Reis Luiza de Campos, Brito Maria Edileuza Felinto de, Almeida Ericka Lima de, Félix Simone Marta, Medeiros Angela Cristina Rapela, Silva Cláudio Júlio, Pereira Valéria Rêgo Alves
Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
Rev Soc Bras Med Trop. 2008 Sep-Oct;41(5):439-43. doi: 10.1590/s0037-86822008000500001.
The diagnosis for American cutaneous leishmaniasis is based on an association of clinical, epidemiological and laboratory characteristics. The present study identified the circulating species of Leishmania in the State of Pernambuco, described its clinical-epidemiological characteristics and diagnosed the disease. Nineteen patients presenting active lesions who had been diagnosed through clinical evaluation and laboratory tests were selected. The tests included direct investigation, in vitro culturing, Montenegro skin test, indirect immunofluorescence and polymerase chain reaction. The Montenegro Skin Test showed positive results in 89% of the patients; indirect immunofluorescence, in 79%; direct investigation, in 58%; and polymerase chain reaction in 75%. Seven Leishmania (Viannia) braziliensis samples were isolated from these patients and were characterized by means of specific monoclonal antibodies. These data confirm that a combination of different diagnosis techniques is needed in order to obtain efficient results and that, so far, Leishmania (Viannia) braziliensis is the only species responsible for American cutaneous leishmaniasis infection in Pernambuco. Thus, it is essential to identify the parasite species involved in cases of human disease in an endemic area in order to determine the clinical and epidemiological characteristics, especially with regard to diagnosis, therapy development and disease prognosis.
美洲皮肤利什曼病的诊断基于临床、流行病学和实验室特征的综合判断。本研究确定了伯南布哥州利什曼原虫的传播种类，描述了其临床流行病学特征，并对该病进行了诊断。选取了19例经临床评估和实验室检查诊断为活动性病变的患者。检测方法包括直接检查、体外培养、蒙氏皮肤试验、间接免疫荧光法和聚合酶链反应。蒙氏皮肤试验在89%的患者中呈阳性结果；间接免疫荧光法为79%；直接检查为58%；聚合酶链反应为75%。从这些患者中分离出7株巴西利什曼原虫（维氏亚属）样本，并用特异性单克隆抗体进行了鉴定。这些数据证实，为了获得有效的结果，需要结合不同的诊断技术，而且到目前为止，巴西利什曼原虫（维氏亚属）是伯南布哥州美洲皮肤利什曼病感染的唯一病原体。因此，确定流行地区人类疾病病例中所涉及的寄生虫种类对于明确临床和流行病学特征至关重要，特别是在诊断、治疗研发和疾病预后方面。
