RESUMEN
O presente trabalho tem como objetivo relatar um caso de um Pastor Belga, do município de Ponta Porã, Mato Grosso do Sul, positivo para Leishmaniose Visceral, atendido em 2017 em uma clínica veterinária localizada em Pedro Juan Caballero, Paraguai. O diagnóstico foi confirmado através dos sinais clínicos característicos, e dos exames ELISA e PCR positivos. O animal foi submetido ao tratamento clínico para melhora dos sintomas, cujo tratamento antiparasitário inicial foi realizado com a associação de estibogluconato de sódio 75 mg/kg e alopurinol 100 mg seguido de aloputinol 100mg de uso contínuo e uso da coleira antileishmaniose. Tratamento esse considerado eficiente, com melhora clínica do animal. Após 24 meses o animal foi diagnosticado com tumor de mama e lesão da bolsa escrotal, sendo submetido a tratamento clínico e cirúrgico. Com 30 e 36 meses do diagnóstico inicial repetiu-se os exames ELISA (positivo) e PCR (negativo), e então o animal foi considerado curado clinicamente devido à ausência de sinais clínicos. Tendo em vista a complexidade dos fatores no ciclo de transmissão, conclui-se que as medidas em saúde ainda são insuficientes para o controle efetivo da doença. É importante o papel do Médico Veterinário na saúde pública, devido a obrigatoriedade de notificação de casos de Leishmaniose Visceral Canina, sendo necessários esforços nas diferentes áreas da saúde animal, humana e do meio ambiente, visando medidas de vigilância e controle da doença no país.
The present work aims to report a case of a Belgian Shepherd, from the municipality of Ponta Porã, Mato Grosso do Sul, positive for Visceral Leishmaniasis, treated in 2017 in a veterinary clinic located in Pedro Juan Caballero, Paraguay. The diagnosis was confirmed through the characteristic clinical signs, and the positive ELISA and PCR tests. The animal was submitted to clinical treatment for improvement of symptoms, whose initial antiparasitic treatment was performed with the association of sodium stibogluconate 75 mg/kg and allopurinol 100 mg followed by alloputinol 100mg of continuous use and use of the antileishmaniasis collar. This treatment was considered efficient, with clinical improvement of the animal. After 24 months the animal was diagnosed with a breast tumor and scrotum injury, and was submitted to clinical and surgical treatment. At 30 and 36 months from the initial diagnosis, the ELISA tests (positive) and PCR (negative) were repeated, and then the animal was considered clinically cured due to the absence of clinical signs. Considering the complexity of the factors in the transmission cycle, it is concluded that the health measures are still insufficient for the effective control of the disease. The role of the veterinarian in public health is important, due to the obligatory notification of cases of Canine Visceral Leishmaniasis, being necessary efforts in the different areas of animal health, human and environment, aiming at measures of surveillance and control of the disease in the country.
Asunto(s)
Animales , Perros , Perros/microbiología , Dermatitis Seborreica/veterinaria , Leishmaniasis Visceral/clasificación , Leishmaniasis Visceral/veterinaria , Medicina Veterinaria , Ensayo de Inmunoadsorción Enzimática , Reacción en Cadena de la PolimerasaRESUMEN
To elucidate portions of the transmission cycles of American tegumentary leishmaniasis (TL) and visceral leishmaniasis (VL) occurring in the region surrounding the Lençóis Maranhenses National Park, an important tourist center in Brazil, the present study objectives were to determine the rate of natural infection by Leishmania spp. and the blood meal in caught sand flies species in the region. Sand flies were captured over 36 mo in 62 locations of the municipality of Barreirinhas, Maranhão with notifications of disease incidence. Species identification of parasites was performed with internal transcribed spacer 1 (ITS1) PCR-RFLP using HaeIII enzyme. Blood meal identification was performed with cytochrome b (cytb) gene PCR-RFLP using HaeIII and MboI enzyme. The species Lutzomyia longipalpis (Lutz and Neiva 1912) presented a positivity rate of 3.7% for Leishmania infantum. Species not considered vectors of this parasite such as Lu. lenti (Mangabeira 1938) and Lu. whitmani (Antunes & Coutinho 1939) showed infection rates of 0.6% and 0.9%, respectively. Among the vectors of Leishmania spp. was Lu. whitmani with detection rate of 0.3% for Le. braziliensis and Lu. flaviscutellata (Mangabeira 1942) with a detection rate of 8% for Le. amazonensis. After restriction of amplification product encoding a 359bp sequence of the cytb recognized in as follows: pigs (37.9%); dogs (27.4%); chickens (20.9%); horses (9%), rodents (3.3%), and humans (1.4%). The presence of Leishmania DNA in sand flies fed with human blood and domestic animals in villages with transmission of VL and TL suggests that transmission could be occurring in the locations of the infected patients.
