Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Am J Trop Med Hyg. 2022 Oct 10;107(5):996-998. doi: 10.4269/ajtmh.21-1120. Print 2022 Nov 14.
Cutaneous leishmaniasis (CL) is endemic in Israel, caused mainly by Leishmania major (L. major) and L. tropica. In addition, returning travelers import another leishmanial species such as L. braziliensis. Although we are dealing with a skin disease, the blood bank in Israel does not accept blood donations from people infected with CL in cases of multiple lesions due to the possibility of transfusion. Our purpose was to investigate the prevalence of Leishmania in the blood of patients with active or previous CL. This pilot study screened patients with active or previous CL for parasites in their blood. All patients were infected in Israel or were returning travelers with leishmaniasis acquired in Latin America. Patients were seen at the Sheba Medical Center. In addition, patients were seen at their homes in L. tropica and L. major endemic regions in Israel. Blood samples were taken from each patient for culture and polymerase chain reaction (PCR). Altogether 62 blood samples were examined (L. tropica = 26, L. major = 33, and L. braziliensis = 3). Twenty-seven patients had an active disease and 35 were recovered. All blood cultures and PCR were negative for parasites except one blood sample that was PCR positive for L. braziliensis. The findings of our study, although a small sample, suggest that people with active or recent CL caused by L. major and L. tropica, do not harbor parasites in their blood. Thus, their exclusion from blood donation should be revisited. Further studies are needed with larger sample size and highly sensitive tests.
皮肤利什曼病（CL）在以色列流行，主要由利什曼原虫（L. major）和 L. tropica 引起。此外，返回的旅行者会携带另一种利什曼原虫，如 L. braziliensis。虽然我们处理的是一种皮肤病，但由于输血的可能性，以色列的血库不接受患有多处病变的 CL 感染者的献血。我们的目的是调查活动期或既往 CL 患者血液中利什曼原虫的流行情况。这项初步研究筛查了活动性或既往 CL 患者血液中的寄生虫。所有患者均在以色列感染，或为从拉丁美洲感染利什曼病的返回旅行者。患者在谢巴医疗中心就诊。此外，在利什曼原虫和 L. tropica 流行地区的患者家中也对其进行了诊治。从每位患者采集血样进行培养和聚合酶链反应（PCR）检测。共检查了 62 份血样（L. tropica = 26，L. major = 33，L. braziliensis = 3）。27 名患者患有活动性疾病，35 名患者已康复。除了一份 PCR 检测为 L. braziliensis 阳性的血样外，所有血液培养和 PCR 均未检测到寄生虫。尽管我们的研究样本较小，但结果表明，由 L. major 和 L. tropica 引起的活动性或近期 CL 患者的血液中不携带寄生虫。因此，应重新考虑将其排除在献血之外。需要进一步研究，样本量更大且采用更灵敏的检测方法。
