Indigenous leishmaniasis in Taiwan: report of a case

Molecular diagnosis and therapy for cutaneous leishmaniasis of a returned traveler from Mexico

Leishmaniasis is prevalent in Southern Europe, the Middle East, India, Africa, and Central and South America. Cutaneous leishmaniasis may spontaneously heal over time without treatment; however, risk of visceral dissemination and the impact of cosmetic defect are important concerns. We report a Case of cutaneous leishmaniasis in a patient who ever traveled to Mexico before the onset of a deteriorating wound around the swollen left eyebrow. A diagnosis of infection with Leishmania mexicana was made based on histopathological examination and molecular identification. Systemic treatment with liposomal amphotericin B and ketoconazole were administered with gradual healing of the lesion. Also, this traveler case implicates that the spread of endemic parasitic diseases may be a concealed risk on the public health for Taiwan underlying globalization.

Molecular epidemiology of leishmaniasis in Asia (focus on cutaneous infections)

PURPOSE OF REVIEW

Leishmaniasis has a wider geographical distribution than before. This review focuses on molecular epidemiological studies of new foci of cutaneous leishmaniasis in South and Southeast Asia.

RECENT FINDINGS

In Pakistan, the main causative agent in southern dry areas was determined as Leishmania major followed by Leishmania tropica. There was no correlation between the skin lesion types and the causative species. In the western Indian Himalayas, L. tropica and Leishmania donovani have been reported as the causative pathogens. In Nepal, molecular methods revealed the first case of L. major cutaneous leishmaniasis. Microsatellite analysis of Sri Lankan strains isolated from cutaneous leishmaniasis patients identified L. donovani strains that were closely related to a group of visceral L. donovani isolates from India, Bangladesh, and Nepal. In Taiwan, a third case of indigenous cutaneous leishmaniasis was reported, and the parasite was L. tropica.

SUMMARY

The distribution of cutaneous leishmaniasis has expanded definitively in South and Southeast Asia. Because the possible sandfly vector species are distributed widely over the disease endemic areas, further epidemiological studies are required. Microsatellite analysis of the parasites will be a powerful tool for population genetic and epidemiological studies of Leishmania species in Asia.