Cases Of Cutaneous Leishmaniasis Research Articles

Evaluation of the Diagnostic Sensitivity of the VIASURE Leishmania Real-Time PCR Detection Kit Prototype for the Diagnosis of Cutaneous and Visceral Leishmaniasis

Leishmaniasis is a parasitic disease with clinical presentations that vary from asymptomatic infection to cutaneous, mucocutaneous, or visceral disease. Global change, with migratory movements and travels, among others, has had an impact on the presentation of the clinical forms of leishmaniasis in a given area, hindering its diagnosis. The traditional parasitological techniques have limited sensitivity, and currently, there is no reference or gold-standard molecular diagnostic method. The aim of this study was to evaluate the effectivity of the VIASURE Leishmania Real-Time PCR Detection Kit prototype (CerTest Biotec, Zaragoza, Spain) for the diagnosis of autochthonous and imported leishmaniasis in comparison with two other commercialized molecular kits: STAT-NAT® Leishmania spp. (Sentinel, Milano, Italy) and Leishmania spp. Real-TM PCR Kit (Sacace Biotechnologies, Como, Italy). Four species of Leishmania, L. infantum, L. major, L. braziliensis, and L. panamensis, were targeted to assess analytical sensitivity, whereas diagnostic sensitivity was evaluated by studying a panel of 49 DNA samples from patients with suspected or confirmed Leishmania infection. The prototype could detect all the New and Old World species studied and achieved a limit of detection of 5 × 10−5 ng DNA/μL in all species. Also, it allowed the diagnosis of autochthonous and imported cases of cutaneous and visceral leishmaniasis (VL). Diagnostic sensitivity was 81.8% for the prototype and 100% for the Sacace kit (27 and 33 positive samples detected, respectively). The STAT-NAT® kit failed to detect Vianna species. The VIASURE Leishmania Real-Time PCR Detection Kit prototype was found to have good analytical and diagnostic sensitivity. Using a simple protocol and ready-to-use reagents, results are obtained quickly and are easy to interpret. The evaluation results indicate that the test is a promising candidate for routine diagnosis of cutaneous leishmaniasis and VL in endemic countries, but more studies are necessary to address its sensitivity and specificity.

Entomological, parasitological and molecular investigations in a new focus of cutaneous leishmaniasis in Youssoufia region, Morocco.

Leishmaniasis is a neglected tropical infection caused by Leishmania parasite that affect human and animal. In Morocco, the cutaneous leishmaniasis has spread substantially to the new areas. The surveillance limited to active foci may underestimate the occurrence of cutaneous leishmaniasis (CL). This study aims to investigate the local transmission of CL in rural districts of Youssoufia province, central Morocco, as a potential focus of CL. For this purpose, parasitological, molecular and entomological investigations were carried out in this area. Data collection concerns potential vectors and human cases. Thus, 402 patients were examined for suspected leishmaniasis lesions in three localities of the province of Youssoufia. In these same localities, 983 sand flies were collected by CDC light traps and sticky paper during one-night per month during 6 months. These sand flies were all identified morphologically using the Moroccan identification key. The results showed that among the 25 skin lesions detected in a population of 402 individuals, 18 were confirmed by kDNA nested PCR as CL positive patients, of which only 25% were positive by direct examination. Leishmania tropica and Leishmania major were identified as causative agents of CL in the study area. Direct parasitological examination showed a low sensitivity (27.78%), especially for L. major, although its specificity was evaluated at 100%. Regarding entomological results, both genera of the Moroccan sand fly were collected in the study area: Genus/Phlebotomus (75.28%) and Sergentomyia (24.72%). Phlebotomus (P) papatasi, the proven vector of L. major, was the most abundant species (33.98%), followed by Paralongicollum sergenti (22.58%), the confirmed vector of L. tropica; while Sergentomyia (S) minuta, P. longicuspis, S. fallax and P. kazeruni were collected with, respectively, 17.60%, 16.99%, 7.12% and 1.73%. This study constitutes the first report of CL in the study areas, as well as the coexistence of L. tropica and L. major in these rural localities. Local transmission of CL is highly probable, as indicated by the prevalence of the two proven vectors of L. major and L. tropica. To control the spread of this disease, our results suggest the use of highly sensitive molecular methods to detect CL cases in potential leishmaniasis foci, which will improve surveillance.

