R e v i s t a d a S o c i e d a d e B r a s i l e i r a d e M e d i c i n a T r o p i c a l 2 1 ( 4 ) : 2 0 9 , O u t - D e z , 1 9 8 8
C A R T A A O E D I T O R
A N O U T B R E A K O F
C U T A N E O U S L E I S H M A N I A S I S
W e wish to rep o rt an outbreak o f cutaneous leishm aniasis in U berlândia, Indianópolis and N o v a P onte areas in the T riângulo M ineiro and A lto P ara- n aib a regions. T he 25 patients acquired the disease on the borders o f the A raguari (22) and P aran aib a (3) rivers probably while fishing.
22
were m ale usually adults. 17 (68
% ) had a single lesion and8
m ore than one (2 lesions in 4 individuals (16% ), 3 in 2 (8
% ), 5 ingranulom as with rare Langehans type giant cells. In the one case from w hom p arasites were not isolated tuberculoid type granulom as were present. D irect immunoffluorescence performed on frozen tissue in 5 pa tients show ed irregular deposits o f IgA , IgG , IgM C Ig C
3
fibrinogen and album in in the derm is, epiderm s and vessel walls. P ositive fluorescent antibody tests occurred in 16 o f 18 sera tested.A n interesting finding was the high num ber of positive im prints for am astigotes suggesting a M exi can a type infection b u t the poor growth in culture and ham sters favours a L e i s h m a n i a v ia n n ia b r a z ilie n s is type parasite2. T axonom ic studies o f these stocks are indicated.
T a b le 1 - D istribution o f patients with A C L from T riângulo M ineiro and A lto P aran aib a according to sex and age
Age
(Years) M ales
Sex
F em ales
T otal
0- 4
1
0
1
5- 9
1
0
1
10-14
0
1
1
15-19
1
0
1
20-29 4
1
530-39 7
0
740-49 4
0
4> 5 0 4
1
5T otal 22 3 25
1 (4 % ) and 10 in 1 (4% ). T h e topographical distribut ion o f all 46 lesions is shown in T able 1. A ll patients responded well to glucantime.
O f 23 patients in whom G iem sa stained tissue im prints from biopsy o f the border of the lesion were examined
22
w ere positive for am astigotes in densities betw een1
+ (1 4 cases) 2 + (2 cases) and 3 +
(6
cases) utilising the W ern er scale3. N o correlation betw een parasite density and tim e o f evolution o f the lesion was observed positive im prints were confirmed by positive cultures ( N N N m edium to which 3.7% o f brain h eart infusion was ad d ed 1). Tw elve prim ary isolates were obtained by ham ster innoculation. T hese stocks grew poorly i n v i t r o and i n v i v o . 2 0 o f the 23 patients biopsied on histological exam ination showed diffuse lym phoplasm o-histocytic infiltration with foci o f ne crosis and a variable quantity o f neutrophils. In 2 cases there were poorly organised epitheloid cellUniversidade Federal de Uberlândia Recebido para publicação em 10/02/88
R E F E R E N C E S
1 . J a f f é C L , G r i m a l d i G , M c M a h o n P r a t t D . T h e c u l t i v a t i o n a n d c l o n i n g o f L e i s h m a n i a . In : G e n e s a n d a n t i g e n s o f p a r a s i t e s : a l a b o r a t o r y m a n u a l . M o r e l C ( e d ) , R i o d e J a n e i r o , p . 4 8 , 1 9 8 5 .
2 . L a i n s o n R , S h a w J J . E v o l u t i o n , c l a s s i f i c a t i o n a n d g e o g r a p h i c a l d i s t r i b u t i o n . I n : T h e l e i s h m a n i a s i s . V o l . 1 , A c a d e m i c P r e s s , L o n d o n , 1 9 8 7 .
3 . W e r n e r J K . C o l o m b i a n s t r a i n s o f L e i s h m a n i a f r o m m a n : g r o w t h c h a r a c t e r i s t i c s i n c u l t u r e m e d i a a n d h a m s t e r s . T r a n s a c t i o n s o f t h e R o y a l S o c i e t y o f T r o p i c a l M e d i c i n e a n d H y g i e n e 7 5 : 6 1 9 - 6 2 2 , 1 9 8 1 .
W e are etc,
Sérgio de A ndrade N ishioka M arcelo Sim ào F erreira M a ria Inès M achado A rnaldo M oreira da Silva A dem ir R ocha
Jú lia M aria C osta-C ruz
M aria do R osário de F átim a G onçalves
