ABSTRACT
La Leishmaniosis Cutánea Localizada (LCL) mejor conocida como "úlcera del chiclero" en el sureste de México fue descrita por SEIDELIN en 1912. Desde entonces la región selvática de la península de Yucatán ha sido identificada como un área endémica de LCL. En el presente estudio se analizaron 73 biopsias de lesiones de casos de LCL causados por Leishmania (Leishmania) mexicana con el fin de: 1) examinar la respuesta a nivel tisular; y 2) relacionar las manifestaciones de esta respuesta con ciertas características de la presentación clínica. Con base en la clasificación histopatológica de Magalhães el patrón histopatológico más frecuente se caracterizó por la presencia de granuloma desorganizado y ausencia de necrosis (43.83%). Otro hallazgo importante a señalar fue la presencia de parásito en 50/73 (68.5%) de las biopsias estudiadas. Respecto a las posibles relaciones significativas hubo una relación directa entre el tamaño de la lesión y el tiempo de evolución (rs = 0.3079, p = 0.03); una correlación inversa entre el tamaño de la lesión y la abundancia de promastigostes (rs = -0.2467, p = 0.03). Con base en la complejidad de los hallazgos clínicos e histopatológicos, consideramos necesario estudiar la respuesta inmune mediada por células relacionada con los cambios histopatológicos, así como el papel de los factores genéticos.
Subject(s)
Adolescent , Adult , Aged , Animals , Child , Female , Humans , Male , Middle Aged , Leishmania mexicana , Leishmaniasis, Cutaneous/pathology , Biopsy , Leishmaniasis, Cutaneous/parasitology , Mexico , Statistics, NonparametricABSTRACT
In the Yucatan Peninsula, Mexico, localized cutaneous leishmaniasis (LCL) caused by Leishmania (Leishmania) mexicana is a typical wild zoonosis restricted to the forest, and humans are only accidentally involved. The transmission of L. (L.) mexicana has been related to the patient's occupation: chicleros(gum collectors) and agricultural workers. The objective of this study was to document L. (L.) mexicana seasonally of transmission in endemic areas of LCL in the state of Campeche, Yucatan Peninsula, Mexico. The timing of incidence of LCL in humans during 1993-1994, as well as the rate and time of infection in rodents and sand flies between February 1993 and March 1995 were analyzed. Rodents and sand flies were found infected between November and March, when men carried out their field activities and are exposed. Based on results analyzed, it is concluded that L. (L.) mexicana in the endemic area of LCL in the state of Campeche, Yucatan Peninsula, Mexico, presents a seasonal transmission restricted to the months of November to March. The knowledge of the timing of the transmission cycle in an endemic area of leishmaniasis is very important because intervention measures on the high-risk focus and population might be restricted.
Subject(s)
Animals , Humans , Endemic Diseases , Leishmania mexicana , Leishmaniasis, Cutaneous , Disease Reservoirs , Incidence , Insect Vectors , Leishmaniasis, Cutaneous , Mexico , Psychodidae , Rodentia , SeasonsABSTRACT
Localized cutaneous leishmaniasis (LCL), known as "chiclero's ulcer" in southeast Mexico, was described by Seidelin in 1912. Since then, the sylvatic region of the Yucatan peninsula has been identified as an endemic focus of LCL. The purpose of the present work was to describe the clinical picture of LCL caused by Leishmania (Leishmania) mexicana in the Yucatan peninsula. A total of 136 cases of LCL, based on isolation and characterization of L. (L.) mexicana by isoenzymes and/or monoclonal antibodies, were selected. Some variability of clinical features regarding number, type, size, form, location and time of evolution of the lesions was observed. The most frequently observed presentation was a single, ulcerated, rounded small lesion, located on the ear, with an evolution time of less than three months, with neither cutaneous metastases nor lymphatic nor mucosal involvement. This picture corresponds to previous studies carried out in the same endemic area where an organism of the L. mexicana complex has been incriminated as a major aetiological agent of classical "chiclero's ulcer", confirming that in the Yucatan peninsula LCL due to L. (L.) mexicana when located on the pinna of the ear is a remarkable characteristic
Subject(s)
Humans , Animals , Male , Female , Child , Adolescent , Adult , Leishmania mexicana/isolation & purification , Leishmaniasis, Cutaneous/pathology , Leishmaniasis, Cutaneous/parasitology , MexicoABSTRACT
The genus Leishmania includes 30 described species which infect a wide variety of mammalian hosts. The precise identification of leismanial parasites at the species level is very important in order to determine whether an organism, causing the disease in a given area, is of the same biotype as that found in suspected mammalian reservoir. the objectives of the present study were (1) to identify leismanial parasites isolated from humans and wild rodents from the State of Campeche, an endemic focus of localized cutaneous leishmaniasis (LCL) in southern Mexico, using an indirect immunofluorescent assay (IFA) with monoclonal antibodies (Mabs): and (2) to determine if the parasites of the two types of hosts wre of the same biotype. All the wild rodents (six Ototylomys phyllotis, eight Oryzomys melanotis, five Peromyscus yucatanicus and two Sigmodon hispidus) and 96 (por cento) (24/25) of the human isolates were identified as Leishmania (L.) mexicana confirming that this specific LCL focus is a wild zoonosis. The presence of one human isolate of L. (Viannia) braziliensis in the State of Campeche, conirmed the importance of an accurate taxonomic identification at species level.