1921
Volume 72, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Localized cutaneous leishmaniasis (LCL) in India is due mostly to . It is mainly endemic in the deserts of Rajasthan. Recently, Himachal Pradesh has been identified as a new endemic focus for the disease. In the last few years, the number of new cases has been increasing almost to epidemic proportions. This report presents the preliminary findings of clinico-epidemiologic and investigative results of 161 new localized cases of LCL seen between May 2001 and December 2003. The study populaton was composed of 80 males and 81 females between 10 months and 75 years of age. All were indigenous to the sub-alpine valley along the Satluj River in the mountainous region of the Kinnaur District (altitude = 700–2,900 meters). Most patients were seen from April to September and had 1–8 lesions (duration = 1–6 months) that involved mainly the face. Tissue smears were positive for amastigotes in 37% and histopathology showed non-caseating epitheloid cell granuloma in 77% of the cases. Analysis by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) of the ribosomal gene region of 10 biopsy specimens showed amplicons indistinguishable from in eight cases and in two cases. was cultured on modified Nicole-Novy-McNeal (NNN) medium containing RPMI 1640 medium and heat-inactivated fetal bovine serum from 13 of 38 biopsy samples. Three of these isolated strains were identified as while a fourth was by PCR-RFLP of the ribosomal internal transcribed spacer region. One strain had a sequence identical to that of east African strains. Another strain had a unique sequence that has not been found in complex strains. Sand flies trapped in the cattle sheds of a few patients were identified as (Parrot 1928). Treatment with intralesional sodium stibogluconate was effective in all patients without any major side effects. One patient developed lupoid leishmaniasis that responded to higher dose of sodium stibogluconate. Though rarely reported as a cause of LCL, seems to be the predominant pathogen in this new focus of cutaneous leishmaniasis. is a possible vector, albeit based on circumstantial evidence.

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2005-06-01
2017-09-21
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  • Received : 17 May 2004
  • Accepted : 21 Nov 2004

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