Clinical features and diagnosis of 42 travellers with cutaneous leishmaniasis.

Abstract:

BACKGROUND:Leishmania species that occur within different geographical areas may cause different clinical manifestations, virulence and drug sensitivity. Patients/Methods. All patients with a clinical diagnosis of cutaneous leishmaniasis seen at the Hospital for Tropical Diseases from 1997 to 2000 were identified and clinical details recorded onto a database, with emphasis on clinical presentation, risk factors, travel history and laboratory diagnosis. RESULTS:Forty-two patients were identified, 23 of whom had travelled to New World and 19 to Old World countries. Clinical presentation typically consisted of a single nodule with ulceration. In 50% infection was caused by L. (Viannia) braziliensis. PCR was performed in specimens from 34 patients and species identification was possible in 32 cases (sensitivity 94%), the two PCR negative patients had amastigotes demonstrated by histology and culture. Patients were treated with established therapies. Seventy one percent were cured by treatment, 12% had a spontaneous cure, 7% were lost to follow-up and the remaining 10% required a second-line therapy. No relapses were reported during a mean follow-up period of 27 months. CONCLUSIONS:Our study highlights the need for comprehensive investigations and the advantages of PCR in the diagnosis of patients with suspected leishmaniasis in non-endemic regions of the world.

journal_name

Travel Med Infect Dis

authors

Scarisbrick JJ,Chiodini PL,Watson J,Moody A,Armstrong M,Lockwood D,Bryceson A,Vega-López F

doi

10.1016/j.tmaid.2004.11.002

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

14-21

issue

1

eissn

1477-8939

issn

1873-0442

pii

S1477-8939(04)00123-1

journal_volume

4

pub_type

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