title: Polymerase chain reaction detection of Leishmania kDNA from the urine of Peruvian patients with cutaneous and mucocutaneous leishmaniasis.
abstract: We hypothesized that Leishmania kDNA may be present in urine of patients with cutaneous leishmaniasis (CL). Urine samples and standard diagnostic specimens were collected from patients with skin lesions. kDNA polymerase chain reaction (PCR) was performed on samples from patients and 10 healthy volunteers from non-endemic areas. Eighty-six of 108 patients were diagnosed with CL and 18 (21%) had detectable Leishmania Viannia kDNA in the urine. Sensitivity and specificity were 20.9% (95% confidence interval [CI] 12.3-29.5%) and 100%. Six of 8 patients with mucocutaneous involvement had detectable kDNA in urine versus 12 of 78 patients with isolated cutaneous disease (P < 0.001). L. (V.) braziliensis (N = 3), L. (V.) guyanensis (N = 6), and L. (V.) peruviana (N = 3) were identified from urine. No healthy volunteer or patient with an alternate diagnosis had detectable kDNA in urine. Sensitivity of urine PCR is sub-optimal for diagnosis. On the basis of these preliminary data in a small number of patients, detectable kDNA in urine may identify less localized forms of infection and inform treatment decisions.
authors: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru. nicolasveland@yahoo.com
authors: Nicolas
authors: N
authors: Veland
authors: Diego
authors: D
authors: Espinosa
authors: Braulio Mark
authors: BM
authors: Valencia
authors: Ana Pilar
authors: AP
authors: Ramos
authors: Flor
authors: F
authors: Calderon
authors: Jorge
authors: J
authors: Arevalo
authors: Donald E
authors: DE
authors: Low
authors: Alejandro
authors: A
authors: Llanos-Cuentas
authors: Andrea K
authors: AK
authors: Boggild
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018105:DNA, Kinetoplast / Q000235:genetics / Q000302:isolation & purification* / Q000652:urine*; D005260:Female; D006801:Humans; D007891:Leishmania / Q000235:genetics* / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology / Q000469:parasitology / Q000652:urine*; D007897:Leishmaniasis, Mucocutaneous / Q000453:epidemiology / Q000469:parasitology / Q000652:urine; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D055815:Young Adult
chemical_list: D018105:DNA, Kinetoplast