Diagnostic yield of various traditional laboratory investigations in the diagnosis of cutaneous leishmaniasis
Keywords:
Cutaneous leishmaniasis, leishmanin test, direct microscopy, Leishmania cultureAbstract
Background Leishmaniasis is a tropical protozoal infection endemic in certain areas ofPakistan. The clinical diagnosis of disease can be confirmed by various laboratory investigations like direct microscopy, culture, Leishmanin test and newer serological tests.Objective To determine the diagnostic yield of Leishmanin test, direct microscopy and leishmania culture in the diagnosis of cutaneous leishmaniasis inPakistan.Patients and methods In this observational study conducted at the Skin Department, PNS Shifa and DESTO Laboratories,Karachi, 40 patients were included. Leishmanin test, direct microscopy and leishmania culture was performed on all these patients.Results Leishmanin skin test was positive in all the 40 patients (100%), direct microscopy of the smear in 28 patients (70%) and Leishmania culture in 32 patients (80%).Conclusion Traditional methods of diagnosis have a high yield of positivity in the diagnosis of cutaneous leishmaniasis.ÂReferences
Rowland M, Munir A, Durrani N et al. An outbreak of cutaneous leishmaniasis in an Afghan refugee settlement in northwest Pakistan. Trans R Soc Trop Med Hyg 1999; 93: 133-6.
Gontijo B, Carvalho L. American cutaneous leishmaniasis. Rev Soc Bras Med Trop 2003; 36: 71-80.
Asher AM, Khalid H. Efficacy of allopurinol compared with pentostam in the treatment of Old World cutaneous leishmaniasis. J Coll Physicians Surg Pak 2001; 11: 367-70.
Manson-Bahr PEC. Diagnosis. In Peters W, Killick-Kendrick R, eds: The leishmaniasis in biology and medicine, 1st edn. San Deigo: Academic Press; 1987. p. 703-29.
Vega-Lopez F. Diagnosis of cutaneous leishmaniasis. Curr Opin Infect Dis 2003; 16: 97-101.
Silveira FT, Lainson R, Shaw JJ et al. Cutaneous leishmaniasis due to Leishmania amazonensis in Amazonian Brazil, and the significance of negative Montenegro skin test in human infections. Trans R Soc Trop Med Hyg 1991; 85: 735-8.
Pampiglione S, Manson-Bahr PE, La Placa M et al. Studies on Mediterranean leishmaniasis. IV. The leishmanin skin test in cutaneous leishmaniasis. Trans R Soc Trop Med Hyg 1976; 70: 62-5.
Akuffo H, Darce M, Maasho K et al. In vivo evaluation of immune responses in leishmaniasis: the use of cross-species leishmanin preparations for skin testing. Am J Trop Med Hyg 1995; 53: 16-22.
Robinson RJ, Agudelo S, Muskus C et al. The method used to sample ulcer influences the diagnosis of cutaneous leishmaniasis. Trans R Soc Trop Med Hyg 2002; 96 (Suppl 1): 69-71.
Ramirez JR, Agudelo S, Muskus C et al. Diagnosis of cutaneous leishmaniasis in Colombia: the sampling site within lesions influences the sensitivity of parasitologic diagnosis. J Clin Microbiol 2000; 38: 3768-73.
Rahman SB, Bari AU. Laboratory profile in patients of cutaneous leishmaniasis from various regions of Pakistan. J Coll Physicians Surg Pak 2003; 13: 313-6.
Romero GA, Vinitius DF, Guerra M et al. Comparison of cutaneous leishmaniasis due to Leishmania braziliensis and L. guyanensis in Brazil: clinical findings and diagnostic approach. Clin Infect Dis 2001; 32: 1304-12.
Salinas G, Valderrama L, Palma G et al. Detection of amastigotes in cutaneous and mucocutaneous leishmaniasis using the immunoperoxidase method, using polyclonal antibody: sensitivity and specificity compared with conventional methods of diagnosis. Mem Inst Oswaldo Cruz 1989; 84: 53-60.
Sharty AM, Oster CN, Mebrahtu YB et al. Mouse foot-pad inoculation as an aid to the isolation of leishmania spp. from patients. Trans R Soc Trop Med Hyg 1988; 82: 701-3.
Navin TR, Arana FE, de Merida AM et al. Cutaneous leishmaniasis in Guatemala: comparison of diagnostic methods. Am J Trop Med Hyg 1990; 42: 36-40.