Asunto(s)
Animales Domésticos , Leishmania/fisiología , Leishmaniasis Cutánea/epidemiología , Leishmaniasis Visceral/epidemiología , Psychodidae/parasitología , Roedores , Animales , Brasil/epidemiología , ADN Protozoario/análisis , Humanos , Incidencia , Insectos Vectores/parasitología , Leishmania/clasificación , Leishmania/genética , Leishmaniasis Cutánea/clasificación , Leishmaniasis Cutánea/parasitología , Leishmaniasis Visceral/clasificación , Leishmaniasis Visceral/parasitología , Parques RecreativosRESUMEN
Leishmaniasis (Kala-azar) from different endemic regions of China expresses different clinic and epidemiological features, and traditionally is classified as hilly, plain and desert types/foci. We concentrated our review on whether the pathogens from those foci were different at molecular level, if so, whether there are were molecular markers readily identifiable by molecular technologies. This was a review of a 20-year search for such markers by using kinetoplastic DNA (kDNA), nDNA hybridization, PCR-SSCP, RAPD and sequence analysis of SSU rDNA variable regions and LACK gene. The results showed that heterogeneities at molecular level exist in Leishmania isolated from different foci of China, which could be used as markers for different types of Leishmaniasis in China.
Asunto(s)
Dermatoglifia del ADN , ADN Protozoario/genética , Leishmania donovani/genética , Leishmaniasis Visceral/parasitología , China , ADN Protozoario/análisis , Genotipo , Humanos , Leishmania donovani/clasificación , Leishmania donovani/aislamiento & purificación , Leishmaniasis Visceral/clasificación , MutaciónRESUMEN
BACKGROUND: Visceral leishmaniasis (VL) is almost always lethal if not treated, but most infections with the causative agents are clinically silent. Mannan-binding lectin (MBL), an opsonin, is a candidate molecule for modifying progression to VL because it may enhance infection with intracellular pathogens. Mutations in the MBL2 gene decrease levels of MBL and may protect against development of VL. This case-control study examines genotypes of MBL2 and levels of MBL in individuals presenting with different outcomes of infection with Leishmania chagasi. METHODS: Genotypes for MBL2 and levels of serum MBL were determined in uninfected control subjects (n=76) and in individuals presenting with asymptomatic infection (n=90) or VL (n=69). RESULTS: Genotypes resulting in high levels of MBL were more frequent (odds ratio [OR], 2.5 [95% confidence interval [CI], 1.3-5.0]; P=.006) among individuals with VL than among those with asymptomatic infections and were even more frequent (OR, 3.97 [95% CI, 1.10-14.38]; P=.043) among cases of VL presenting with clinical complications than among those with uneventful courses. Serum levels of MBL were higher (P=.011) in individuals with VL than in asymptomatic infections . CONCLUSIONS: Genotypes of the MBL2 gene predict the risk for developing VL and clinical complications in infections with L. chagasi.
