Abstract
BackgroundLeishmaniases are regularly seen in non-endemic areas due to the increase of international travels. They include cutaneous leishmaniases (CL) and mucocutaneous (MC) caused by different Leishmania species, and visceral leishmaniases (VL) which present with non-specific symptoms.MethodsWe reviewed all consecutive leishmaniasis cases seen between September 2012 and May 2020. The diagnostic strategy included microscopy after May-Grünwald-Giemsa staining, a diagnostic quantitative PCR (qPCR) assay, and species identification based on sequencing of the cytochrome b gene.ResultsEighty-nine patients had a definitive leishmaniasis diagnosis. Nine patients had VL with Leishmania infantum. Eighty patients had CL. Twelve patients acquired CL after trips in Latin America (7 Leishmania guyanensis, 2 Leishmania braziliensis, 2 Leishmania mexicana, and 1 Leishmania panamensis). Species could be identified in 63 of the 68 CLs mainly after travel in North Africa (59%) with Leishmania major (65%), Leishmania tropica/killicki (24%), and L. infantum (11%), or in West Sub-Saharan Africa (32%), all due to L. major. The median day between appearance of the lesions and diagnosis was 90 [range 60–127].ConclusionsOur diagnostic strategy allows both positive diagnoses and species identifications. Travelers in West Sub-Saharan Africa and North Africa should be better aware of the risk of contracting leishmananiasis.
Highlights
Leishmaniases are zoonotic and anthroponotic diseases caused by several protozoan species in the genus Leishmania that are transmitted by the bites of phlebotomine sand flies
Leishmaniasis diagnosis and species identification Overall, 292 and 662 patients were tested for a suspicion of cutaneous leishmaniases (CL) and visceral leishmaniases (VL), respectively, during the study period
For 76 of the 89 (85.4%) positive samples, the diagnosis was made by microscopy showing the presence of amastigote forms on thin smears, while 13 of 89 (14.6%) samples (11 CLs and 2 VLs) were quantitative PCR (qPCR)-positive only
Summary
Leishmaniases are zoonotic and anthroponotic diseases caused by several protozoan species in the genus Leishmania that are transmitted by the bites of phlebotomine sand flies. They represent a major public health problem in endemic countries, with regular increases reported in the past decade [1,2,3]. Whereas VL in non-endemic areas is usually seen in immunocompromised adult patients living or having lived in endemic areas, imported CLs are linked to international travels. Leishmaniases are regularly seen in non-endemic areas due to the increase of international travels They include cutaneous leishmaniases (CL) and mucocutaneous (MC) caused by different Leishmania species, and visceral leishmaniases (VL) which present with non-specific symptoms. Travelers in West Sub-Saharan Africa and North Africa should be better aware of the risk of contracting leishmananiasis
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