Localized cutaneous leishmaniosis using polymerase chain reaction: a Venezuelan family report

RESUMO

In this study, we have tested the sensitivity of a specific probe such as the polymerase chain reaction (PCR), as an altemative approach to parasitological methods to evaluate patients with cutaneous leishmaniosis (CL). The assay was designed to evaluate a familiar group with an infection of 4 months. The patients were diagnosed according to clinical criteria, parasitological, immunological assay and PCR specific probe. Five of the family group reported a clinical picture with a lymphadenopathy, localizad CL lesions with 2, 15, 27, 30 and 60 cutaneous lesions and with different size (mean= 5 x 7 for 27 x 35 mm of diameter), detestable on the exposed body surface: face (cheek, nose, forehead, front), neck, shoulder, hand, forearm and foot. The 6 patients were diagnosed by leishmanin skin test (LST) (mean= 26.2 x 28.4 mm of diameter). Anti-Leishmania specific antibody were detected by serodiagnosis by the direct agglutination test (DAT), immunofluorescence antibody test (IFAT) and Enzyme-linked immunosorbent assay (ELISA) in all patients. The Leishmania parasite were evident in the lesions of 5 patients, using Giemsa-stained of smear specimens from the lesion, imprint of biopsies the lesion, culture and inoculation in hamster of lesions material, sections histological by convencional stained, immunostaining techniques and by PCR assay on serum samples. The PCR procedure increased the sensitivity of direct microscopy diagnostic of CL, therefore should be considered as a valuable and sensitive diagnostic tool in the identification of species of Leishmania and in the diagnosis de CL in the asymptomatic patients