Genetic characterization and description of Leishmania (Leishmania) ellisi sp. nov.: a new human-infecting species from the USA

In a 2018 report, an unusual case of cutaneous leishmaniasis was described in a 72-year-old female patient residing in Arizona, United States of America (USA). Preliminary analysis of the 18S rDNA and glyceraldehyde-3-phosphate dehydrogenase genes supported the conclusion that the Leishmania strain (strain 218-L139) isolated from this case was a novel species, though a complete taxonomic description was not provided. Identification of Leishmania at the species level is critical for clinical management and epidemiologic investigations so it is important that novel human-infecting species are characterized taxonomically and assigned a unique scientific name compliant with the ICZN code. Therefore, we sought to provide a complete taxonomic description of Leishmania strain 218-L139. Phylogenetic analysis of several nuclear loci and partial maxicircle genome sequences supported its position within the subgenus Leishmania and further clarified the distinctness of this new species. Morphological characterization of cultured promastigotes and amastigotes from the original case material is also provided. Thus, we conclude that Leishmania (Leishmania) ellisi is a new cause of autochthonous cutaneous leishmaniasis in the USA.

A Case of Cutaneous Leishmaniasis Cured by a Combined Treatment of Topical Miltefosine and Injectable Amphotericin B

<img src=” https://s3.amazonaws.com/production.scholastica/article/90983/large/prnano_1012023bg.jpg?1702069910”> A male rural worker with cutaneous leishmaniasis (CL) was initially treated with repeated cycles of Meglumine Antimoniate (Glucantime®) and two cycles of Amphotericin B deoxycholate during a three-year period. However, the patient remained with two active lesions. An experimental topical treatment with liposomal Miltefosine was tested. The efficacy was determined from the MD’s in-spection of the patient and analysis of the lesions’ photographic images, lesions samples culture, and anti-Leishmania antibodies quantification. The parasites from the patient were isolated. The parasites were typified as Leishmania braziliensis, and their susceptibility to Miltefosine, Meglu-mine Antimoniate, and Amphotericin B was measured. The wound healing was initially good with the topical treatment, but the clinical cure was achieved only with a combination of the topical lipo-somal Miltefosine and intravenous Amphotericin B. Of note, the treatment efficacy was strongly correlated with the degree of stress suffered by the patient. To our knowledge, this is the first report on using a topical Miltefosine formulation on a CL patient.

Leishmaniasis: neglected diseases also by health professionals

The increasing number of cases of leishmaniasis, the expansion of transmission areas, and its high impact on public health highlight that there are still many challenges to achieving success in the Surveillance and Control Program of this neglected disease. Additionally, the inherent difficulty in early diagnosis and prompt and accurate therapeutic intervention make leishmaniasis still a health problem that afflicts society. In 2017, the first case of human visceral leishmaniasis (VL) was reported in Lavras, in the southern state of Minas Gerais. Since then, seven more cases have been reported, with two resulting in death. Regarding Cutaneous Leishmaniasis (CL), it has also been reported in several municipalities in the region. In this context, it is necessary to study new control strategies, as well as optimize existing ones, to prevent the occurrence of new cases of the disease. In light of the above, this study aimed to investigate cases of VL and CL in the area covered by the Regional Health Secretariat (RHS) of Varginha and understand the perception of primary health care professionals (PHCPs) regarding this condition. To meet these objectives, existing data in the RHS of Varginha were analyzed, seeking a better understanding of the existing gaps in the field of leishmaniasis. A total of 115 PHCPs representing all 50 municipalities in the Health Region participated in the study. Participants were questioned about the management of leishmaniasis cases, transmission mode, clinical signs, and biological, and epidemiological aspects of the disease. After analyzing the results, it was possible to perceive a lack of knowledge about the local epidemiological reality, as well as difficulties in identifying prevention and control measures related to reservoirs, the environment, and humans. The conceptual gaps among health professionals reinforce the pressing need to implement continuing education programs, given the indispensable role of these professionals in the success of the control program.

Epidemiological survey, molecular profiling and phylogenetic analysis of cutaneous leishmaniasis in Khyber Pakhtunkhwa, Pakistan.

