[Cutaneous Leishmaniasis Cases Caused by Leishmania infantum in Şanlıurfa Province, Turkey]. 2020

Fadile Yıldız Zeyrek, and Seray Töz, and Nermin Uluca, and Nebiye Doni, and Şahin Toprak, and Yusuf Özbel
Harran University Faculty of Medicine, Department of Medical Microbiology, Şanlıurfa,Turkey.

Leishmaniases are a group of vector-borne diseases, and two clinical forms, visceral (VL) and cutaneous leishmaniasis (CL, Oriental sore), are seen in Turkey. While VL cases are recorded as 20-25 per year, CL cases are reported around 2000 per year, and nearly half of CL cases were recorded in Şanlıurfa province. Therefore, by knowing the epidemiology of the disease in Şanlıurfa province, it is possible to develop control measures and reduce the total number of cases across the country. Although Leishmania tropica is known as the main causative agent in Şanlıurfa, other Leishmania species have also been identified as a result of mass human movements in the last 10 years. In this study, we aimed to present the first CL cases caused by Leishmania infantum in Şanlıurfa. A total of 14 cases, which were admitted with the suspicion of CL and diagnosed as positive by direct microscopy and/or real-time ITS1-PCR using lesion aspiration samples are included in the study. Two or more smears were prepared from the samples taken from the lesions of the patients by fine needle aspiration. One of the smears was stained with Giemsa stain after fixation with methyl alcohol and examined under the light microscope at x1000 magnification for the presence of Leishmania amastigotes. DNA isolation was made from the other unstained preparations with a commercial kit (Qiagen DNeasy, Germany) according to the recommendations of the manufacturer. The real-time ITS1-PCR method was performed by using the Old World species-specific primers and probes. As a result, by the identification of the species with real-time ITS1-PCR, it was determined that the causative agent was L.infantum in five cases, L.major in one case and L.tropica in eight cases. It was learned that four of the cases in which L.infantum was detected as the causative agent were local, one was Syrian and they lived in the city center. Also two of the eight cases, which were identified as L.tropica, were Syrian and six of them were domestic cases and all of them lived in the city center. While all 14 patients included in the study were positive with real-time ITS1-PCR, amastigotes were detected in 10 cases only. The cases of CL presented in this study are the first cases caused by L.infantum reported from Şanlıurfa, and are important in terms of concretely demonstrating the effect of mass human mobility and migration on the epidemiology of the infection.

UI MeSH Term Description Entries
D007895 Leishmania tropica A parasitic hemoflagellate of the subgenus Leishmania leishmania that infects humans and rodents. This taxonomic complex includes species which cause a disease called Oriental sore which is a form of cutaneous leishmaniasis (LEISHMANIASIS, CUTANEOUS) of the Old World. Leishmania (Leishmania) tropica,Leishmania tropica minor,Leishmania leishmania tropica,Leishmania tropicas
D007898 Leishmaniasis, Visceral A chronic disease caused by LEISHMANIA DONOVANI and transmitted by the bite of several sandflies of the genera Phlebotomus and Lutzomyia. It is commonly characterized by fever, chills, vomiting, anemia, hepatosplenomegaly, leukopenia, hypergammaglobulinemia, emaciation, and an earth-gray color of the skin. The disease is classified into three main types according to geographic distribution: Indian, Mediterranean (or infantile), and African. Black Fever,Kala-Azar,Fever, Black,Kala Azar,Visceral Leishmaniasis
D005858 Germany A country in central Europe, bordering the Baltic Sea and the North Sea, between the Netherlands and Poland, south of Denmark. The capital is Berlin.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014421 Turkey Country in Southeastern Europe and Southwestern Asia bordering the Black Sea, between Bulgaria and Georgia, and bordering the Aegean Sea and the Mediterranean Sea, between Greece and Syria. The capital is Ankara. Turkiye
D016773 Leishmaniasis, Cutaneous An endemic disease that is characterized by the development of single or multiple localized lesions on exposed areas of skin that typically ulcerate. The disease has been divided into Old and New World forms. Old World leishmaniasis is separated into three distinct types according to epidemiology and clinical manifestations and is caused by species of the L. tropica and L. aethiopica complexes as well as by species of the L. major genus. New World leishmaniasis, also called American leishmaniasis, occurs in South and Central America and is caused by species of the L. mexicana or L. braziliensis complexes. Leishmaniasis, American,Leishmaniasis, New World,Leishmaniasis, Old World,Oriental Sore,American Leishmaniasis,Cutaneous Leishmaniases,Cutaneous Leishmaniasis,Leishmaniases, Cutaneous,New World Leishmaniasis,Old World Leishmaniasis,Sore, Oriental
D018314 Leishmania infantum A parasitic hemoflagellate of the subgenus Leishmania leishmania that infects man and animals and causes visceral leishmaniasis (LEISHMANIASIS, VISCERAL). Human infections are confined almost entirely to children. This parasite is commonly seen in dogs, other Canidae, and porcupines with humans considered only an accidental host. Transmission is by Phlebotomus sandflies. Leishmania (Leishmania) infantum,Leishmania donovani chagasi,Leishmania donovani infantum,Leishmania (Leishmania) chagasi,Leishmania chagasi,Leishmania chagasi chagasi,Leishmania chagasi subsp. Chagasi,Leishmania infantum chagasi,Leishmania leishmania infantum,chagasi chagasi, Leishmania,chagasi, Leishmania,chagasi, Leishmania chagasi,chagasi, Leishmania infantum,donovani chagasi, Leishmania,donovani infantum, Leishmania,infantum chagasi, Leishmania,infantum, Leishmania donovani,infantum, Leishmania leishmania,leishmania infantum, Leishmania

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