title: First report of diffuse cutaneous leishmaniasis and Leishmania amazonensis infection in Rio de Janeiro State, Brazil.
abstract: Diffuse cutaneous leishmaniasis (DCL) is characterised by multiple and progressive cutaneous lesions, resistance to chemotherapy and Leishmania-specific T-cell anergy. We report the first autochthonous DCL case and the first human infection with Leishmania amazonensis in Rio de Janeiro State, Brazil, where only L. braziliensis is considered to be the causative agent of cutaneous leishmaniasis. Leishmania amazonensis was identified by multilocus enzyme electrophoresis and PCR-RFLP. Our case was diagnosed as DCL according to clinical, parasitological, histopathological and immunological criteria. These observations indicate that L. amazonensis is increasing its geographical distribution in Brazil, accounting for unusual clinical presentations in new transmission areas.
authors: Departamento de Imunologia, Instituto Oswaldo Cruz-FIOCRUZ, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brazil.
authors: R B G
authors: RB
authors: Azeredo-Coutinho
authors: F
authors: F
authors: Conceição-Silva
authors: A
authors: A
authors: Schubach
authors: E
authors: E
authors: Cupolillo
authors: L P
authors: LP
authors: Quintella
authors: M F
authors: MF
authors: Madeira
authors: R S
authors: RS
authors: Pacheco
authors: C M
authors: CM
authors: Valete-Rosalino
authors: S C F
authors: SC
authors: Mendonça
mesh_terms: D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002648:Child; D006801:Humans; D007891:Leishmania / Q000302:isolation & purification; D016774:Leishmaniasis, Diffuse Cutaneous / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D008297:Male