DIAGNÓSTICO DE LEISHMANIASIS UTILIZANDO MEDIO DE CULTIVO TSTB EN PACIENTES DE TROPICO DE COCHABAMBA

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Abstract

Se realizó un estudio prospectivo, analítico y experimental para determinar el porcentaje de sensibilidad de un nuevo medio de cultivo para el diagnóstico de Leishmania, denominado TSTB (Torrico-Solano-Torrico-Bermúdez). Se obtuvieron las muestras por aspirado de úlceras con sospecha clínica de Leishmaniasis de pacientes provenientes del trópico de Cochabamba. Los objetivos planteados fueron determinar el porcentaje de sensibilidad del cultivo ya mencionado y analizar el crecimiento de parásitos de Leishmania. Como resultados se obtuvo un 90% de sensibilidad mediante este método diagnóstico y una mínima contaminación por hongos (mohos y levaduras); además, un cambio de coloración en el medio de cultivo debido al crecimiento y multiplicación de los parásitos por consumo de los nutrientes.

Translated abstract

A prospective, analytic and experimental study was realized, in which we tried to determine the percentage of sensitive of a new culture medium for the diagnosis of Leishmania, denominated Torrico-Solano-Torrico-Bermudez (TSTB). Samples were obtained by a piration of ulcers with clinical suspicion of Leishmaniasis from patients proceeding from the tropical area of Cochabamba. The objectives planted were to determine the percentage of sensitive of the mentioned culture and to analyze the growth of the parasites of Leishmania. As a result, a 90 % of positivity was obtained with this diagnostic method, with a minimum contamination by fungus (moss and yeast); further more, a change in the colour of culture medium was observed, because of the growth and multiplication of the parasites by consumption of the nutrients.

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Most cited references 35

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Diagnosis of cutaneous and mucocutaneous leishmaniasis in Colombia: a comparison of seven methods.

K Weigle, M de Dávalos, P Heredia … (1987)

Seven methods of diagnosing leishmaniasis were compared in 177 patients presenting with lesions of the skin (165) or mucosa (12) in Tumaco and Cali, Colombia. The three methods of visualizing amastigotes in tissue samples (histological staining of tissue sections, impression smears of punch biopsies, and smears of dermal scraping from slits in the lesion margins) were less sensitive than the four Leishmania isolation methods (aspiration of lesion border cultured in biphasic media, aspirate inoculated into hamster nasal tissue, culture of punch biopsy macerate, and hamster inoculation of macerate). The aspirate-culture and biopsy-hamster methods employed in this study proved most sensitive of the four methods for the recovery of parasites. The combined overall sensitivity of the 7 methods was 67% for all enrolled patients and 75% for Montenegro skin test-positive patients. The individual sensitivities for the methods for all patients and Montenegro-positive positive, patients, respectively, were: histopathology 14% and 16%, impression smear 19% and 21%, dermal scraping 22% and 26%, aspirate-culture 58% and 64%, aspirate-hamster 38% and 41%, biopsy-culture 50% and 55%, and biopsy-hamster 52% and 57%. All methods were less sensitive in lesions of greater than 6 months duration than in lesions of more recent onset. Mucosal lesions were best diagnosed by the culture or hamster inoculation of a macerated mucosal biopsy. The diagnosis by inoculation of hamsters was achieved within 2 to 12 weeks, a mean of 34.5 days. Promastigotes were seen on Senekjie's medium within 3-8 days.(ABSTRACT TRUNCATED AT 250 WORDS)

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Diagnosis of cutaneous leishmaniasis in Colombia: the sampling site within lesions influences the sensitivity of parasitologic diagnosis.

