Authors:
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1.
Muñoz-Oca JE, Villarreal Morales ML, Nieves-Rodriguez A, Martínez-Bonilla L, 2017. Concomitant disseminated histoplasmosis and disseminated tuberculosis after tumor necrosis factor inhibitor treatment: a case report. BMC Infect Dis 17: 70.
-
2.
Marcoval J, Penín RM, Sabé N, Valentín-Medina F, Bonfill-Ortí M, Martínez-Molina L, 2017. Cutaneous leishmaniasis associated with anti-tumour necrosis factor-α drugs: an emerging disease. Clin Exp Dermatol 42: 331–334.
-
3.
Català A, Roé E, Dalmau J, Pomar V, Muñoz C, Yelamos O, Puig L, 2015. Anti-tumour necrosis factor-induced visceral and cutaneous leishmaniasis: case report and review of the literature. Dermatology 230: 204–207.
-
4.
Mueller MC, Fleischmann E, Grunke M, Schewe S, Bogner JR, Löscher T, 2009. Case report: relapsing cutaneous leishmaniasis in a patient with ankylosing spondylitis treated with infliximab. Am J Trop Med Hyg 81: 52–54.
-
5.
Romaní-Costa V, Sánchez C, Moyá F, Estany C, 2004. Visceral leishmaniasis related to infliximab administration. Enferm Infecc Microbiol Clin 22: 310.
-
6.
Neumayr ALC et al. 2013. Clinical aspects and management of cutaneous leishmaniasis in rheumatoid patients treated with TNF-α antagonists. Travel Med Infect Dis 11: 412–420.
-
7.
Alvar J, Cañavate C, Gutiérrez-Solar B, Jiménez M, Laguna F, López-Vélez R, Molina R, Moreno J, 1997. Leishmania and human immunodeficiency virus coinfection: the first 10 years. Clin Microbiol Rev 10: 298–319.
-
8.
Alvar J, Aparicio P, Aseffa A, Den Boer M, Cañavate C, Dedet JP, Gradoni L, Ter Horst R, López-Vélez R, Moreno J, 2008. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 21: 334–359.
-
9.
Tomás-Pérez M, Fisa R, Riera C, 2013. The use of fluorescent fragment length analysis (PCR-FFL) in the direct diagnosis and identification of cutaneous Leishmania species. Am J Trop Med Hyg 88: 586–591.
-
10.
Fisa R, Riera C, Ribera E, Gállego M, Portús M, 2002. A nested polymerase chain reaction for diagnosis and follow-up of human visceral leishmaniasis patients using blood samples. Trans R Soc Trop Med Hyg 96 (Suppl 1): S191–S194.
-
11.
Riera C, Valladares JE, Gállego M, Aisa MJ, Castillejo S, Fisa R, Ribas N, Carrió J, Alberola J, Arboix M, 1999. Serological and parasitological follow-up in dogs experimentally infected with Leishmania infantum and treated with meglumine antimoniate. Vet Parasitol 84: 33–47.
-
12.
Jiménez-Marco T, Riera C, Fisa R, Girona-Llobera E, Sedeño M, Goodrich RP, Pujol A, Guillen C, Muncunill J, 2012. The utility of pathogen inactivation technology: a real-life example of Leishmania infantum inactivation in platelets from a donor with an asymptomatic infection. Blood Transfus 10: 536–541.
-
13.
Downey C, 2016. Serious infection during etanercept, infliximab and adalimumab therapy for rheumatoid arthritis: a literature review. Int J Rheum Dis 19: 536–550.
-
14.
Schneider P, Bouaziz JD, Foulet F, Doung TA, Valeyrie Allanorea L, Bagot M, 2009. Leishmaniose cutanée multifocale à Leishmania infantum sous traitment par adalimumab. Ann Dermatol Venereol 136: 815–820.
-
15.
Roberts RM, Mukherjee J, Phillips D, 2016. Laryngeal leishmaniasis in a patient taking inhaled corticosteroids. BMJ Case Rep 2016: pii: bcr2016215444.
-
16.
Oliveira F, Bafica A, Rosato AB, Favali CB, Costa JM, 2011. Short report: lesion size correlates with Leishmania antigen-stimulated TNF-levels in human cutaneous leishmaniasis. Am J Trop Med Hyg 85: 70–73.
-
17.
Brito G, Dourado M, Guimarães LH, Meireles E, Schriefer A, de Carvalho EM, Lima Machado PR, 2017. Oral pentoxifylline associated with pentavalent antimony: a randomized trial for cutaneous leishmaniasis. Am J Trop Med Hyg 96: 1155–1159.
-
18.
Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, den Boer M; WHO Leishmaniasis Control Team, 2012. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 7: e35671.
-
19.
Centro Nacional de Epidemiología, CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 2016. Resultados de la vigilancia epidemiológica de las enfermedades transmisibles. Informe anual. Año 2014. Available at: http://gesdoc.isciii.es/gesdoccontroller?action=download&id=14/10/2016-3a996e69f2. Accessed September 28, 2017.
