Advertisement

 

 

Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina.

Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina.
Author Information (click to view)

Krolewiecki AJ, Almazan MC, Quipildor M, Juarez M, Gil JF, Espinosa M, Canabire M, Cajal SP,


Krolewiecki AJ, Almazan MC, Quipildor M, Juarez M, Gil JF, Espinosa M, Canabire M, Cajal SP, (click to view)

Krolewiecki AJ, Almazan MC, Quipildor M, Juarez M, Gil JF, Espinosa M, Canabire M, Cajal SP,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

PLoS neglected tropical diseases 2017 10 0511(10) e0005980 doi 10.1371/journal.pntd.0005980
Abstract

Leishmania (Viannia) braziliensis is the species most frequently implicated with cutaneous and mucosal leishmaniasis in the Americas; its diagnosis is based on the identification of amastigotes in lesions, which is limited by low parasite burden. Leishmanin Skin Test (LST) is a support tool for diagnosis, based on delayed type hypersensitivity responses to Leishmania antigens injected intradermally, used in endemic areas as a complement to diagnosis. A retrospective analysis of individuals evaluated for their first episode of tegumentary leishmaniasis at a reference center in Argentina during the period 2006-2015 was performed, with the goal of assessing its usefulness as a support tool in the diagnosis of leishmaniasis. Demographic, clinical and diagnostic work-up were analyzed in individuals with clinically compatible lesions, lesion`s smear and LST. A total of 733 cases that met the case definition were included in the analysis; 678 (93%) localized cutaneous cases, 50 (7%) with mucosal involvement and 5 (<1%) disseminated. Diagnostic confirmation was reached in 474 (65%) cases through positive smears from skin or mucosal lesions, with only 6 cases among this group having negative LST. Among smear negative cases, 190 were negative also by LST, but in 69 instances LST was positive. Across age groups, similar ratios of sensitivity between smear and LST were calculated. Lesions older than 21 days-old were found to correlate with positive results both for smear and LST significantly more than younger lesions. These findings support the clinical use of LST as a diagnostic complement for American Cutaneous Leishmaniasis across all age groups even in endemic areas. In this analysis, the correlation with smear was high. Standardization of this technique and further research into its most adequate preparation and utilization protocols across different sites will help in the management of suspicious clinical cases.

Submit a Comment

Your email address will not be published. Required fields are marked *

three × four =

[ HIDE/SHOW ]