Coinfection of Leishmania (Viannia) braziliensis and Streptococcus pneumoniae in multiple cutaneous lesions

Key learning points Cutaneous leishmaniasis is the most common clinical disease caused by all the Leishmania species that are pathogenic to humans. Other bacterial coinfections of Leishmania lesions have been described, but this is the first report of coinfection with Leishmania and S. pneumoniae. S. pneumoniae is also able to cause skin infections, for that reason the pneumococcal diagnosis could be underestimated in Leishmania lesions coinfected with bacterial pathogens, particularly in endemic areas. An accurate microbiological diagnosis of Leishmania coinfections is essential for a correct antimicrobial treatment of skin infections.. Pentavalent antimonials, such as meglumine antimoniate, are considered the first-line antimicrobial therapy for the treatment of leishmaniasis.Fil: Cortes, Paulo R.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Chiapello, Laura Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Dib, David. Hospital Pediátrico del Niño Jesús; ArgentinaFil: Herrero, Mónica V.. Hospital Córdoba; ArgentinaFil: Nuncira, Carmen T.. Hospital Pediátrico del Niño Jesús; ArgentinaFil: De Petris, Carlos. Hospital Pediátrico del Niño Jesús; ArgentinaFil: Echenique, Jose Ricardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; Argentin

Microscopic identification of <i>Leishmania</i> amastigote forms.

<p>Biological samples obtained from ulcer were stained by Giemsa technique. (A) image of a peripheral lesion biopsy; (B) image of a deep lesion biopsy. The amastigote forms are indicating by arrows.</p

Skin lesion caused by <i>Leishmania (Viannia) braziliensis</i> and coinfected with <i>Streptococcus pneumoniae</i>.

<p>(A) Image of an untreated ulcer when the patient was admitted at the hospital. (B) Image of the same ulcer shown in panel A after the treatment with antibiotics (rifampicin/trimethoprim) and meglumine antimoniate (Glucantime).</p

BOX-PCR DNA profiles of <i>S</i>. <i>pneumoniae</i> isolates.

<p>Four pneumococcal strains (lines 2–5) isolated from different ulcers showing genetic identity between them and the same clonal origin. DNA from R6 pneumococcal strain was used as control (line 1). MM, molecular DNA marker (phage λ DNA digested with HindIII/EcoRI).</p