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First Case of Indigenous Visceral Leishmaniasis from Central India

Visceral leishmaniasis is endemic in the eastern states of India, but central India remains free of leishmaniais. This report describes the first indigenous case of visceral leishmaniasis in a seven-year-old girl from central India. The child presented with fever for 10 days and was diagnosed by bone marrow examination, serology using rKE16 and rK39 antigens, and a polymerase chain reaction specific for the kinesin gene. Sequencing of the immunodominant region of the kinesin gene of the parasite showed four tandem repeats, each 117 basepairs. The first tandem repeat of this strain had 97% homology with the corresponding first tandem repeat of the Leishmania donovani KE16 strain and 92% homology with the L. chagasi BA-2 strain. The second, third, and fourth tandem repeats had 97%, 98%, and 99% homology, respectively, with the L. donovani KE16 strain, and 89%, 96%, and 92% homology, respectively, with the L. chagasi BA-2 strain. This case shows that more than one genetic variant of L. donovani is circulating in various parts of India.

Received October 6, 2006. Accepted for publication December 5, 2006.

Acknowledgments: We thank Dr. Sharmila Sengupta (Kailash Hospital, Noida, India) for referring this case and Dr. Shyamal Ray Chaudhuri (Inbios, Seattle, WA) for supplying the anti-rK39 dipstick test kits.

Financial support: This study was supported by a grant from Department of Biotechnology, Government of India, to Sarman Singh (grant no. BT/PR3502/Med/14/461/2002), a research fellowship from the Department of Biotechnology, Government of India, to Ayan Dey, and a grant from the Indian Council of Medical Research to Umakant Sharma.

^* Address correspondence to Sarman Singh, Division of Clinical Microbiology, All India Institute of Medical Sciences, PO Box 4398, Ansari Nagar, New Delhi 110029, India: E-mail: sarman_singh{at}yahoo.com

Authors’ address: Ayan Dey, Umakant Sharma, and Sarman Singh, Division of Clinical Microbiology, All India Institute of Medical Sciences, PO Box 4398, Ansari Nagar, New Delhi 110029, India, Telephone: 91-11-2658-8484, Fax: 91-11-2658-8663 and 91-11-2658-8641, E-mail: sarman_singh{at}yahoo.com.