J Ramirez, S Agudelo, C Muskus … (2000)

Parasitologic confirmation of cutaneous leishmaniasis is obligatory before chemotherapy can be considered. Direct microscopic examination of scrapings taken from indurated borders of ulcers has been routinely used as primary method of diagnosis. In this report we compared the sensitivity of examination of dermal scrapings taken from the bottoms of ulcers (BDS) with that of dermal scrapings taken from indurated active margins of lesions (MDS) in a total of 115 patients. The sensitivities of the microscopic examination were 90.4 and 78.3% for BDS and MDS samples, respectively. When the PCR method was used with a group of 40 patients, we also observed a higher sensitivity when BDS samples were examined (80.8% in BDS samples versus 57.7% in MDS samples). The improvement of the diagnostic sensitivity in the BDS samples appears to be related to the higher parasite load and more easily detectable morphology of amastigotes in the centers of the ulcers. Other parasitologic diagnostic methods, such as culture and histopathologic examination of biopsies, are less sensitive (67.5 and 64.3%, respectively). Aspirate culture, however, was shown to be the most sensitive method for the diagnosis of patients with chronic ulcers. When microscopic examinations of both MDS and BDS samples are combined, the sensitivity of diagnosis may rise up to 94%. We therefore recommend this method as a primary routine procedure for diagnosis of cutaneous leishmaniasis.

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PCR-based diagnosis of acute and chronic cutaneous leishmaniasis caused by Leishmania (Viannia).

Kristen A Weigle, Luz Labrada, Caterin Lozano … (2002)

We evaluated PCR methods for diagnosis of acute and chronic cutaneous leishmaniasis (CL) in an area of Colombia where Leishmania (Viannia) is endemic. The PCR method specifically amplified whole linearized minicircle kinetoplast DNA (kDNA) of the Leishmania subgenus Viannia from biopsy lysates. PCR products were detected in agarose gels. For 255 acute cases, this PCR method had greater sensitivity (75.7%) than each conventional method, i.e., microscopic examination of Giemsa-stained lesion scraping (46.7%), biopsy culture (55.3%), aspirate culture (46.3%), and the conventional methods combined (70.2%). Among 44 cases of chronic CL, amplification of biopsy DNA was more sensitive (45.5%) than the individual (4.5 to 27.7%) and combined (27.3%) conventional methods. The detection of kDNA in biopsies from chronic lesions was enhanced by a chemiluminescent dot blot hybridization, which produced a sensitivity of 65.8% when alone and 90.9% when in combination with DNA extraction of biopsy lysates (P 0.05). This enhanced PCR method in chronic biopsies was so much more sensitive than conventional methods that it should be considered the preferred diagnostic method for chronic CL. These findings support the appropriate incorporation of PCR into diagnostic strategies for cutaneous leishmaniasis.

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Author and article information

Contributors

Hernán Bermúdez: Role: ND

Marco Solano: Role: ND

Mary Cruz Torrico Rojas: Role: ND

Mauricio Carballo Montero: Role: ND

Omar Lafuente Covarrubias: Role: ND

María del Pilar Lara Arias: Role: ND

Paola Paredes Torrico: Role: ND

Journal

Journal ID (publisher-id): gmb

Title: Gaceta Médica Boliviana

Abbreviated Title: Gac Med Bol

Publisher: Facultad de Medicina de la Universidad Mayor de San Simón (Cochabamba, , Bolivia )

ISSN (Electronic): 1012-2966

Publication date (Print and electronic): 2005

Volume: 28

Issue: 2

Pages: 31-35

Affiliations

[03] orgnameUMSS orgdiv1Facultad de Medicina

[01] orgnameLABIMED CUMETROP

[02] orgnameIIBISMED

Article

Publisher ID: S1012-29662005000200006

SO-VID: 3cd0d699-ff79-4861-8d80-3a7fe6e20977

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 5

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SciELO Bolivia

Keywords: Leishmania,Diagnóstico,Cultivo,Aspirado,Diagnosis,Culture,Aspiration

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Keywords: Leishmania, Diagnóstico, Cultivo, Aspirado, Diagnosis, Culture, Aspiration

DIAGNÓSTICO DE LEISHMANIASIS UTILIZANDO MEDIO DE CULTIVO TSTB EN PACIENTES DE TROPICO DE COCHABAMBA

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Abstract

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SciELO Bolivia

Most cited references 35

Diagnosis of cutaneous and mucocutaneous leishmaniasis in Colombia: a comparison of seven methods.

Diagnosis of cutaneous leishmaniasis in Colombia: the sampling site within lesions influences the sensitivity of parasitologic diagnosis.

PCR-based diagnosis of acute and chronic cutaneous leishmaniasis caused by Leishmania (Viannia).

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