Dados do Trabalho

Título

ULCERATED CUTANEOUS LEISHMANIASIS CAUSED BY L. (L.) infantum IN IMMUNOCOMPETENT PATIENTS

Objetivos(s)

In Brazil, American Tegumentary Leishmaniasis (ATL) can be caused by seven different Leishmania species; however, L. (V.) braziliensis is the most prevalent species throughout the territory. Leishmania (L.) infantum causes visceral leishmaniasis, although there are some clinical reports of cutaneous leishmaniasis caused by this Leishmania specie in immunosuppressed patients. Therefore, the correct identification of etiological agents is essential in epidemiological, clinical and pharmacological studies. Our objectives in this case report are: describe two clinical reports of ulcerated cutaneous leishmaniasis caused by L. (L.) infantum in immunocompetent patients from an endemic area for visceral leishmaniasis and show the importance of PCR targeting ITS-1 followed by sequencing to identify the Leishmania species of our clinical reports.

Relato do Caso

Two skin lesion samples were obtained by biopsy according to the routine established in the outpatient clinics of the Instituto de Infectologia Emilio Ribas (IIER). The genus Leishmania was determined by PCR (polymerase chain reaction) targeting ITS-1, using the LITSR and L5.8S primers, according to Godoy et al, 2020. In addition, the DNA amplification obtained was sequenced by the Sanger technique and analyzed in the BLAST software to identify the specie. Patient 1: Had an ulcerated skin lesion on the left leg. He was from Paraíba (northeast of Brazil) and his pet dog died of visceral leishmaniasis. Patient 2: He had a foot lesion followed by another lesion in the armpits. She was from Bahia (northeast of Brazil). L. (L.) infantum was the etiological agent identified after PCR-ITS1 and sequencing in these two patients. These two patients were treated according to the Brazilian leishmaniasis control guidelines and they were clinical cure after the treatment.

Conclusão

The detection of L. (L.) infantum in two non-immunosuppressed patients with clinical manifestations of ATL draws attention to this specie, which commonly occurred in visceral leishmaniasis, and demonstrated the importance of ITS-1-PCR followed by sequencing in epidemiological and clinical studies.