Relevance of epidemiological surveillance in travelers: an imported case of Leishmania tropica in Mexico

We report the case of a patient with cutaneous leishmaniasis who showed a rapidly progressing ulcerative lesion after traveling to multiple countries where different Leishmania species are endemic. Diagnosis of Leishmania tropica, an exotic species in Mexico was established by using serological and molecular tools.

Leishmania tropica; Molecular epidemiology; Local cutaneous leishmaniasis; Travel medicine

Authorship

Edith Araceli Fernández-Figueroa

Instituto Nacional de Medicina Genómica, Departamento de Genómica Poblacional, Genómica Computacional e Integrativa, Ciudad de México, MexicoInstituto Nacional de Medicina GenómicaMexicoCiudad de México, MexicoInstituto Nacional de Medicina Genómica, Departamento de Genómica Poblacional, Genómica Computacional e Integrativa, Ciudad de México, Mexico

Universidad Nacional Autónoma de México, Facultad de Medicina, Unidad de Investigación en Medicina Experimental, Centro de Medicina Tropical, Ciudad de México, MexicoUniversidad Nacional Autónoma de MéxicoMexicoCiudad de México, MexicoUniversidad Nacional Autónoma de México, Facultad de Medicina, Unidad de Investigación en Medicina Experimental, Centro de Medicina Tropical, Ciudad de México, Mexico

https://orcid.org/0000-0002-5159-8300

Sokani Sánchez-Montes

https://orcid.org/0000-0001-6316-2187

Haydee Miranda-Ortíz

Instituto Nacional de Medicina Genómica, Unidad de Secuenciación, Ciudad de México, MexicoInstituto Nacional de Medicina GenómicaMexicoCiudad de México, MexicoInstituto Nacional de Medicina Genómica, Unidad de Secuenciación, Ciudad de México, Mexico

https://orcid.org/0000-0003-2275-3727

Alfredo Mendoza-Vargas

https://orcid.org/0000-0001-8774-1706

Rocely Cervantes-Sarabia

Universidad Nacional Autónoma de México, Facultad de Medicina, Unidad de Investigación en Medicina Experimental, Laboratorio de Inmunoparasitología, Ciudad de México, MexicoUniversidad Nacional Autónoma de MéxicoMexicoCiudad de México, MexicoUniversidad Nacional Autónoma de México, Facultad de Medicina, Unidad de Investigación en Medicina Experimental, Laboratorio de Inmunoparasitología, Ciudad de México, Mexico

Roberto Alejandro Cárdenas-Ovando

Instituto Tecnológico y de Estudios Superiores de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Nuevo León, MexicoInstituto Tecnológico y de Estudios Superiores de MonterreyMexicoMonterrey, Nuevo León, MexicoInstituto Tecnológico y de Estudios Superiores de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Nuevo León, Mexico

https://orcid.org/0000-0002-8261-1037

Adriana Ruiz-Remigio

Ingeborg Becker

https://orcid.org/0000-0003-3821-4998

Correspondence to: Ingeborg Becker Hospital General de México, Dr. Balmis 148, Col. Doctores, 06726, Ciudad de Mexico, Mexico Tel: +52 555623 2674 Email:becker@unam.mx

SCIMAGO INSTITUTIONS RANKINGS

Figures | Tables

Figures (2)
Tables (1)

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Figure 1
Photographs of the ulcer on the forearm: A) active injury; B) injury after the glucantime treatment.

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Figure 2
Molecular identification of Leishmania tropica: A) ALAT. PCR products of parasites isolated from the patient in lines 1 and 2 (3 and 2 µL, respectively), Leishmania mexicana positive control (line 3), Nuclease-free water as the negative control (line 4). L=Ladder 100 pb; B) hsp70-C) ITS1. PCR products of parasites isolated from the patient in lines 1 and 3 (3 and 2 µL, respectively), positive control (line 5), and negative control (line 4); D) Maximum Likelihood phylogenetic trees generated using the Tamura three-parameter distance model with Invariant sites (+I) with partial sequences of the ALAT gene, and E) Hasegawa-Kishino-Yano with Gamma distribution (+G) of the hsp70 gene from several members of the genus Leishmania. Bootstrap values greater than 50 are indicated on the nodes. The sequences generated in this study are indicated with red triangles.

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Table 1
The mean optical densities (OD) recorded in ELISA test for each Leishmania species.

Figure 1 Photographs of the ulcer on the forearm: A) active injury; B) injury after the glucantime treatment.

Figure 2 Molecular identification of Leishmania tropica: A) ALAT. PCR products of parasites isolated from the patient in lines 1 and 2 (3 and 2 µL, respectively), Leishmania mexicana positive control (line 3), Nuclease-free water as the negative control (line 4). L=Ladder 100 pb; B) hsp70-C) ITS1. PCR products of parasites isolated from the patient in lines 1 and 3 (3 and 2 µL, respectively), positive control (line 5), and negative control (line 4); D) Maximum Likelihood phylogenetic trees generated using the Tamura three-parameter distance model with Invariant sites (+I) with partial sequences of the ALAT gene, and E) Hasegawa-Kishino-Yano with Gamma distribution (+G) of the hsp70 gene from several members of the genus Leishmania. Bootstrap values greater than 50 are indicated on the nodes. The sequences generated in this study are indicated with red triangles.

Table 1 The mean optical densities (OD) recorded in ELISA test for each Leishmania species.

Species	OD	Cut point	Result	Interpretation
Leishmania braziliensis	0.501	0.249	0.252	Borderline
Leishmania infantum/chagasi	0.356	0.178	0.178	Borderline
Leishmania major	0.435	0.191	0.244	Positive
Leishmania mexicana	0.548	0.204	0.344	Positive

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Relevance of epidemiological surveillance in travelers: an imported case of Leishmania tropica in Mexico

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[1] Correspondence to: Ingeborg Becker Hospital General de México, Dr. Balmis 148, Col. Doctores, 06726, Ciudad de Mexico, Mexico Tel: +52 555623 2674 Email:becker@unam.mx