Diffuse Cutaneous Leishmaniasis in Mexico

Oscar VelascoInstituto de Salubridad y Enfermedades Tropicales, Duke University Medical Center, Pan American Health Organization, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Durham, North Carolina, Mexico

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Stephen J. SavarinoInstituto de Salubridad y Enfermedades Tropicales, Duke University Medical Center, Pan American Health Organization, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Durham, North Carolina, Mexico

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Bryce C. WaltonInstituto de Salubridad y Enfermedades Tropicales, Duke University Medical Center, Pan American Health Organization, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Durham, North Carolina, Mexico

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Albert A. GamInstituto de Salubridad y Enfermedades Tropicales, Duke University Medical Center, Pan American Health Organization, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Durham, North Carolina, Mexico

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Franklin A. NevaInstituto de Salubridad y Enfermedades Tropicales, Duke University Medical Center, Pan American Health Organization, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Durham, North Carolina, Mexico

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In Mexico, 6 cases of diffuse cutaneous leishmaniasis (DCL) were found in widely separated geographic regions. Information was also available on 2 other cases. In addition to the typical clinical features, half of the patients had evidence of nasopharyngeal mucosal involvement. All isolates from the DCL patients were identified as Leishmania mexicana mexicana by isoenzyme analysis and monoclonal antibody typing. In 1 region of Tabasco state where DCL was found, uncomplicated cutaneous leishmaniasis appeared to be highly endemic, and isolates from a few such patients were identified as L. mexicana mexicana. An incidental finding was the recovery of an isolate of L. braziliensis braziliensis from a patient with chiclero ulcer in Oaxaca state. The clinical and epidemiological significance of the reported cases are discussed.

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