Cutaneous leishmaniasis (CL), an emerging vector-borne ailment in Khyber Pakhtunkhwa (KPK), Pakistan, exhibits diverse spread patterns and outbreaks. To comprehend its epidemiology and identify parasite species, we conducted an active survey on suspected CL cases (n=8845) in KPK. Microscopy and internal transcribed spacer-1 PCR-restriction fragment length polymorphism (RFLP) molecular techniques detected Leishmania spp. in blood samples. Phylogenetic analysis gauged genetic affinities with other areas. District Bannu displayed the highest CL impact (14.58%), while Swat had the lowest impact (4.33%) among cases. Annual blood examination rate, parasite incidence and slide positivity rate were 4.96 per 1000 people, 0.0233 and 0.047%, respectively. CL infections were prevalent in 1- to 20-y-olds, with males (57.17%) more vulnerable than females (42.82%). Single lesions occurred in 43.73% of patients, while 31.2% people had two lesions, 17.31% had three lesions and 7.74% had more than three lesions. Most had sand-fly exposure but lacked preventive measures like repellents and bed nets. Leishmania tropica was confirmed via RFLP analysis in amplified samples. Phylogenetic analysis unveiled genetic parallels between L. tropica of KPK and isolates from China, Iran, Afghanistan, India, Syria and Morocco. Urgent comprehensive control measures are imperative. Early detection, targeted interventions and raising awareness of CL and sand-fly vectors are vital for reducing the disease's impact. International collaboration and monitoring are crucial to tackle Leishmania spp.'s genetic diversity and curtail its cross-border spread.

The History of New World Leishmaniases From a Brazilian Perspective

Abstract This article addresses the leishmaniases in the Americas from a Brazilian perspective. The first cases of cutaneous and mucocutaneous leishmaniasis were described in 1909 in São Paulo. Latin American researchers gained international projection because of their work on this disease they considered autochthonous, which came to be known as American tegumentary leishmaniasis. But visceral leishmaniasis only emerged as a public health problem in the Americas in 1934 thanks to a new diagnostic technique for yellow fever. Zoonoses earned greater attention later, especially in the laboratory founded in 1965 at the Evandro Chagas Institute by Ralph Lainson and Jeffrey Shaw. Here we examine their connections with other teams and the resulting changes when they proved that parasite, vector, and host populations were much more heterogeneous than previously imagined. Technical innovations provided a better understanding of the distinct epidemiological characteristics of the illnesses caused by different Leishmania amid a backdrop of far-reaching transnational networks.

1392. An observational study to test efficacy of oral fluconazole in pediatric cases of Cutaneous Leishmaniasis

Abstract Background Cutaneous Leishmaniasis(CL) is the commonest form of Leishmaniasis with a worldwide incidence of about 0.7 to 1.2 million cases per year and 90% of these cases are in Asia, the Middle East, South America, and North Africa. Pentavalent antimony medications are still the most effective treatments for leishmaniasis, however, due of the severe side effects and the need for parenteral administration, other therapies, such as oral medicines for cutaneous leishmaniasis, have been sought. Given the extended duration of the illness and the disfiguring impact of unhealed skin lesions, a well-tolerated oral medication would be beneficial. In vitro, certain azole antifungal medications exhibit cidal action against leishmania. Fluconazole, a triazole antifungal drug available for oral administration, has clinical efficacy against leishmania but very limited data is available to support this. Methods To test the efficacy of oral fluconazole in CL in children we treated 14 Indian patients of age less than 12 years with once daily doses of fluconazole for four weeks. Patients less than 12 years old with clinically and smear positive confirmed cases were included in the study. Immuno-compromised patients were excluded. Results In the majority of patients, a parasitological smear was used to confirm the diagnosis, and in a few cases, histological testing was used. 10 patients were male, and mean values (SE:Standard error) at study entry were: age, 7(2) years; weight, 20 (3) kg; duration of illness, 2·4 (0·4) months. All children were prescribed fluconazole dispersible tablet at the dose of 3-5 mg/kg body weight to adjust doses in multiple of 50 mg of dispersible tablet daily. No drug discontinuation or any case drop out was noted as the drug was well tolerated and there was good noticeable clinical response. Intermittent nausea and occasional diarrhea was the most common side effect (7% of cases). Clinical cure was noted with complete clearance of skin lesions in all 14 cases and no appearance of any new lesions was observed over next 3 months. The average treatment response time was 43 days Conclusion There are very limited studies on the use of fluconazole in pediatric CL in endemic areas and this study suggests a very safe and effective treatment option. Disclosures All Authors: No reported disclosures

Cutaneous Leishmaniasis Prevalence and Clinical Overview: A Single Center Study from Saudi Arabia, Eastern Region, Al-Ahsa.

Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease that is transmitted via the bites of infected female sandflies. CL has been endemic in several countries worldwide for many decades, and numerous cases have been reported in Saudi Arabia, particularly across six regions; one of which is AL-Ahsa. Our research aimed to evaluate the epidemiological situation of CL among the patients in Al-Ahsa, Eastern region, Kingdom of Saudi Arabia, during the period from 2017 to 2023. The data were collected from the patients' registries and included 245 patients who were diagnosed with CL in Al-Ahsa, Saudi Arabia. Fewer than half of the cases (47.8%) were Saudi patients, with a significant number of them being males (84.5%). Over half of the cases (52.7%) were aged between 21 and 40 years, and about three-quarters (74.7%) of the cases resided in rural areas. Regarding the nature of the lesions, 38.4% of the cases had one lesion, which was mainly distributed on a lower extremity (62.0%) or an upper extremity (52.2%). A high percentage of the lesions (75.2%) were wet lesions and caused by L. major. Concerning risk factors, a greater number of patients (71.4%) had been in rural areas within the last three months. Additionally, more than half of the cases (54.3%) had close contact with rodents, followed by birds (28.2%), sheep (22.0%), dogs (16.3%), and other animals (1.2%). The results showed a low number of reported CL cases in 2020 and 2021, followed by a surge in 2022 and 2023. The study shows that cutaneous leishmaniasis is still a public health problem in Al-Ahsa and is primarily associated with rural areas.

Health Profile of Afghan Pediatric Refugees Resettled to Philadelphia in 2021-2022.

To elucidate the physical and psychosocial health needs of newly arrived Afghan children, we conducted a retrospective chart review of patients 0 to 19 years re-settled to Philadelphia with ≥1 outpatient visit during August 2021 to August 2022. Findings on 121 patients include dental caries (74%), elevated lead (32%), eosinophilia (29%), malnutrition (25%), schistosomiasis (6%), strongyloidiasis (8%), latent tuberculosis (7%), and two cases of cutaneous leishmaniasis. Mental health symptoms include poor sleep in 16%, low energy in 10%, and behavioral concerns in 13%. Families with low English proficiency were more often met with delayed medical care (26.7% vs 11.5% P = .12). Parents with less than a high school education were more likely to experience delayed care (38.5% vs 9.1%; P = .001). We conclude that recently arrived Afghan children have unique physical and mental health needs that need to be addressed.

Clinical Risk Factors of Systemic Antimony Treatment Failure in Patients with Acute Cutaneous leishmaniasis referred to the Dermatology Clinics of Mashhad University of Medical Sciences, Iran

Background: Systemic or topical forms of pentavalent antimony compounds such as meglumine antimoniate (MA) are used as standard treatment for cutaneous leishmaniasis (CL). However, an increasing number of studies demonstrate evidence of treatment failure with these drugs. The objective of this study was to determine the factors associated with systemic MA treatment failure in patients with acute CL. Methods: In this case-control study, patients with urban cutaneous referred to leishmaniasis clinics in Mashhad from 2017 to 2018 were followed up 12 months after the start of treatment and were evaluated for improvement or failure according to the national leishmaniasis protocol. Results: A total of 112 cases of CL (59 men and 53 women) with a mean age of 23.3±21.11 years were studied. The number of patients with clinical improvement was significantly higher in women (P=0.005). Age, body mass index (BMI), occupation and education, the possible infection and living location, past medical, drug and leishmaniasis recurrence history, lesion’s characteristics and ulceration were also significantly different between the two groups of improved and unhealed patients. Conclusion: The results of this study showed that the male sex, age less than 18 years, receiving pentostam, previous treatment history, lymphadenopathy, urban leishmaniasis, duration of illness more than 4 months, having a single lesion especially on the face, BMI less than 18 kg/m2 and a lesion size of more than 3 cm is more common in patients with treatment failure.

