title: A 22-year survey of leishmaniasis cases in a tertiary-care hospital in an endemic setting.
abstract: The northward spread of leishmaniasis from Mediterranean to Continental Europe affects our area where it is typically associated with Leishmania infantum infection. In this study a 22-year survey was performed in patients (including both patients with and without history of travel through endemic areas other than Italy) attending the University Hospital of Parma, Northern Italy, in order to make a contribution to describe the cases of the visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL) diagnosed in this area. One hundred fifty-six samples from 134 patients with clinical suspicion of leishmaniasis (96 suspected of having VL, 37 CL and one both VL and CL) were analyzed in our laboratory during 1992-2013 by microscopy, culture and, from 2005, also by real-time PCR. Leishmania spp. were detected in 23 samples of 15 patients (seven with VL and eight with CL), representing an infection rate of 11.2%. The figure of the cases of leishmaniasis herein reported, even if not comparable to that described for Italian areas other than Parma, underlines that suitable tools are mandatory for correct diagnosis. Moreover, the severity of this disease, particularly VL with its documented northward spread, requires physicians of continental Europe to increase their attention about the possibility of suspecting leishmaniasis in patients reporting related signs and symptoms and/or risk factors.
authors.affiliation: Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy. adriana.calderaro@unipr.it.
authors.forename: Adriana
authors.initials: A
authors.lastname: Calderaro
authors.affiliation: Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy. sara.montecchini@unipr.it.
authors.forename: Sara
authors.initials: S
authors.lastname: Montecchini
authors.affiliation: Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy. srossi@ao.pr.it.
authors.forename: Sabina
authors.initials: S
authors.lastname: Rossi
authors.affiliation: Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy. cgorrini@ao.pr.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Gorrini
authors.affiliation: Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy. mdellanna@ao.pr.it.
authors.forename: Maria Loretana
authors.initials: ML
authors.lastname: Dell'Anna
authors.affiliation: Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy. giovanna.piccolo@unipr.it.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Piccolo
authors.affiliation: Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy. mariacristina.medici@unipr.it.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Medici
authors.affiliation: Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy. mariacristina.arcangeletti@unipr.it.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Arcangeletti
authors.affiliation: Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy. carlo.chezzi@unipr.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Chezzi
authors.affiliation: Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy. flora.deconto@unipr.it.
authors.forename: Flora
authors.initials: F
authors.lastname: De Conto
mesh_terms: D000328:Adult; D002648:Child; D046508:Culture Techniques; D019353:Endemic Diseases / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000453:epidemiology*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D060888:Real-Time Polymerase Chain Reaction; D062606:Tertiary Care Centers / Q000706:statistics & numerical data