after the inoculation, experimental animals presented cutaneous lesions similar to those of the cat.

Figure 1 .
Figure 1.Cutaneous leishmaniasis in a feline infected with Leishmania (Leishmania) amazonensis; (A) ulcerated lesion on the nose and (B) nodules on the ear border.

Figure 2 .
Figure 2. Extracellular and intracellular amastigotes found in smear from a lesion aspirate (arrows) from a feline infected with Leishmania (Leishmania) amazonensis.
Souza AI et al.Domestic feline cutaneous leishmaniasis in the municipality of Ribas do Rio Pardo, Mato Grosso do Sul, State, Brazil: A case report.J Venom Anim Toxins incl Trop Dis.2009;15(2):363