title: Detection of Leishmania parasites in the blood of patients with isolated cutaneous leishmaniasis.
abstract: BACKGROUND
  The consequences of the spread of Leishmania parasites to the blood from lesions in patients with cutaneous leishmaniasis are numerous. To assess the magnitude of this invasion we conducted the present study on patients referred to the American University of Beirut Medical Center for cutaneous leishmaniasis.
  
  
  METHODS
  Patients referred for the management of cutaneous leishmaniasis were included in the study. Skin and blood cultures for Leishmania were taken from these patients.
  
  
  RESULTS
  One hundred sixty-two patients were proven to have cutaneous leishmaniasis by pathology; 52% were males and 44% females (gender information was missing for 4%). Patient age ranged from 5 months to 70 years. None of the patients had received treatment for Leishmania. We obtained parasite isolates from 85 patients (52.5%), proven by cultures from skin and blood/blood components. Interestingly, the parasite was isolated in the blood and blood components of 50 patients (30.9%). Isoenzyme analysis confirmed the fact that the organisms in blood and skin were the same; from the 28 isolates that were positive in both skin and blood, eight isolates were Leishmania major and two were Leishmania tropica. The remaining isolates, whether positive in both blood and skin or in either of these tissues, skin or blood and its products, were Leishmania infantum sensu lato.
  
  
  CONCLUSIONS
  In the current study, the detection rate of parasites in the blood of patients with cutaneous leishmaniasis was high. This illustrates the invasive characteristic of the parasite that has escaped the skin. Testing should be considered in areas other than Lebanon, especially around the Mediterranean basin. Whether these findings support the administration of systemic treatment for cutaneous leishmaniasis or not needs to be confirmed in larger prospective studies.
authors.affiliation: Department of Physiology, Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
authors.forename: Hania
authors.initials: H
authors.lastname: Nakkash-Chmaisse
authors.forename: Raja
authors.initials: R
authors.lastname: Makki
authors.forename: Georges
authors.initials: G
authors.lastname: Nahhas
authors.forename: Khouzama
authors.initials: K
authors.lastname: Knio
authors.forename: Nuha
authors.initials: N
authors.lastname: Nuwayri-Salti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001706:Biopsy; D001769:Blood / Q000469:parasitology*; D002648:Child; D002675:Child, Preschool; D003470:Culture Media; D005260:Female; D006801:Humans; D007223:Infant; D007861:Lebanon; D018320:Leishmania major / Q000145:classification / Q000201:enzymology / Q000302:isolation & purification*; D007895:Leishmania tropica / Q000145:classification / Q000201:enzymology / Q000302:isolation & purification*; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000469:parasitology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000469:parasitology* / Q000473:pathology; D055815:Young Adult
chemical_list: D003470:Culture Media