Disseminated cutaneous leishmaniasis caused by Leishmania braziliensis in Southern Brazil

ABSTRACT The authors report a case of disseminated cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis, in a 55 years old patient with 1,119 lesions distributed throughout the body. The patient resides in Sabáudia municipality, North of Paraná State, Southern Brazil, where there was no previous report of this form of leishmaniasis. Treatment with meglumine antimoniate was successful, although the diagnosis was made only five months later.

Casos alóctones de leishmaniose visceral canina no Paraná, Brasil: implicações epidemiológicas / Allochthonous cases of canine visceral leishmaniasis in Paraná, Brazil: epidemiological implications

O presente trabalho teve como objetivo pesquisar a ocorrência de leishmaniose visceral em cães com sinais clínicos compatíveis, procedentes de clínicas veterinárias das diferentes regiões do Estado do Paraná e em caso positivo verificar a autoctonia dos mesmos. Dos animais com suspeita clínica e epidemiológica de LV, foi coletada amostra de sangue para realização de hemograma, provas bioquímicas, sorologia, cultura do parasito, PCR e RAPD. Os cães portadores de quadro clínico, como febre, hiperqueratose, onicogrifose e emagrecimento exagerado, tiveram gânglio poplíteo e/ou medula óssea puncionados e o conteúdo inoculado em meio de cultivo NNN. A extração de DNA do parasito em sangue e cultura foi realizada pelo método fenol/clorofórmio. A amplificação de DNA do protozoário foi feita por PCR e RAPD. Dos 24 animais analisados, o parasito foi isolado em 19 cães. As técnicas moleculares permitiram identificar 14 isolados como L. (Leihmania) infantum e cinco como L. (Viannia) braziliensis. A análise epidemiológica dos casos permitiu determinar o local de transmissão e definir que todos os cães com LV diagnosticados eram casos alóctones, ou seja eram importados de regiões endêmicas. Sugere-se que a migração dos cães de regiões endêmicas para regiões indenes poderá permitir a instalação de novos focos, desde que o agente encontre ecótopo adequado e vetor específico (Lutzomyia longipalpis).

The south region is the only area in Brazil that does not present autochthonous cases of visceral leishmaniasis (VL), however, in the state of Parana, dogs and humans have been found showing a VL compatible clinical profile. In view of this problem, the present work aimed at isolating and identifying the parasite and determining the cases autochthony. All animals clinically suspect of VL were clinically evaluated, and had samples of their blood collected for hemoculture (NNN culture medium), serology, PCR and RAPD-PCR, hemogram, and biochemical assays. The dogs presenting VL clinical profile had their lymph nodes and/or bone marrow punctured and their content inoculated in NNN culture medium. The protozoan isolated was identified by PCR and PCR-RAPD. Strains of Leishmania were isolated in 19 out of the 24 studied animals. Fourteen isolates were identified as L. (Leishmania) infantum, and five were L. (Viannia) braziliensis. In the epidemiological analysis, it was possible to determine that all dogs with L. (L.) infantum being allochthonous cases. Leishmaniasis is a zoonose that has the domestic dog as reservoir, the migration ofsuch animals can disseminate the parasite to other regions, provided the agent finds an adequate ecotope and a specific vector (Lutzomyia longipalpis).

Leishmaniose tegumentar americana humana e canina no Município de Mariluz, Estado do Paraná, Brasil / Human and canine American cutaneous leishmaniasis in Mariluz, Paraná State, Brazil

Relata-se a ocorrência de um surto de leishmaniose tegumentar americana no ano de 2002, no Município de Mariluz, mesorregião noroeste do Estado do Paraná, Brasil. Das 38 pessoas investigadas, quatro tinham lesões cicatrizadas, 10 em cicatrização e 24 tinham lesões ativas. Dos 126 cães investigados, 20 (15,9 por cento) tinham lesões sugestivas e 24 (19 por cento) tiveram sorologia positiva. Os parasitos isolados de dois pacientes e de três cães foram identificados como Leishmania (Viannia) braziliensis serodema I. Os flebotomíneos coletados foram identificados como Nyssomyia whitmani, N. neivai e Migonemyia migonei. Considerando que a área onde ocorreram os casos é semelhante a outras de colonização antiga no Estado do Paraná, acredita-se que as alterações ambientais e as matas remanescentes propiciam a manutenção do ciclo enzoótico do parasito e a transmissão para o homem e para os animais domésticos, mantendo o caráter endêmico da leishmaniose tegumentar americana.

An outbreak of American cutaneous leishmaniasis was reported in 2002 in Mariluz, northwestern Paraná State, Brazil. Of 38 humans who were investigated, four had healed lesions, ten showed lesions in the healing process, and 24 had active lesions. Of the 126 dogs, 20 (15.9 percent) presented suggestive lesions and 24 (19 percent) had positive serology. Parasites isolated from two patients and three dogs were identified as Leishmania (Viannia) braziliensis serodeme I. The captured sand flies were identified as Nyssomyia whitmani, N. neivai, and Migonemyia migonei. Considering that the region where the cases occurred is similar to other old human settlements in Paraná State, the environmental alterations and remaining forests facilitate the maintenance of the parasite's enzootic cycle and transmission to humans and domestic animals, thereby maintaining the endemicity of American cutaneous leishmaniasis.

Flebotomíneos de municípios do norte do estado do Paraná, sul do Brasil / Sandflies of municipalities in North of Paraná State, South of Brazil

This work reports the results of sandfly collections in several places, during 2001 and 2002, in Bom Sucesso, Jardim Alegre, Kaloré, Londrina and Sabáudia municipalities, North of the State. The sandflies catches were performed with Shannon and Falcão traps in domiciliary areas, domestic animal shelters, barns and in the forest. A total of 4,019 specimens of 8 species were captured. Nyssomyia whitmani predominates in all of the municipalities. The species Migonemyia migonei, Nyssomyia neivai and N. whitmani may be involved in the epidemiology of American Tegumentary Leishmaniasis in this state.