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Case Reports
. 2019:26:30.
doi: 10.1051/parasite/2019030. Epub 2019 May 23.

First report of Leishmania (Viannia) lindenbergi causing tegumentary leishmaniasis in the Brazilian western Amazon region

Lilian Motta Cantanhêde  1 , Cristiane Batista Mattos  1 , Camila de Souza Ronconi  1 , Camila Patrício Braga Filgueira  2 , Cipriano Ferreira da Silva Júnior  3 , Claudino Limeira  1 , Helen Paula de Jesus Silva  1 , Gabriel Eduardo Melim Ferreira  1 , Renato Porrozzi  2 , Ricardo de Godoi Mattos Ferreira  1 , Elisa Cupolillo  2
Affiliations
Case Reports

First report of Leishmania (Viannia) lindenbergi causing tegumentary leishmaniasis in the Brazilian western Amazon region

Lilian Motta Cantanhêde et al. Parasite. 2019.

Abstract
in English, French

Tegumentary Leishmaniasis (TL) in the Brazilian Amazon region is associated with several Leishmania species. In this report, we describe two cases of TL related to Leishmania lindenbergi occurring in different locations of Rondônia state. After clinical diagnosis, lesion samples were collected for parasitological diagnoses via direct microscopic visualization, parasite isolation, and PCR. PCR reactions were positive in both clinical samples. Parasite isolation was possible for both patients, and isolates were submitted to species identification by isoenzyme electrophoresis and DNA sequencing. This report is the first to describe human infections caused by L. lindenbergi since the initial description and record of human infection by this species in 2002.

La leishmaniose tégumentaire (TL) en Amazonie brésilienne est associée à plusieurs espèces de Leishmania. Dans ce rapport, nous décrivons deux cas de TL liés à Leishmania lindenbergi survenus à différents endroits de l’état de Rondônia. Après le diagnostic clinique, des échantillons de lésion ont été recueillis à des fins de diagnostic parasitologique par visualisation au microscope direct, isolement du parasite et PCR. Les réactions de PCR étaient positives dans les deux échantillons cliniques. L’isolement des parasites a été possible pour les deux patients et les isolats ont été soumis à l’identification de l’espèce par électrophorèse des isoenzymes et séquençage de l’ADN. Ce rapport est le premier à décrire les infections humaines causées par L. lindenbergi depuis la description initiale et le signalement de cas d’infection humaine par cette espèce en 2002.

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Figures

Figure 1
Figure 1
Map of Brazil showing the localities where Leishmania (Viannia) lindenbergi was already detected. The Amazon region is presented in grey, and in green are the two States (PA = Pará; RO = Rondônia) showing the municipalities that presented cases of human cutaneous leishmaniasis caused by L. lindenbergi.
Figure 2
Figure 2
Single cutaneous Leishmaniasis lesion associated with Leishmania lindenbergi observed in a patient (Patient 2) from the State of Rondônia, Brazil. Clinical diagnosis was confirmed by direct and indirect parasitological tests (see Table 1 for details), and Leishmania species identification was achieved by Multilocus Enzyme Electrophoresis (MLEE).
Figure 3
Figure 3
Multilocus Enzyme Electrophoresis (MLEE) and hsp70 PCR-RFLP for Leishmania species identification. (A) Agarose gels stained for activity of 6-phosphogluconate dehydrogenase (6PGD) and glucose-6-phosphate dehydrogenase (G6PD) showing the patterns for Leishmania parasites isolated from Patients 1 and 2. (B) Polyacrylamide gel showing hsp70 products digested with HaeIII for Leishmania parasites isolated from Patients 1 and 2. In both assays, the profiles obtained for the two samples were compared to reference strains from different Leishmania species. For MLEE, the pattern was compatible with Leishmania (Viannia) lindenbergi. hsp70 PCR-RFLP was not useful for species identification of parasites from the two patients studied, as this marker cannot distinguish between L. (V.) lindenbergi and L. (V.) guyanensis. Lg = L. guyanensis, Lb = L. braziliensis, Lla = L. lainsoni, Ln = L. naiffi, Ls = L. shawi, Lu = L. utingensis, Lli = L. lindenbergi, and La = L. amazonensis; NC = Negative Control; MW = Molecular Weight
Figure 4
Figure 4
Neighbor-joining trees based on the analysis of partial sequences of hsp70, icd and mpi for L. (Viannia) species, indicating the identity of IOC/3645 and IOC/L3746 with L. lindenbergi. Bootstrap test (1000 replicates) was performed and values above 70% are shown. The trees are drawn to scale. The evolutionary distances were computed using the number of differences method [8]. GenBank accession numbers for each sequence are presented before the name of the species corresponding to each branch.
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References

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