Widespread atypical cutaneous Leishmaniasis caused by Leishmania (L.) Chagasi in Nicaragua.

A Belli Infectious Diseases Unit, Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley 94720-7360, USA.

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D García Infectious Diseases Unit, Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley 94720-7360, USA.

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X Palacios Infectious Diseases Unit, Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley 94720-7360, USA.

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B Rodriguez Infectious Diseases Unit, Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley 94720-7360, USA.

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S Valle Infectious Diseases Unit, Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley 94720-7360, USA.

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E Videa Infectious Diseases Unit, Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley 94720-7360, USA.

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E Tinoco Infectious Diseases Unit, Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley 94720-7360, USA.

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F Marín Infectious Diseases Unit, Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley 94720-7360, USA.

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E Harris Infectious Diseases Unit, Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley 94720-7360, USA.

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DOI:
https://doi.org/10.4269/ajtmh.1999.61.380
Volume/Issue:
Volume 61: Issue 3
Page(s):
380–385
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Leishmania chagasi, the causative agent of visceral leishmaniasis (VL) in the Americas, has recently been associated with atypical cutaneous leishmaniasis (ACL) in Central America; however, little comprehensive information about this disease is available. Clinical, epidemiologic, and parasitologic characteristics of 252 ACL cases and 44 VL cases in Nicaragua were analyzed. Visceral leishmaniasis is primarily associated with malnourished children less than five years of age, whereas ACL is found predominantly in children greater than five years of age and young adults. Genetically similar parasites are associated with both disease manifestations. The sand fly Lutzomyia evansi, in addition to Lu. longipalpis, may be involved in transmission of L. chagasi to humans. Our results indicate that ACL is more prevalent than previously thought, affecting up to 10% of a local population. The fact that the same parasite appears to cause both ACL and the potentially fatal visceral disease suggests that the host immune response is critical in determining the outcome of L. chagasi infection. The public health implications of the wide-spread presence of L. chagasi are discussed.

Author Notes

Published Online:
Sep 1999
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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