Asunto(s)
Leishmania infantum/patogenicidad , Leishmaniasis Visceral/genética , Lectina de Unión a Manosa/genética , Adolescente , Adulto , Anciano , Animales , Estudios de Casos y Controles , Niño , Preescolar , Susceptibilidad a Enfermedades , Femenino , Genotipo , Humanos , Lactante , Leishmaniasis Visceral/clasificación , Leishmaniasis Visceral/inmunología , Masculino , Lectina de Unión a Manosa/sangre , Persona de Mediana Edad , Estadística como AsuntoRESUMEN
No período de 1999 a agosto de 2005, 54 óbitos e 462 casos humanos de leishmaniose visceral americana foram confirmados na região de Araçatuba, noroeste do Estado de São Paulo, onde a enzootia canina está presente em 31 municípios. Frente ao agravamento desta situação, a identificação da taxa de infecção dos flebotomíneos é um parâmetro importante para a priorização das áreas a serem trabalhadas. O presente estudo teve como objetivos: padronizar e avaliar a técnica da reação em cadeia pela polimerase (PCR) para identificar flebotomíneos experimentalmente infectados por Leishmania chagasi, bem como estabelecer e manter a colônia de Lutzomyia longipalpis; infectar experimentalmente exemplares de Lutzomyia longipalpis; definir a sensibilidade da PCR para detecção de L. chagasi e comparar a microscopia direta do trato digestivo e a PCR para detecção e identificação de flebotomíneos experimentalmente infectados por L. chagasi. Para a extração de DNA foi utilizado o método fenol/clorofórmio, após digestão prévia com proteinase K. A partir de uma seqüência que codifica para a região 28S ribossomal de Lutzomyia longipalpis, oligonucleotídeos foram desenhados utilizando-se o programa Primer 3â. Exemplares de F1 de Lu. Longipalpis, obtidos de colônia, foram contaminados artificialmente com diluições seriadas, na base 10, de formas promastigotas de L. chagasi mantidas em cultura e exemplares de flebotomíneos, capturados em campo, foram infectados experimentalmente por formas amastigotas e promastigotas de L. chagasi. Para a amplificação de fragmento de DNA de cinetoplasto de Leishmania sp foram utilizados oligonucleotídeos iniciadores descritos por Rodgers et al. (1990). A PCR padronizada para identificação de Lu. Longipalpis resultou em amplificação de um fragmento de DNA de 370 pares de base (pb). Quanto aos exemplares de LU. Longipalpis contaminados com as formas flageladas de L. chagasi, quando submetidos à técnica de PCR, observou-se a presença de fragmento de 120 pb em todas diluições testadas, bem como nos exemplares infectados experimentalmente, demonstrando-se a potencialidade desta ferramenta na detecção de flebotomíneos infectados.
Asunto(s)
Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Perros , Cobayas , Animales , Humanos , Leishmaniasis Visceral , Leishmaniasis Visceral/complicaciones , Leishmaniasis Visceral/embriología , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/inmunología , Leishmaniasis Visceral/prevención & control , Leishmaniasis Visceral/transmisión , Brasil , Leishmaniasis Visceral/clasificación , Leishmaniasis Visceral/sangreRESUMEN
Visceral leishmaniases (VL), with spreading epidemics in India and Sudan, and sporadic cases in mediterranean basin, show clinical, therapeutical and public health aspects varying according to the geographic context. Co-infection of VL with the human immunodeficiency virus emerged in southwestern Europe and could occur in a next future in India, in Sudan, in Ethiopia or in Brazil. Today, lipid formulations of amphotericin B should be the first line drugs in Mediterranean basin. Elsewhere, pentavalent antimonials remain the cornerstone of treatment in non resistant areas, conventional amphotericin B or miltefosine being an alternative in areas of resistance to antimony.
Asunto(s)
Leishmaniasis Visceral , Fosforilcolina/análogos & derivados , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Adulto , Anfotericina B/administración & dosificación , Anfotericina B/uso terapéutico , Animales , Antimonio/administración & dosificación , Antimonio/uso terapéutico , Antiprotozoarios/administración & dosificación , Antiprotozoarios/uso terapéutico , Brasil/epidemiología , Preescolar , Perros , Etiopía/epidemiología , Europa (Continente)/epidemiología , Humanos , Incidencia , India/epidemiología , Lactante , Recién Nacido , Leishmaniasis Visceral/clasificación , Leishmaniasis Visceral/tratamiento farmacológico , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/parasitología , Fosforilcolina/administración & dosificación , Fosforilcolina/uso terapéutico , Prevalencia , Factores de Tiempo , ZoonosisRESUMEN
Leishmanioses are a group of infections caused by the protozoa Leishmania. Humans are infected by female sandfly bites. Leishmaniosis is found in Mediterranean Europe, America, Africa and Asia. Various clinical expressions are possible: visceral (kala-azar) or cutaneous (Old world cutaneous leishmaniosis). In Mediterranean Europe, visceral leishmaniosis with the classical triad, splenomegaly, pallor, fever, was traditionally a childhood disease whereas today the disease with atypical clinical expressions strikes immunocompromised patients. In these atypical forms of visceral leishmaniosis, diagnosis and treatment are particularly difficult. Leishmania-DNA research using polymerase chain reaction is often necessary to perform the diagnosis, and lipid-associated formulations of amphotericin B, rapidly effective and well-tolerated in patients without immunodeficiency, do not prevent recurrences in immunocompromised patients.
