title: Disseminated cutaneous leishmaniasis resembling post-kala-azar dermal leishmaniasis caused by Leishmania donovani in three patients co-infected with visceral leishmaniasis and human immunodeficiency virus/acquired immunodeficiency syndrome in Ethiopia.
abstract: We report paired strains of Leishmania parasites, one from the viscera and the other from skin lesions that were isolated from three patients with visceral leishmaniasis and disseminated cutaneous leishmaniasis that were co-infected with human immunodeficiency virus. The causative parasites were characterized by polymerase chain reaction-restriction length polymorphism of the ribosomal DNA internal transcribed spacer 1 and by a panel of multilocus microsatellite markers. We demonstrated that the causative agent was Leishmania donovani in all cases, irrespective of the phenotype of the disease. The paired strains from viscera and skin lesions of the same patients showed genetic identity across the 14 microsatellite markers investigated. These findings demonstrate that the skin lesions in these human immunodeficiency virus-positive patients with visceral leishmaniasis were caused by dissemination of viscerotropic L. donovani parasites as a consequence of severe immunosuppression. However, in all three patients, rapid clearance of the skin lesions was observed after antimonial therapy.
authors.affiliation: Institut für Mikrobiologie und Hygiene, Charité Universitätsmedizin Berlin, Dorotheenstrasse 96, Berlin, Germany. tesfayegela2002@yahoo.com
authors.forename: Tesfaye
authors.initials: T
authors.lastname: Gelanew
authors.forename: Zewdu
authors.initials: Z
authors.lastname: Hurissa
authors.forename: Ermias
authors.initials: E
authors.lastname: Diro
authors.forename: Aysheshm
authors.initials: A
authors.lastname: Kassahun
authors.forename: Katrin
authors.initials: K
authors.lastname: Kuhls
authors.forename: Gabriele
authors.initials: G
authors.lastname: Schönian
authors.forename: Asrat
authors.initials: A
authors.lastname: Hailu
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016054:DNA, Protozoan / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000235:genetics; D005002:Ethiopia / Q000453:epidemiology; D006678:HIV / Q000302:isolation & purification* / Q000472:pathogenicity; D006801:Humans; D007165:Immunosuppression Therapy; D007893:Leishmania donovani / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D016773:Leishmaniasis, Cutaneous / Q000150:complications / Q000469:parasitology*; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000469:parasitology*; D008297:Male; D018895:Microsatellite Repeats; D016133:Polymerase Chain Reaction
chemical_list: D016054:DNA, Protozoan; D021903:DNA, Ribosomal Spacer