A case of unhealing skin ulcer with iatrogenic Cushing’s syndrome

Cutaneous Leishmaniasis is a rare disease in South-East Asian countries like Bangladesh, often presenting as skin lesions, ulcers or granulomatous plaques on the arm or back. As the disease is uncommon, high index of suspicion is required for the diagnosis. We are presenting a case of cutaneous Leishmaniasis in a migrant Bangladeshi worker in the Kingdom of Saudi Arabia (KSA). The case was initially treated with antibiotics, emollients and systemic steroid for a long time. However, the disease progressed, and the patient developed features of iatrogenic Cushing syndrome. The diagnosis was confirmed with a skin biopsy, which revealed Leishmania parasite. He received treatment with Injectable liposomal Amphotericin B (LAmB) and oral Miltefosine with promising clinical response. Clinicians should be vigilant while treating non-healing ulcers, and consider CL when there is history of travelling to CL endemic areas J Bangladesh Coll Phys Surg 2023; 41(4): 334-337

Investigation of Leishmania Parasite from Suspected Cases of Cutaneous Leishmaniasis

Çalışmada Mersin Üniversitesi Hastanesi Dermatoloji Polikliniği’ne başvuran kutanöz leishmaniasis (KL) şüpheli olgularda üç farklı yöntem kullanılarak Leishmania paraziti araştırılması ve vakaların epidemiyolojik açıdan değerlendirilmesi amaçlanmıştır. KL şüpheli 16 hastanın, mikroskobik inceleme yapılmak üzere cilt lezyonlarından kazıntı alındı. Giemsa boyama yöntemi ile hazırlanan preparatlar ışık mikroskobunda incelenerek parazitin amastigot formları araştırıldı. Yara bölgesinden aspirat alınarak polimeraz zincir reaksiyonu (PZR) yöntemi ile parazitin DNA’sı araştırıldı. Beş hastadan alınan örneğin Novy-MacNeal-Nicolle (N.N.N) besiyerine ekimi yapıldı. Çalışmaya katılan hastaların %50 (n=8)’si erkek, %50 (n=8)’si kadındır. Türk kökenli hastaların oranı %37,5 (n=6), Suriye kökenli hastaların oranı %62,5 (n=10) olarak bulundu. Çalışmaya katılan KL şüpheli hastaların yaş ortalaması 28,31±24,73’tür. Mikroskobik incelemede pozitif vakalarının oranı %25 (n=4), PZR yöntemi ile tanı alan vakaların oranı ise %37,5 (n=6) olarak tespit edildi. Kültürü yapılan hiçbir örnekte üreme olmadı. PZR sonucuna göre pozitif olan 6 hastanın %83,3’ü (n=5) Suriye göçmeni iken %16,7 (n=1)’si Türk’tür. Türkiye’nin bazı bölgelerinde KL halen bir halk sağlığı sorunudur. KL’nin doğru tanısı için klinik bulgular laboratuvar tanısı ile desteklenmelidir. Kullanılan yöntemler arasında en duyarlı yöntem PZR’dir. Mikroskobik inceleme daha az duyarlılık göstermektedir. Ayrıca Suriye’de yaşanan savaştan dolayı KL vaka sayısı artışı Türkiye’ye yansımıştır. Mersin’de yapılan bu çalışmada KL tanısı alan vakaların çoğunun Suriye kökenli bulunması hastalığın göçe bağlı artış gösterebileceğini düşündürmektedir.

Epidemiological Features and Clinical Manifestations of Cutaneous Leishmaniasis: An Emerging Health Risk in Hambantota, Sri Lanka

Cutaneous leishmaniasis (CL) is an established disease in Sri Lanka. Present study was designed to investigate the epidemiological features, clinical manifestations and the relationship between CL cases and rainfall in Hambantota district, Sri Lanka from March, 2014 to December, 2015. CL suspected patients who presented to Tangalle and Hambantota hospitals during this period were included in the study. After conducting a clinical examination, a descriptive study was carried out using a questionnaire. Slit-skin smears were taken, stained with Giemsa and examined under a light microscope to identify Leishmania amastigotes. Results showed that the highest CL cases were reported from Tangalle District Secretory Division (DSD) out of 12 DSDs in Hambantota district (P<0.05). Majority of patients were >50 years old. Males were more infected than females. Higher number of CL patients were students (χ2 (10) = 6.41, P=0.781). Most of the patients had single lesion on arms, legs and faces/cheeks. Size of the most lesions was >2mm -<1cm and the duration of the most lesions were <06 months. The common clinical characteristics of lesions were erythematous and dry. Further, findings revealed that the higher number of CL cases were reported in March, May, August, October in 2014 and January to March in 2015 in which the study area had received higher amount of rainfall. Findings of the present study showed that the CL incidences and its distribution within Hambantota district had increased. It is essential to consider CL as a public health problem in Hambantota district. Bangladesh J. Zool. 51(1): 71-85, 2023

