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Failure to Detect Leishmania in the Blood of Patients with Old-World Cutaneous Leishmaniasis: Implications for Blood Donation
ABSTRACT.
Cutaneous leishmaniasis (CL) is endemic in Israel, caused mainly by Leishmania major (L. major) and L. tropica. In addition, returning travelers import another leishmanial species such as L. braziliensis. Although we are dealing with a skin disease, the blood bank in Israel does not accept blood donations from people infected with CL in cases of multiple lesions due to the possibility of transfusion. Our purpose was to investigate the prevalence of Leishmania in the blood of patients with active or previous CL. This pilot study screened patients with active or previous CL for parasites in their blood. All patients were infected in Israel or were returning travelers with leishmaniasis acquired in Latin America. Patients were seen at the Sheba Medical Center. In addition, patients were seen at their homes in L. tropica and L. major endemic regions in Israel. Blood samples were taken from each patient for culture and polymerase chain reaction (PCR). Altogether 62 blood samples were examined (L. tropica = 26, L. major = 33, and L. braziliensis = 3). Twenty-seven patients had an active disease and 35 were recovered. All blood cultures and PCR were negative for parasites except one blood sample that was PCR positive for L. braziliensis. The findings of our study, although a small sample, suggest that people with active or recent CL caused by L. major and L. tropica, do not harbor parasites in their blood. Thus, their exclusion from blood donation should be revisited. Further studies are needed with larger sample size and highly sensitive tests.
Author Notes
Authors’ addresses: Michal Solomon and Ariel Gimple, Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel, and The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, E-mails: solomondr1@gmail.com and a.gimple@gmail.com. Inbal Fuchs and Assi Cicurel, Faculty of Health Sciences, Department of Family Medicine, Ben Gurion University, Clalit Health Services, Southern District, Beersheba, Israel, E-mails: inbalfp@gmail.com and cicurels@gmail.com. Tal Meninger, The Institute of Geographic Medicine and Tropical Diseases and the Laboratory for Tropical Diseases Research, Sheba Medical Center, Tel Hashomer, Israel, E-mail: talsegman@gmail.com. Dror Avni and Eli Schwartz, The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, and The Institute of Geographic Medicine and Tropical Diseases and the Laboratory for Tropical Diseases Research, Sheba Medical Center, Tel Hashomer, Israel, E-mails: dror.avni@sheba.health.gov.il and elischwa@tauex.tau.ac.il. Abed Nasereddin and Charles L. Jaffe, Department Microbiology and Molecular Genetics, Kuvin Center, The Hebrew University - Hadassah Medical Center, Jerusalem, Israel, E-mails: abedn@ekmd.huji.ac.il and cjaffe@mail.huji.ac.il.