-
20.
Govern de les Illes Balears, 2016. Xarxa de Vigilància Epidemiològica de les Illes Balears. Informes anuales 2005–2015. Available at: http://www.caib.es/sacmicrofront/noticias.do?idsite=337&tipo=12245&mcont=84507. Accessed September 29, 2017.
-
21.
Bañuls AL, Bastien P, Pomares C, Arevalo J, Fisa R, Hide M, 2011. Clinical pleiomorphism in human leishmaniases, with special mention of asymptomatic infection. Clin Microbiol Infect 17: 1451–1461.
-
22.
Generalitat Valenciana, 2016. Conselleria de Sanitat Universal i Salut Pública de la Generalitat Valenciana. Informes anuales 2005–2015. Available at: https://www.sp.san.gva.es/indexPortal.jsp?menuRaizPortal=SANMS50000&Portal=EPIDEMIOLOGIA&perfil=inst. Accessed September 29, 2017.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1792 | 1671 | 476 |
| Full Text Views | 774 | 9 | 1 |
| PDF Downloads | 264 | 13 | 3 |
Case Report: Diffuse Cutaneous Leishmaniasis by Leishmania infantum in a Patient Undergoing Immunosuppressive Therapy: Risk Status in an Endemic Mediterranean Area
M. Magdalena Alcover
M. Magdalena Alcover
Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain;
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Vicenç Rocamora
Vicenç Rocamora
Department of Dermatology, Hospital de Manacor, Balearic Islands, Spain;
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M. Carmen Guillén
M. Carmen Guillén
Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain;
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Diana Berenguer
Diana Berenguer
Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain;
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Marta Cuadrado
Marta Cuadrado
Department of Pathology, Hospital de Manacor, Balearic Islands, Spain
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Cristina Riera
Cristina Riera
Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain;
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Roser Fisa
Roser Fisa
Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain;
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This case report highlights the risk of severe cutaneous leishmaniasis (CL) by Leishmania infantum in patients undergoing immunosuppressant therapy who either live in an endemic area or are visiting in the transmission season. The case patient, resident in Majorca (Balearic Islands), presented 12 disseminated erythematous skin lesions, 1–6 cm in diameter, located on the scalp, cheek, umbilical region, and lower extremities 8 years after undergoing anti–tumor necrosis factor (TNF) therapy. Parasite presence in peripheral blood and high levels of specific antibodies were also observed, indicating a possible risk of CL shifting toward a visceral infection. However, once CL was diagnosed, anti-TNF therapy was discontinued and liposomal amphotericin B was administered, resulting in a complete healing of lesions, no Leishmania DNA detection in blood, and an important serological decrease in antibodies. The lack of data on the supposed epidemiological association between leishmaniasis and immunosuppressive therapy highlights the importance of implementing surveillance systems in endemic areas. No obvious relationship was found based on the data provided by the Balearic Islands Epidemiological System, in contrast with data reported in nearby endemic areas. This indicates that if the suspected association is to be clarified, greater efforts are needed to report information about concomitant diseases and therapies in leishmaniasis patients.
Author Notes
Authors’ addresses: Ma Magdalena Alcover, Ma Carmen Guillén, Diana Berenguer, Cristina Riera, and Roser Fisa, Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain, E-mails: mmagdalenaalcoveramengual@ub.edu, carmeguillen@ub.edu, berenguer.diana@gmail.com, mcriera@ub.edu, and rfisa@ub.edu. Vicenç Rocamora, Department of Dermatology, Hospital de Manacor, Balearic Islands, Spain, E-mail: vrocamora@hmanacor.org. Marta Cuadrado, Department of Pathology, Hospital de Manacor, Balearic Islands, Spain, E-mail: mcuadrado@hmanacor.org.
Reprint requests: Roser Fisa, Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Avinguda Joan XXIII n. 27-31, E-08028, Barcelona, Catalonia, Spain, E-mail: rfisa@ub.edu, Tel: +34 934024502, Fax: +34 934024504.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Muñoz-Oca JE, Villarreal Morales ML, Nieves-Rodriguez A, Martínez-Bonilla L, 2017. Concomitant disseminated histoplasmosis and disseminated tuberculosis after tumor necrosis factor inhibitor treatment: a case report. BMC Infect Dis 17: 70.
-
2.
Marcoval J, Penín RM, Sabé N, Valentín-Medina F, Bonfill-Ortí M, Martínez-Molina L, 2017. Cutaneous leishmaniasis associated with anti-tumour necrosis factor-α drugs: an emerging disease. Clin Exp Dermatol 42: 331–334.
-
3.
Català A, Roé E, Dalmau J, Pomar V, Muñoz C, Yelamos O, Puig L, 2015. Anti-tumour necrosis factor-induced visceral and cutaneous leishmaniasis: case report and review of the literature. Dermatology 230: 204–207.
-
4.
Mueller MC, Fleischmann E, Grunke M, Schewe S, Bogner JR, Löscher T, 2009. Case report: relapsing cutaneous leishmaniasis in a patient with ankylosing spondylitis treated with infliximab. Am J Trop Med Hyg 81: 52–54.
