Unexpected co-detection of promastigote and amastigote Leishmania forms in a human cutaneous lesion: implications for leishmaniasis physiopathology and treatment

• Published in: Diagnostic microbiology and infectious disease Vol. 81; no. 1; pp. 18 - 20
• Main Authors: Haouas, Najoua, Remadi, Latifa, Chaara, Dhekra, Chargui, Najla, Dabghi, Radhia, Jbeniani, Henda, Babba, Hamouda, Ravel, Christophe
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2015; Elsevier
• Subjects: Administration, Topical; Betamethasone - administration & dosage; Betamethasone - therapeutic use; Child; Cutaneous lesion; Fusidic Acid - administration & dosage; Fusidic Acid - therapeutic use; Human health and pathology; Humans; Hydrogen-Ion Concentration; Infectious Disease; Infectious diseases; Internal Medicine; Leishmania major - pathogenicity; Leishmania major - physiology; Leishmania promastigote; Leishmaniasis, Cutaneous - drug therapy; Leishmaniasis, Cutaneous - parasitology; Leishmaniasis, Cutaneous - pathology; Life Sciences; Maceration; Male; Microbiology and Parasitology; Physiopathology; Tunisia; Tunisia; Cutaneous lesion; Leishmania promastigote; Maceration; Physiopathology
• ISSN: 0732-8893; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2014.09.014

Abstract Cutaneous leishmaniasis pathogenicity depends on the survival and replication of the parasitic protozoa in the form of non-motile amastigotes inside macrophages. Here, we report the unprecedented observation of both Leishmania major amastigote and promastigote forms (the latter is normally detected only in the mid gut of the insect vector or in vitro culture) in a cutaneous lesion of a 6-year-old boy. This finding suggests that modifications of the skin lesion environment, such as maceration and changes in pH or temperature, could promote the in situ transformation of Leishmania amastigotes into promastigotes. This observation raises questions about the physiopathology of cutaneous leishmaniasis and the influence of micro-environmental changes on the efficiency of topical treatments.