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First isolation of Leishmania from Northern Thailand: case report, identification as Leishmania martiniquensis and phylogenetic position within the Leishmania enriettii complex.

Pothirat T, Tantiworawit A, Chaiwarith R, Jariyapan N, Wannasan A, Siriyasatien P, Supparatpinyo K, Bates MD, Kwakye-Nuako G, Bates PA - PLoS Negl Trop Dis (2014)

Bottom Line: Here we report a case in a 52-year-old Thai male from northern Thailand, who presented with subacute fever, huge splenomegaly and pancytopenia.This is the first report of visceral leishmaniasis caused by L. martiniquensis from the region.Moreover, the majority of parasites previously identified as "L. siamensis" also appear to be L. martiniquensis.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

ABSTRACT
Since 1996, there have been several case reports of autochthonous visceral leishmaniasis in Thailand. Here we report a case in a 52-year-old Thai male from northern Thailand, who presented with subacute fever, huge splenomegaly and pancytopenia. Bone marrow aspiration revealed numerous amastigotes within macrophages. Isolation of Leishmania LSCM1 into culture and DNA sequence analysis (ribosomal RNA ITS-1 and large subunit of RNA polymerase II) revealed the parasites to be members of the Leishmania enriettii complex, and apparently identical to L. martiniquensis previously reported from the Caribbean island of Martinique. This is the first report of visceral leishmaniasis caused by L. martiniquensis from the region. Moreover, the majority of parasites previously identified as "L. siamensis" also appear to be L. martiniquensis.

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Related in: MedlinePlus

Light micrograph of Leishmania amastigotes in bone marrow aspirate.Two infected macrophages are stained (large arrows), each with a nucleus (N) and numerous amastigotes (examples with small arrows) within the cytoplasm. The specimen was stained using Wright's stain. The bar represents 20 µm.
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pntd-0003339-g001: Light micrograph of Leishmania amastigotes in bone marrow aspirate.Two infected macrophages are stained (large arrows), each with a nucleus (N) and numerous amastigotes (examples with small arrows) within the cytoplasm. The specimen was stained using Wright's stain. The bar represents 20 µm.

Mentions: Bone marrow (BM) aspiration showed numerous amastigotes within macrophages (Fig. 1), recognised by their size and presence of nucleus and kinetoplast. Therefore, the patient was diagnosed with visceral leishmaniasis. The BM sample was sent to the Department of Parasitology, Faculty of Medicine, Chiang Mai University for Leishmania species identification. Amphotericin B deoxycholate (1 mg/kg/day) was administered for 21 days, and BM samples taken on the 2nd day and 14th day of treatment showed decreased numbers of amastigotes. The serum creatinine became elevated to a maximum level of 3.1 mg/dL while receiving treatment. However, at 2 weeks after discharge from the hospital the patient was doing well and his serum creatinine had returned to baseline levels. DNA was extracted from BM and used as a template for PCR using the LeF/LeR primers for Leishmania rRNA ITS-1 [17]. A correctly sized PCR product was amplified from initial BM samples, disappearing upon treatment (Fig. 2), confirming the clinical and parasitological diagnosis.


First isolation of Leishmania from Northern Thailand: case report, identification as Leishmania martiniquensis and phylogenetic position within the Leishmania enriettii complex.

Pothirat T, Tantiworawit A, Chaiwarith R, Jariyapan N, Wannasan A, Siriyasatien P, Supparatpinyo K, Bates MD, Kwakye-Nuako G, Bates PA - PLoS Negl Trop Dis (2014)

Light micrograph of Leishmania amastigotes in bone marrow aspirate.Two infected macrophages are stained (large arrows), each with a nucleus (N) and numerous amastigotes (examples with small arrows) within the cytoplasm. The specimen was stained using Wright's stain. The bar represents 20 µm.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4256172&req=5

pntd-0003339-g001: Light micrograph of Leishmania amastigotes in bone marrow aspirate.Two infected macrophages are stained (large arrows), each with a nucleus (N) and numerous amastigotes (examples with small arrows) within the cytoplasm. The specimen was stained using Wright's stain. The bar represents 20 µm.
Mentions: Bone marrow (BM) aspiration showed numerous amastigotes within macrophages (Fig. 1), recognised by their size and presence of nucleus and kinetoplast. Therefore, the patient was diagnosed with visceral leishmaniasis. The BM sample was sent to the Department of Parasitology, Faculty of Medicine, Chiang Mai University for Leishmania species identification. Amphotericin B deoxycholate (1 mg/kg/day) was administered for 21 days, and BM samples taken on the 2nd day and 14th day of treatment showed decreased numbers of amastigotes. The serum creatinine became elevated to a maximum level of 3.1 mg/dL while receiving treatment. However, at 2 weeks after discharge from the hospital the patient was doing well and his serum creatinine had returned to baseline levels. DNA was extracted from BM and used as a template for PCR using the LeF/LeR primers for Leishmania rRNA ITS-1 [17]. A correctly sized PCR product was amplified from initial BM samples, disappearing upon treatment (Fig. 2), confirming the clinical and parasitological diagnosis.

Bottom Line: Here we report a case in a 52-year-old Thai male from northern Thailand, who presented with subacute fever, huge splenomegaly and pancytopenia.This is the first report of visceral leishmaniasis caused by L. martiniquensis from the region.Moreover, the majority of parasites previously identified as "L. siamensis" also appear to be L. martiniquensis.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

ABSTRACT
Since 1996, there have been several case reports of autochthonous visceral leishmaniasis in Thailand. Here we report a case in a 52-year-old Thai male from northern Thailand, who presented with subacute fever, huge splenomegaly and pancytopenia. Bone marrow aspiration revealed numerous amastigotes within macrophages. Isolation of Leishmania LSCM1 into culture and DNA sequence analysis (ribosomal RNA ITS-1 and large subunit of RNA polymerase II) revealed the parasites to be members of the Leishmania enriettii complex, and apparently identical to L. martiniquensis previously reported from the Caribbean island of Martinique. This is the first report of visceral leishmaniasis caused by L. martiniquensis from the region. Moreover, the majority of parasites previously identified as "L. siamensis" also appear to be L. martiniquensis.

Show MeSH
Related in: MedlinePlus