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Cutaneous and mucocutaneous leishmaniasis: experience of a Mediterranean hospital.
- Source :
-
Parasites & vectors [Parasit Vectors] 2020 Jan 13; Vol. 13 (1), pp. 24. Date of Electronic Publication: 2020 Jan 13. - Publication Year :
- 2020
-
Abstract
- Background: Leishmaniasis, considered by the World Health Organization as one of the most important tropical diseases, is endemic in the Mediterranean Basin. The aim of this study was to evaluate epidemiological and clinical characteristics of cutaneous (CL) and mucocutaneous leishmaniasis (MCL) in La Fe University Hospital, Valencia, Spain. The particular focus was on diagnosis techniques and clinical differences according to the immunological status of the patients.<br />Methods: An eleven-year retrospective observational study of CL and MCL episodes at the hospital was performed. Epidemiological, clinical and therapeutic variables of each case, together with the microbiological and anatomopathological diagnosis, were analyzed.<br />Results: A total of 42 patients were included, 30 of them were male and 28 were immunocompetent. Most of the cases (36/42) were diagnosed in the last 5 years (2013-2017). The incidence of CL and MCL increased from 3.6/100,000 (2006-2012) to 13.58/100,000 (2013-2017). The majority of the patients (37/42) exhibited CL, in 30 cases as single lesions (30/37). Ulcerative lesions were more common in immunosuppressed patients (13/14) than in immunocompetent patients (20/28), (P = 0.2302). The length of lesion presence before diagnosis was 7.36 ± 6.72 months in immunocompetent patients and 8.79 ± 6.9 months in immunosuppressed patients (P = 0.1863). Leishmania DNA detection (92.3%) was the most sensitive diagnostic technique followed by Giemsa stain (65%) and histopathological examination (53.8%). Twelve patients (12/42) had close contact with dogs or were living near to kennels, and 10 of them did not present underlying conditions. Intralesional glucantime (21/42) and liposomal amphotericin B (7/42) were the most common treatments administered in monotherapy. All patients evolved successfully and no relapse was reported.<br />Conclusions: Some interesting clinical and epidemiological differences were found in our series between immunocompetent and immunosuppressed patients. Future studies can take these results further especially by studying patients with biological therapy. Skin biopsies combining NAAT with histological techniques are the most productive techniques for CL or MCL diagnosis.
- Subjects :
- Administration, Cutaneous
Adolescent
Adult
Aged
Amphotericin B administration & dosage
Child
Child, Preschool
Female
Humans
Immunocompromised Host
Leishmania isolation & purification
Male
Meglumine Antimoniate administration & dosage
Middle Aged
Retrospective Studies
Risk Factors
Spain epidemiology
Young Adult
Leishmania drug effects
Leishmaniasis, Cutaneous diagnosis
Leishmaniasis, Cutaneous drug therapy
Leishmaniasis, Cutaneous immunology
Leishmaniasis, Cutaneous pathology
Leishmaniasis, Mucocutaneous diagnosis
Leishmaniasis, Mucocutaneous drug therapy
Leishmaniasis, Mucocutaneous immunology
Leishmaniasis, Mucocutaneous pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1756-3305
- Volume :
- 13
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Parasites & vectors
- Publication Type :
- Academic Journal
- Accession number :
- 31931865
- Full Text :
- https://doi.org/10.1186/s13071-020-3901-1