Intestinal helminth coinfection is associated with mucosal lesions and poor response to therapy in American tegumentary leishmaniasis

•We evaluated the response to antimonial therapy of 109 American tegumentary leishmaniasis patients.•We compared patients with confirmed intestinal parasitic coinfections to patients without demonstration of parasites on stool examination.•Mucosal leishmaniasis was associated with intestinal helmint...

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Published in:Acta tropica 2016-02, Vol.154, p.42-49
Main Authors: Azeredo-Coutinho, Rilza Beatriz G., Pimentel, Maria Inês, Zanini, Graziela Maria, Madeira, Maria F., Cataldo, Jamyra Iglesias, Schubach, Armando O., Quintella, Leonardo Pereira, de Mello, Cintia Xavier, Mendonça, Sergio C.F.
Format: Article
Language:English
Subjects:
Adult
Animals
Ascaris lumbricoides
Cohort Studies
Coinfection
Coinfection - drug therapy
Feces - parasitology
Female
Helminths
Humans
Intestinal Diseases, Parasitic - drug therapy
Leishmania (Viannia) braziliensis
Leishmaniasis, Cutaneous - drug therapy
Leishmaniasis, Mucocutaneous
Male
Middle Aged
Mucocutaneous leishmaniasis
Nematodes
Retrospective Studies
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Summary:•We evaluated the response to antimonial therapy of 109 American tegumentary leishmaniasis patients.•We compared patients with confirmed intestinal parasitic coinfections to patients without demonstration of parasites on stool examination.•Mucosal leishmaniasis was associated with intestinal helminth coinfection.•Intestinal helminth coinfection was associated with poor response to therapy.•Intestinal protozoan coinfection had no effect on the clinical course of the disease. The most severe clinical form of American tegumentary leishmaniasis (ATL) due to Leishmania braziliensis is mucosal leishmaniasis (ML), characterized by destructive lesions in the facial mucosa. We performed a retrospective cohort study of 109 ATL patients from Rio de Janeiro State, Brazil, where ATL is caused by L. braziliensis, to evaluate the influence of intestinal parasite coinfections in the clinical course of ATL. Parasitological stool examination (PSE) was performed with samples from all patients by the sedimentation, Kato-Katz and Baermann-Moraes methods. The diagnosis of ATL was made from lesion biopsies by direct observation of amastigotes in Giemsa-stained imprints, isolation of Leishmania promastigotes or histopathological examination. All patients were treated with meglumine antimoniate. Patients with positive PSE had a frequency of mucosal lesions significantly higher than those with negative PSE (p
ISSN:0001-706X
1873-6254
DOI:10.1016/j.actatropica.2015.10.015