[Generalized Old World Leishmaniasis: First Moroccan Case in an Immunocompetent Adult?]

Overview

Journal Med Trop Sante Int

Specialty Public Health

Date 2022 Jul 27

PMID 35891918

Authors

Soumiya Chiheb

Zineb Tazi Saoud

Imane El Idrissi Saik

Dounia Darif

Fouzia Hali

Fatima Zahra El Fatoiki

Hayat Skali Dahbi

Ayyoub Kihel

Ikram Hammi

Maha Soussi Abdellaoui

Myriam Riyad

Affiliations

Soon will be listed here.

Abstract

Background: Post-kala-azar dermal (PKDL) is a rare skin syndrome observed after treatment of visceral (VL) with pentavalent antimonial organic salts, never described in Morocco before. Here we report a case in an immunocompetent adult.

Case: A 36-year-old-man from Tata in southern Morocco, with a history of visceral 2 years before and treated with meglumine antimoniate and amphotericin B with good clinical course, was hospitalized in dermatology for an erythematous papulo-nodular closet of the face. Six months ago, he presented oral mucosa involvement, then 3 months later, cutaneous lesions appeared on the face. The dermatological examination revealed a papulo-nodular erythematous closet extending to the nose and both cheeks, crusty and lupoid lesions on the forehead, around the eyes and chin, associated with an ulcerative and painless lesion on the heeL. The examination of the oral mucosa revealed an ulceration of the posterior third of the tongue and a papillomatous aspect of the soft palate. The skin biopsy and smear found some amastigote forms of bodies. ITS1 PCR was positive (genus The HIV serology was negative. The diagnosis of PKDL was then evoked. The patient received intra-muscular injections of meglumine antimoniate with good progress.

Conclusion: To our knowledge, this is the first case of generalised leishmaniasis suggesting PKDL reported in a Moroccan immunocompetent adult.

References

Guessous-Idrissi N, Chiheb S, Hamdani A, Riyad M, Bichichi M, Hamdani S . Cutaneous leishmaniasis: an emerging epidemic focus of Leishmania tropica in north Morocco. Trans R Soc Trop Med Hyg. 1998; 91(6):660-3. DOI: 10.1016/s0035-9203(97)90511-3. View

Duthie M, Goto Y, Ghosh P, Mondal D . Impact of sequelae of visceral leishmaniasis and their contribution to ongoing transmission of Leishmania donovani. Pathog Dis. 2019; 77(6). PMC: 6830496. DOI: 10.1093/femspd/ftz057. View

Verma S, Bhandari V, Avishek K, Ramesh V, Salotra P . Reliable diagnosis of post-kala-azar dermal leishmaniasis (PKDL) using slit aspirate specimen to avoid invasive sampling procedures. Trop Med Int Health. 2013; 18(3):268-75. DOI: 10.1111/tmi.12047. View

Mondal D, Bern C, Ghosh D, Rashid M, Molina R, Chowdhury R . Quantifying the Infectiousness of Post-Kala-Azar Dermal Leishmaniasis Toward Sand Flies. Clin Infect Dis. 2018; 69(2):251-258. PMC: 6603265. DOI: 10.1093/cid/ciy891. View

Badirzadeh A, Mohebali M, Ghasemian M, Amini H, Zarei Z, Akhoundi B . Cutaneous and post kala-azar dermal leishmaniasis caused by Leishmania infantum in endemic areas of visceral leishmaniasis, northwestern Iran 2002-2011: a case series. Pathog Glob Health. 2013; 107(4):194-7. PMC: 4001470. DOI: 10.1179/2047773213Y.0000000097. View

Ridolfo A, Gervasoni C, Antinori S, Pizzuto M, Santambrogio S, Trabattoni D . Post-kala-azar dermal leishmaniasis during highly active antiretroviral therapy in an AIDS patient infected with Leishmania infantum. J Infect. 2000; 40(2):199-202. DOI: 10.1053/jinf.1999.0630. View