A challenging case of cutaneous leishmaniasis with thrombophlebitic complication

AbstractWe report a case of cutaneous leishmaniasis caused by Leishmania guyanensis with sporotrichoid lymphocutaneous dissemination of the parasite and thrombophlebitic complication in a 32‐year‐old man who had recently travelled to French Guiana. After initial failure of empirical treatment with amphotericin B, the patient evolved favourably on high doses of intramuscular injections of meglumine antimoniate for 2 months. This case illustrates the existence of lymphocutaneous forms and possible thrombophlebitic complications of leishmaniasis. It also highlights the challenges in the management of leishmaniasis, despite the existence of guidelines and a wide therapeutic arsenal.

Real-time impact of COVID-19 pandemic on cutaneous leishmaniasis case finding and strategic planning, preventive interventions, control and epidemiology in a region with a high burden of cutaneous leishmaniasis and COVID-19: A cross-sectional descriptive study based on registry data in Ilam-Iran.

Cutaneous leishmaniasis (CL) is a severe parasitic disease affecting people, mostly in underdeveloped nations. As a zoonotic infection yearly incidence of CL depends on several parameters such as demographic, epidemiological, and environmental factors as well as prevention and control measures. The sudden outbreak of pandemics such as SARS-Corona-Virus-2 pandemic, can probably affect the incidence or reporting of other diseases, especially infectious diseases, in various ways such as pressure on health systems, providing sanitary services and its components, lockdowns and changes in people's living habits. This study aimed to evaluate the COVID-19 impact on the incidence and other epidemiological aspects as well as control measures of CL in Ilam Province-Iran. Required data was extracted from the CL registration system in Ilam from 2014 to 2021 to demonstrate the trend of CL incidence before and after COVID-19 pandemic. Based on our results, a declining pattern of CL incidence was observed, accompanied by the advent and intensification of the viral pandemic in Iran and Ilam province. Although, this decreasing pattern was not integral in all areas, and even increase in CL detection was emphasized in some regions. It may be inferred that the COVID-19 pandemic may disrupt treatment programs of CL cases, rodent nest destruction, and fighting vector insects.

Leishmania donovani persistence and circulation causing cutaneous leishmaniasis in unusual-foci of Nepal

Cutaneous leishmaniasis cases have increased dramatically in recent years in Nepal. The study offers molecular identification of the Leishmania species using 40 patient’s aspiration biopsy samples, targeting markers kinetoplast minicircle DNA (kDNA) and internal transcribed spacer-1 (ITS1). Among molecularly diagnosed 22 cutaneous leishmaniasis cases, L. donovani complex was identified in 13 instances and L. major in 9 cases. The ITS1 PCR was positive in 12 of the positive nested- kDNA PCR cases (12/22), confirming L. donovani complex in seven of the cases and L. major in five of the cases. In addition, the study conclude that concurrent occurrence of atypical cutaneous infections caused by L. donovani parasite in 59.1% of cases and typical cutaneous infections caused by L. major parasite in 40.9% of cases. A Phylogentic analaysis showed that the detected L. donovani species present null genetic distances from seven references of L. donovani, but slight differences between ITS1 sequences and not grouped into a significant monophyletic cluster.

