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Leprosy Associated with Atypical Cutaneous Leishmaniasis in Nicaragua and Honduras

Acosta Soto, L; Caballero, N; Ruth Fuentes, L; Torres Munoz, P; Gomez Echevarria, JR; Perez Lopez, M; Bornay Llinares, FJ; ... Donoghue, HD; + view all (2017) Leprosy Associated with Atypical Cutaneous Leishmaniasis in Nicaragua and Honduras. The American Journal of Tropical Medicine and Hygiene , 97 (4) pp. 1103-1110. 10.4269/ajtmh.16-0622. Green open access

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Abstract

In Central America, few cases of leprosy have been reported, but the disease may be unrecognized. Diagnosis is based on clinical criteria and histology. Preliminary field work in Nicaragua and Honduras found patients, including many children, with skin lesions clinically suggestive of atypical cutaneous leishmaniasis or indeterminate leprosy. Histology could not distinguish these diseases although acid-fast organisms were visible in a few biopsies. Lesions healed after standard antimicrobial therapy for leprosy. In the present study, patients, family members, and other community members were skin-tested and provided nasal swabs and blood samples. Biopsies were taken from a subgroup of patients with clinical signs of infection. Two laboratories analyzed samples, using local in-house techniques. Mycobacterium leprae, Leishmania spp. and Leishmania infantum were detected using polymerase chain reactions. Mycobacterium leprae DNA was detected in blood samples and nasal swabs, including some cases where leprosy was not clinically suspected. Leishmania spp. were also detected in blood and nasal swabs. Most biopsies contained Leishmania DNA and coinfection of Leishmania spp. with M. leprae occurred in 33% of cases. Mycobacterium leprae DNA was also detected and sequenced from Nicaraguan and Honduran environmental samples. In conclusion, leprosy and leishmaniasis are present in both regions, and leprosy appears to be widespread. The nature of any relationship between these two pathogens and the epidemiology of these infections need to be elucidated.

Type: Article
Title: Leprosy Associated with Atypical Cutaneous Leishmaniasis in Nicaragua and Honduras
Open access status: An open access version is available from UCL Discovery
DOI: 10.4269/ajtmh.16-0622
Publisher version: https://doi.org/10.4269/ajtmh.16-0622
Language: English
Additional information: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
URI: https://discovery.ucl.ac.uk/id/eprint/10092877
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