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Am. J. Trop. Med. Hyg., 71(1), 2004, pp. 71-72
Copyright © 2004 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT: TREATMENT FAILURE DUE TO MIXED INFECTION BY DIFFERENT STRAINS OF THE PARASITE LEISHMANIA INFANTUM

MARIA ANTONIOU, C. DOULGERAKIS, F. PRATLONG, J. P. DEDET, AND Y. TSELENTIS
Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Herkalion, Crete, Greece; Department of Nephrology, Red Cross Hospital, Athens, Greece; Laboratoire de Parasitologie and Centre National de Référence des Leishmania, Montpellier, France

 

ABSTRACT

Therapeutic failure in a human immunodeficiency virus-negative patient with visceral leishmaniasis was due to mixed infection by two different Leishmania infantum zymodemes: L. infantum zymodeme MON-98, which is a rare zymodeme and is reported for the first time in Greece, and zymodeme MON-1, which is common in the Mediterranean region. The two strains were isolated from two samples of bone marrow from the patient obtained before the administration of treatment and 20 days later, since there was no improvement in the clinical signs. The zymodemes MON-98 and MON-1 exhibited different behaviors in vitro and showed different sensitivities to meglumine antimoniate in vitro and in vivo, as shown by clinical findings. Mixed infections with different Leishmania strains may explain the differences in the clinical course of leishmaniasis in many patients and may be the reason for treatment failures.

Received November 12, 2003. Accepted for publication March 16, 2004.

Acknowledgment: We thank Ippokratis Messaritakis for technical assistance.

Financial support: This work is part of a project supported by the European Commission Research Directorates (Contract no. QLK-CT-2001-01810).

Authors’ addresses: Maria Antoniou and Y. Tselentis, Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, PO Box 1393, Heraklion, Crete 71409, Greece, Telephone: 30-2810-394-746, Fax: 30-2810-394-740, E-mails: antoniou{at}med.uoc.gr and tselendi{at}med.uoc.gr C. Doulgerakis: Department of Nephrology, Red Cross Hospital, Athens, Greece, Telephone: 30-22610 20051, Fax: 30-22610-24753. F. Pratlong and J. P. Dedet, Laboratoire de Parasitologie and Centre National de Référence des Leishmania, Centre Hospitalier Universitaire de Montpellier, 163 Rue Auguste Broussonet, 34090 Montpellier, France. Telephone: 33-4-67-63-27-51, Fax: 33-4-67-63-00-49, E-mail: parasito{at}univ-montp1.fr.




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