A rare form of leishmaniasis, identified in the Russian Federation

Diffuse cutaneous leishmaniasis is a rare form of cutaneous leishmaniasis characterized by an inadequate immune response of the host cells to parasitic invasion (weak T-helper (Th)1 response or Th2 response with the production of interleukin IL-4 and IL-10). The characteristic features of the disease include diffuse nodular eruption, masquerading as leprosy and a frequent association with immunosuppression (HIV co-infection, for example). The Russian Federation is a non-endemic country for leishmaniasis, but this disease can be brought into the country by tourists, immigrants, refugees and military personnel. A clinical case of diffuse cutaneous leishmaniasis and HIV co-infection is presented. The patient was a citizen of Uzbekistan, a country endemic for leishmaniasis. The authors were unable to find domestic scientific publications describing cases of diffuse cutaneous leishmaniasis detected in the Russian Federation. The presented clinical case of diffuse cutaneous leishmaniasis in a patient with HIV is the first in the Russian literature.

Molecular Identification of Cutaneous Leishmaniasis Vectors in Alborz Province, North of Iran.

Cutaneous leishmaniasis (CL) is a vector-borne disease widely distributed in tropical and subtropical areas of North and South America, Europe, Asia, and Africa. Considering the increasing number of CL cases in recent years and the fact that no study has been conducted to identify CL fauna and vectors in Alborz province, this study was carried out to identify sand flies and CL vectors in this region. Sand flies were collected from August to October 2021 from plain and mountainous indoor and outdoor areas of the region using sticky paper traps and were detected morphologically. DNA was extracted from the midguts of female sand flies. In this study, 1157 sand flies were collected and identified. The number of sand flies caught from indoor and outdoor places was 367 (31.72%) and 790 (68.28%), respectively. Overall, six species of flies were of the genus Phlebotomus (Raynal, 1937), including Phlebotomus papatasi (P. papatasi, 695 [60.07%]; Scopoli, 1786), P. kandelakii (13 [1.12%]; Shchurenkova, 1926), P. sergenti (232 [20.05%]; Parrot, 1917), P. major (14 [1.21%]; Annandale, 1910), P. caucasicus (4 [0.35%]; Marzinowsky, 1917), P. alexandri (18 [1.56%]; Alexandri Sinton, 1920), and four were of the genus Sergentomyia (Artemiev, 1978), including Sergentomyia tiberiadis (109 [9.42%]; Adler, Theodor & Lourie, 1930), Sergentomyia baghdadis (53 [4.58%]), Sergentomyia sintoni (14 [1.21%]; Sintoni Pringle, 1933), Sergentomyia clydei (5 [0.43%]). P. papatasi spp. were dominant in indoor and outdoor places, with a prevalence of 695 (60.07%). The Leishmania major (L. major) gene was identified in five samples of P. papatasi spp. This suggests that P. papatasi is the potential vector spp. in the study area. Moreover, L. major was confirmed as the aetiological agent of CL cases in Alborz province. The identification of vectors and parasite spp. is very important for the treatment and operational planning of disease vectors.

Application of CL Detect™ rapid test for diagnosis and liposomal amphotericin B for treatment of cutaneous leishmaniasis: A retrospective analysis from a tertiary care centre in a non-endemic area in India.

Background Increasing urbanisation has led to the occurrence of cutaneous leishmaniasis (CL) in new areas, which was otherwise localised to endemic areas. Healthcare workers should be made aware of this entity to ensure clinical suspicion of CL and investigations needed to confirm CL. The article describes patients seen at a tertiary hospital in Delhi. Aims To establish the utility of the CL Detect Rapid test as a diagnostic tool and the efficacy of Liposomal Amphotericin B (LAmB) for the complete cure of CL patients. Methods Data of patients of CL (n = 16) was retrospectively analysed concerning diagnosis and treatment. Diagnosis rested on histopathology, real-time PCR, and CL Detect Rapid Test. Speciation of the parasite was based on the Internal transcribed spacer-I gene. Patients were treated with LAmB (i.v., 5 mg/kg up to three doses, five days apart). Results A positivity of 81.3% (95%CI, 54.4-96) was observed for CL Detect Rapid test in comparison with 100% (95%CI, 79.4-100.0) for real-time PCR and 43.8% (95%CI, 19.8-70.1) for microscopy/histopathological examination. L. tropica was the infective species in all cases. All the patients treated with LAmB responded to treatment, and 9/10 patients demonstrated complete regression of lesions, while one was lost to follow-up. Limitations It is a retrospective study, and the data includes only confirmed cases of CL at a single centre. Conclusion This study highlights the utility of CL Detect as a promising diagnostic tool and the efficacy of LAmB for the complete cure of CL.