-
5.
Romaní-Costa V, Sánchez C, Moyá F, Estany C, 2004. Visceral leishmaniasis related to infliximab administration. Enferm Infecc Microbiol Clin 22: 310.
-
6.
Neumayr ALC et al. 2013. Clinical aspects and management of cutaneous leishmaniasis in rheumatoid patients treated with TNF-α antagonists. Travel Med Infect Dis 11: 412–420.
-
7.
Alvar J, Cañavate C, Gutiérrez-Solar B, Jiménez M, Laguna F, López-Vélez R, Molina R, Moreno J, 1997. Leishmania and human immunodeficiency virus coinfection: the first 10 years. Clin Microbiol Rev 10: 298–319.
-
8.
Alvar J, Aparicio P, Aseffa A, Den Boer M, Cañavate C, Dedet JP, Gradoni L, Ter Horst R, López-Vélez R, Moreno J, 2008. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 21: 334–359.
-
9.
Tomás-Pérez M, Fisa R, Riera C, 2013. The use of fluorescent fragment length analysis (PCR-FFL) in the direct diagnosis and identification of cutaneous Leishmania species. Am J Trop Med Hyg 88: 586–591.
-
10.
Fisa R, Riera C, Ribera E, Gállego M, Portús M, 2002. A nested polymerase chain reaction for diagnosis and follow-up of human visceral leishmaniasis patients using blood samples. Trans R Soc Trop Med Hyg 96 (Suppl 1): S191–S194.
-
11.
Riera C, Valladares JE, Gállego M, Aisa MJ, Castillejo S, Fisa R, Ribas N, Carrió J, Alberola J, Arboix M, 1999. Serological and parasitological follow-up in dogs experimentally infected with Leishmania infantum and treated with meglumine antimoniate. Vet Parasitol 84: 33–47.
-
12.
Jiménez-Marco T, Riera C, Fisa R, Girona-Llobera E, Sedeño M, Goodrich RP, Pujol A, Guillen C, Muncunill J, 2012. The utility of pathogen inactivation technology: a real-life example of Leishmania infantum inactivation in platelets from a donor with an asymptomatic infection. Blood Transfus 10: 536–541.
-
13.
Downey C, 2016. Serious infection during etanercept, infliximab and adalimumab therapy for rheumatoid arthritis: a literature review. Int J Rheum Dis 19: 536–550.
-
14.
Schneider P, Bouaziz JD, Foulet F, Doung TA, Valeyrie Allanorea L, Bagot M, 2009. Leishmaniose cutanée multifocale à Leishmania infantum sous traitment par adalimumab. Ann Dermatol Venereol 136: 815–820.
-
15.
Roberts RM, Mukherjee J, Phillips D, 2016. Laryngeal leishmaniasis in a patient taking inhaled corticosteroids. BMJ Case Rep 2016: pii: bcr2016215444.
-
16.
Oliveira F, Bafica A, Rosato AB, Favali CB, Costa JM, 2011. Short report: lesion size correlates with Leishmania antigen-stimulated TNF-levels in human cutaneous leishmaniasis. Am J Trop Med Hyg 85: 70–73.
-
17.
Brito G, Dourado M, Guimarães LH, Meireles E, Schriefer A, de Carvalho EM, Lima Machado PR, 2017. Oral pentoxifylline associated with pentavalent antimony: a randomized trial for cutaneous leishmaniasis. Am J Trop Med Hyg 96: 1155–1159.
-
18.
Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, den Boer M; WHO Leishmaniasis Control Team, 2012. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 7: e35671.
-
19.
Centro Nacional de Epidemiología, CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 2016. Resultados de la vigilancia epidemiológica de las enfermedades transmisibles. Informe anual. Año 2014. Available at: http://gesdoc.isciii.es/gesdoccontroller?action=download&id=14/10/2016-3a996e69f2. Accessed September 28, 2017.
-
20.
Govern de les Illes Balears, 2016. Xarxa de Vigilància Epidemiològica de les Illes Balears. Informes anuales 2005–2015. Available at: http://www.caib.es/sacmicrofront/noticias.do?idsite=337&tipo=12245&mcont=84507. Accessed September 29, 2017.
-
21.
Bañuls AL, Bastien P, Pomares C, Arevalo J, Fisa R, Hide M, 2011. Clinical pleiomorphism in human leishmaniases, with special mention of asymptomatic infection. Clin Microbiol Infect 17: 1451–1461.
-
22.
Generalitat Valenciana, 2016. Conselleria de Sanitat Universal i Salut Pública de la Generalitat Valenciana. Informes anuales 2005–2015. Available at: https://www.sp.san.gva.es/indexPortal.jsp?menuRaizPortal=SANMS50000&Portal=EPIDEMIOLOGIA&perfil=inst. Accessed September 29, 2017.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1792 | 1671 | 476 |
| Full Text Views | 774 | 9 | 1 |
| PDF Downloads | 264 | 13 | 3 |