Document Detail


Mucosal leishmaniasis in Brazil.
MedLine Citation:
PMID:  2671555     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The clinical diagnosis and laboratory identification of Leishmania braziliensis braziliensis, a parasitic disease affecting the upper aerodigestive tract, is difficult. A retrospective computer-assisted analysis of patient records was done after examination of 58 patients with mucosal leishmaniasis in an endemic area of L. braziliensis braziliensis in Bahia, Brazil during January 1987. Biopsies of clinically active and clinically inactive mucosal patients were examined for parasites using routine hematoxylin and eosin histopathology and a new technique for rapid detection of Leishmania amastigotes using a genus-specific indirect immunofluorescent assay. No amastigotes were found in specimens from seven patients with clinically inactive mucosal disease using immunofluorescent monoclonal assay techniques, whereas specimens from seven out of 14 patients with clinically active mucosal disease were positive. These results suggest that the immunofluorescent antibody technique is markedly superior in identifying the intracellular amastigote in tissue sections of mucosal biopsies when compared to histopathology techniques or with other standard tests done in rural areas of Brazil. Various clinical and laboratory test data of the entire group of patients were examined and the efficacy of treatment evaluated. The median interval of time noted between cutaneous and mucosal disease was 4.5 years. Relapse was noted in 31% of patients treated with a low dose of meglumine antimoniate (10 mg per kg of body weight). Patients treated with a high dose of meglumine antimoniate (20 mg per kg of body weight) had a relapse rate of 27.3%. A chi-square statistical analysis revealed no significant difference (chi 2 = 0.049) between the two groups. Patients were considered cured if mucosal granulations were clinically absent after 4.6 years.
Authors:
J T Zajtchuk; J D Casler; E M Netto; M Grogl; R C Neafie; C R Hessel; A V de Magalhaes; P D Marsden
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Laryngoscope     Volume:  99     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  1989 Sep 
Date Detail:
Created Date:  1989-10-12     Completed Date:  1989-10-12     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  925-39     Citation Subset:  IM    
Affiliation:
Otolaryngology/Head and Neck Surgery Service, Walter Reed Army Medical Center, Washington, DC 20307-5001.
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MeSH Terms
Descriptor/Qualifier:
Brazil
Fluorescent Antibody Technique
Humans
Leishmaniasis, Mucocutaneous* / diagnosis,  pathology,  therapy
Otorhinolaryngologic Diseases* / diagnosis,  pathology,  therapy
Grant Support
ID/Acronym/Agency:
AI-16282/AI/NIAID NIH HHS

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