02542nas a2200397   4500000000100000008004100001653003000042653001400072653002500086653001600111653000900127653001200136653002900148653001500177653001100192653001300203653001100216653002200227653000900249653001000258100001300268700001600281700001500297700002000312700002600332700001400358700002300372700001500395700001500410700001500425245008800440300001400528490000700542520158100549022001402130       2017                            d10apolymerase chain reaction10aNicaragua10aMycobacterium leprae10aMiddle Aged10aMale10aleprosy10aLeishmaniasis, Cutaneous10aLeishmania10aHumans10aHonduras10aFemale10aAged, 80 and over10aAged10aAdult1 aAcosta L1 aCaballero N1 aFuentes LR1 aTorres Muñoz P1 aGómez Echevarría JR1 aLópez MP1 aBornay Llinares FJ1 aStanford J1 aStanford C1 aDonoghue H00aLeprosy Associated with Atypical Cutaneous Leishmaniasis in Nicaragua and Honduras.  a1103-11100 v973 a<p>In Central America, few cases of leprosy have been reported, but the disease may be unrecognized. Diagnosis is based on clinical criteria and histology. Preliminary field work in Nicaragua and Honduras found patients, including many children, with skin lesions clinically suggestive of atypical cutaneous leishmaniasis or indeterminate leprosy. Histology could not distinguish these diseases although acid-fast organisms were visible in a few biopsies. Lesions healed after standard antimicrobial therapy for leprosy. In the present study, patients, family members, and other community members were skin-tested and provided nasal swabs and blood samples. Biopsies were taken from a subgroup of patients with clinical signs of infection. Two laboratories analyzed samples, using local in-house techniques. Mycobacterium leprae, Leishmania spp. and Leishmania infantum were detected using polymerase chain reactions. Mycobacterium leprae DNA was detected in blood samples and nasal swabs, including some cases where leprosy was not clinically suspected. Leishmania spp. were also detected in blood and nasal swabs. Most biopsies contained Leishmania DNA and coinfection of Leishmania spp. with M. leprae occurred in 33% of cases. Mycobacterium leprae DNA was also detected and sequenced from Nicaraguan and Honduran environmental samples. In conclusion, leprosy and leishmaniasis are present in both regions, and leprosy appears to be widespread. The nature of any relationship between these two pathogens and the epidemiology of these infections need to be elucidated.</p>
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