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Disseminated Cutaneous Leishmaniasis Resembling Post-Kala-Azar Dermal Leishmaniasis Caused by Leishmania donovani in Three Patients Co-Infected with Visceral Leishmaniasis and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Ethiopia

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  • Institut für Mikrobiologie und Hygiene, Charité Universitätsmedizin Berlin, Germany; Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium
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We report paired strains of Leishmania parasites, one from the viscera and the other from skin lesions that were isolated from three patients with visceral leishmaniasis and disseminated cutaneous leishmaniasis that were co-infected with human immunodeficiency virus. The causative parasites were characterized by polymerase chain reaction–restriction length polymorphism of the ribosomal DNA internal transcribed spacer 1 and by a panel of multilocus microsatellite markers. We demonstrated that the causative agent was Leishmania donovani in all cases, irrespective of the phenotype of the disease. The paired strains from viscera and skin lesions of the same patients showed genetic identity across the 14 microsatellite markers investigated. These findings demonstrate that the skin lesions in these human immunodeficiency virus–positive patients with visceral leishmaniasis were caused by dissemination of viscerotropic L. donovani parasites as a consequence of severe immunosuppression. However, in all three patients, rapid clearance of the skin lesions was observed after antimonial therapy.

Author Notes

*Address correspondence to Tesfaye Gelanew, Institut für Mikrobiologie und Hygiene, Charité Universitätsmedizin, Dorotheenstraβe 96, D-10117, Berlin, Germany. E-mail: tesfayegela2002@yahoo.com

Financial support: Tesfaye Gelanew is a recipient of PhD fellowship from the German Academic Exchange Service. Ermias Diro is a recipient of a PhD scholarship in the Individual PhD Scholarship Programme of the Prince Leopold Instutue of Tropical Medicine, which is supported by the Belgian Development Cooperation.

Authors' addresses: Tesfaye Gelanew, Institut für Mikrobiologie und Hygiene, Charité Universitätsmedizin Berlin, Dorotheenstraße 96, D-10117 Berlin, Germany, and Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia. Zewdu Hurissa, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. Ermias Diro, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia and Prince Leopold Institute of Tropical Medicine, Antwerp B-2000, Belgium. Aysheshm Kassahun and Asrat Hailu, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia. Katrin Kuhls and Gabriele Schönian, Institut für Mikrobiologie und Hygiene, Charité Universitätsmedizin Berlin, Dorotheenstraße 96, D-10117 Berlin, Germany.

Reprint requests: Tesfaye Gelanew, Institut für Mikrobiologie und Hygiene, Charité Universitätsmedizin Berlin, Dorotheenstraße 96, D-10117 Berlin, E-mail: tesfayegela2002@yahoo.com.

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