Brahmachari U . A New Form of Cutaneous Leishmaniasis-Dermal Leishmanoid. Ind Med Gaz. 2017; 57(4):125-127. PMC: 5186533. View

Catorze G, Alberto J, Afonso A, Vieira R, Cortes S, Campino L . [Leishmania infantum/HIV co-infection: cutaneous lesions following treatment of visceral leishmaniasis]. Ann Dermatol Venereol. 2006; 133(1):39-42. DOI: 10.1016/s0151-9638(06)70841-9. View

Baghad B, Razanapinaritra R, Maksouri H, El Bouri H, Outlioua A, Fellah H . Possible introduction of to urban areas determined by epidemiological and clinical profiles of patients with cutaneous leishmaniasis in Casablanca (Morocco). Parasite Epidemiol Control. 2020; 9:e00129. PMC: 7171526. DOI: 10.1016/j.parepi.2019.e00129. View

10.

Aoun K, Bouratbine A . Cutaneous leishmaniasis in North Africa: a review. Parasite. 2014; 21:14. PMC: 3952656. DOI: 10.1051/parasite/2014014. View

11.

Shirian S, Oryan A, Hatam G, Daneshbod Y . Three Leishmania/L. species--L. infantum, L. major, L. tropica--as causative agents of mucosal leishmaniasis in Iran. Pathog Glob Health. 2013; 107(5):267-72. PMC: 4001456. DOI: 10.1179/2047773213Y.0000000098. View

12.

Ramesh V, Singh R, Salotra P . Short communication: post-kala-azar dermal leishmaniasis--an appraisal. Trop Med Int Health. 2007; 12(7):848-51. DOI: 10.1111/j.1365-3156.2007.01854.x. View

13.

Zijlstra E . Biomarkers in Post-kala-azar Dermal Leishmaniasis. Front Cell Infect Microbiol. 2019; 9:228. PMC: 6685405. DOI: 10.3389/fcimb.2019.00228. View

14.

Zijlstra E, Alves F, Rijal S, Arana B, Alvar J . Post-kala-azar dermal leishmaniasis in the Indian subcontinent: A threat to the South-East Asia Region Kala-azar Elimination Programme. PLoS Negl Trop Dis. 2017; 11(11):e0005877. PMC: 5689828. DOI: 10.1371/journal.pntd.0005877. View

15.

Kholoud K, Bounoua L, Sereno D, El Hidan M, Messouli M . Emerging and Re-Emerging Leishmaniases in the Mediterranean Area: What Can Be Learned from a Retrospective Review Analysis of the Situation in Morocco during 1990 to 2010?. Microorganisms. 2020; 8(10). PMC: 7650785. DOI: 10.3390/microorganisms8101511. View

16.

Ramos A, Cruz I, Munez E, Salas C, Fernandez A, Alvarez-Espejo T . Post-kala-azar dermal Leishmaniasis and uveitis in an HIV-positive patient. Infection. 2008; 36(2):184-6. DOI: 10.1007/s15010-007-6279-5. View

17.

Khalil E, Musa A, Younis B, Elfaki M, Zijlstra E, Elhassan A . Blindness following visceral leishmaniasis: a neglected post-kala-azar complication. Trop Doct. 2011; 41(3):139-40. DOI: 10.1258/td.2011.110058. View

18.

Ganguly S, Das N, Barbhuiya J, Chatterjee M . Post-kala-azar dermal leishmaniasis--an overview. Int J Dermatol. 2010; 49(8):921-31. DOI: 10.1111/j.1365-4632.2010.04558.x. View

19.

Mokni M . [Cutaneous leishmaniasis]. Ann Dermatol Venereol. 2019; 146(3):232-246. DOI: 10.1016/j.annder.2019.02.002. View

20.

Asmae H, Fatima A, Hajiba F, Mbarek K, Khadija B, Mohamed R . Coexistence of Leishmania tropica and Leishmania infantum in Sefrou province, Morocco. Acta Trop. 2013; 130:94-9. DOI: 10.1016/j.actatropica.2013.10.012. View