Mucocutaneous leishmaniasis: accuracy and molecular validation of noninvasive procedures in a L. (V.) braziliensis-endemic area.

The aim of this study was to evaluate the effectiveness of polymerase chain reaction (PCR) using Kinetoplastid DNA (kDNA) from nasal swabs (NSs), saliva, and oral filter paper imprints (OFPI) in diagnosing mucocutaneous leishmaniasis (ML) and cutaneous leishmaniasis (CL). Seventeen patients with ML, 19 patients with CL, and 33 controls were evaluated. In patients with ML, PCR from NS showed an 86% diagnostic accuracy (95% confidence interval [CI] = 73.81-93.05), followed by saliva 74% (95% CI = 60.45-84.13) and OFPI 68% (95% CI = 54.19-79.24). The highest sensitivity was reached by using the NS 58.82% (95% CI = 36.01-78.39), followed by saliva 23.53% (95% CI = 9.56-47.26) and OFPI 5.88% (95% CI = 1.05-26.98). The specificities of the tests were complete. The NS and OFPI were positive in 2 cases of CL. Mucous membrane samples exhibited a higher specificity compared to the Montenegro skin test and indirect immunofluorescence. NS sensitivity was higher than that of parasitological examinations.