Asunto(s)
Leishmaniasis Visceral , Anfotericina B/uso terapéutico , Antiprotozoarios/uso terapéutico , Diagnóstico Diferencial , Humanos , Huésped Inmunocomprometido , Leishmaniasis Visceral/clasificación , Leishmaniasis Visceral/diagnóstico , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/parasitología , Leishmaniasis Visceral/terapia , Reacción en Cadena de la Polimerasa , Recurrencia , Resultado del TratamientoRESUMEN
Se presenta un caso de leishmaniasis visceral complicada con síndrome de hipertensión portal, en una paciente femenina, de 55 años de edad, diabética y desnutrida, con hepatoesplenomegalia leve y pancitopenia severa en qien fue difícil el diagnóstico de leismaniasis visceral. esto se logró en una segunda biopsia de médula ósea, y debido a complicaciones atribuibles a su enfermedad, como el síndrome de hipertensión portal fue necesario sustituir el trataminento con glucantime (100 mg/kg/día) por anfotericina B (0,25mg/kg/día), con una buena evolución
Asunto(s)
Humanos , Femenino , Adulto , Anfotericina B/administración & dosificación , Hipertensión/complicaciones , Hipertensión/diagnóstico , Leishmaniasis Visceral/clasificación , Leishmaniasis Visceral/diagnóstico , Leishmaniasis Visceral/prevención & controlRESUMEN
AIDS is defined by the occurrence of an opportunistic infection or tumor considered indicative of advanced infection with human immunodeficiency virus (HIV). Even though recent modifications have improved the widely used AIDS case definition issued by the World Health Organization and the Centers for Disease Control and Prevention, the modified version has fallen short of generating a globally functional instrument for the surveillance of HIV-related infections. The clinical AIDS case definition should be as comprehensive as possible. In many countries, only the diagnosis of an AIDS-defining illness will grant the affected patient social benefits or access to medical care. An expanded AIDS case definition is also likely to improve surveillance of HIV-associated morbidity and mortality; increase the awareness of emerging infections; increase the number of clinical endpoints in clinical trials; and facilitate the introduction of diagnostic tests, screening programs, and preventive measures. Examples of opportunistic infections and tumors that could be considered in future modifications of the AIDS case definition are discussed in detail.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/clasificación , Síndrome de Inmunodeficiencia Adquirida/clasificación , Neoplasias/clasificación , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/terapia , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/terapia , Infecciones por Actinomycetales/clasificación , Animales , Infecciones por Bartonella/clasificación , Linfoma de Burkitt/clasificación , Centers for Disease Control and Prevention, U.S./normas , Enfermedad de Chagas/clasificación , Control de Enfermedades Transmisibles , Salud Global , Enfermedad de Hodgkin/clasificación , Humanos , Leishmaniasis Visceral/clasificación , Microsporida , Micosis/clasificación , Neoplasias/complicaciones , Neoplasias/virología , Infecciones por Papillomavirus/clasificación , Penicillium , Infecciones por Protozoos/clasificación , Estados Unidos , Organización Mundial de la SaludAsunto(s)
Infecciones por VIH/complicaciones , Leishmaniasis Visceral/complicaciones , Antiprotozoarios/uso terapéutico , Linfocitos T CD4-Positivos/microbiología , Linfocitos T CD4-Positivos/parasitología , Centers for Disease Control and Prevention, U.S. , Humanos , Leishmaniasis Visceral/clasificación , Recuento de Leucocitos , Estados UnidosRESUMEN
...En general se recomienda que las investigaciones iniciales con isoenzimas se realicen en detalle a escala regional, y que aborden problemas epidemiológicos específicos e importantes. Es posible mantener la continuidad con los estudios futuros si en todas las comparaciones se utilizan estirpes representativas de Leishmania. Con el tiempo, estas proporcionarán un medio para comparar aislamientos provenientes de distintas regiones geográficas. En condiciones ideales, al menos por lo que se refiere a las cepas de Leishmania de referencia, los perfiles de isoenzimas deben usarse en combinación con otros métodos de caracterización como el cariotipo molecular o la capacidad de reacción frente a anticuerpos monoclonales... (AU)