First Report of Autochthonous Visceral Leishmaniosis in Humans in foz Do Iguaçu, Paraná State, Southern Brazil - Abstract
This is the first report of autochthonous visceral leishmaniosis in humans in Foz do Iguaçu city, Parana, Brazil, bordering Argentina and Paraguay. During his physical examination, a 28-year-old man from Foz do Iguaçu, showed good general health, a slightly bleached, discrete bilateral cervical lymphadenopathy,
38°C fever, confirmation of weight loss and no other symptoms About 15 days after the first visit, he presented with discrete hepatomegaly and splenomegaly palpation of the abdomen. Amyelogram, stained by May-Grunwald-Giemsa, showed normocellular bone marrow for age and presence of Leishmania
amastigotes in macrophages and extracellularly. The parasite was isolated by bone marrow aspiration and cultured in Novy, Mac Neal-Nicolle medium. Serological exams by enzyme-linked immunosorbent assay and DPP were positive. Polymerase chain reaction (PCR) with primers RV1/RV2 was performed on
DNA extracted from bone marrow aspirate and showed an identical pattern to the Leishmania infantum reference strain.The species of the parasite, isolated in culture, was confirmed by PCR using primers for the ITS-1 region followed by restriction fragment length polymorphism (RFLP) pattern analysis and sequencing. RFLP verified the parasite showed a very similar pattern to L. infantum and the forward and reverse sequences presented 99% identity with L. infantum. An epidemiological survey in dogs, in the house of the patient’s home and neighborhood showed 13.3% positivity. Lutzomyia longipalpis was present in the perdomestic environment of the patient’s home.