The Natural History of Cutaneous Leishmaniasis in Guatemala

The natural history of American cutaneous leishmaniasis was studied in Guatemala by analyzing the characteristics of 355 untreated leishmaniallesions, observing the evolution of 57 lesions on persons who received a placebo in treatment trials, and analyzing data from a population-based survey concer...

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Bibliographic Details
Published in:The Journal of infectious diseases 1992-03, Vol.165 (3), p.518-527
Main Authors: Herwaldt, Barbara L., Arana, Byron A., Navin, Thomas R.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Amastigotes
Animals
Biological and medical sciences
Cross-Sectional Studies
Cutaneous leishmaniasis
Databases, Factual
Ear, External
Female
Follow-Up Studies
Guatemala - epidemiology
Healing
Humans
Infections
Infectious diseases
Leishmania braziliensis
Leishmania braziliensis - physiology
Leishmania mexicana
Leishmania mexicana - physiology
Leishmaniasis, Cutaneous - epidemiology
Leishmaniasis, Cutaneous - parasitology
Leishmaniasis, Cutaneous - pathology
Lesions
Major Articles
Male
Medical sciences
Middle Aged
Natural history
Placebos
Pretreatment
Prospective Studies
Skin - pathology
Ulcers
Citations: Items that cite this one
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Summary:The natural history of American cutaneous leishmaniasis was studied in Guatemala by analyzing the characteristics of 355 untreated leishmaniallesions, observing the evolution of 57 lesions on persons who received a placebo in treatment trials, and analyzing data from a population-based survey concerning the duration of 82 untreated lesions. Of 25 lesions caused by Leishmania mexicana that were followed prospectively, 22 (88%) completely reepithelialized by a median lesion age of 14 weeks, and 17 (68%) were classified as cured (no residual wound inflammation or reactivation during at least 6 months of follow-up). In contrast, 7 (22%) of 32 lesions caused by Leishmania braziliensis reepithelialized by a median lesion age of 13 weeks, and only 2 (6%) cured. These data demonstrate that the species of Leishmania is the primary determinant of the clinical course and outcome of untreated lesions and underscore the need for field-applicable diagnostic techniques that provide rapid species identification.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/165.3.518