Clinical diversity and treatment results in Tegumentary Leishmaniasis: A European clinical report in 459 patients
Romain Guery
(1, 2, 3)
,
Stephen Walker
(4, 5)
,
Gundel Harms
(6, 7, 8)
,
Andreas Neumayr
(9, 10)
,
Pieter van Thiel
(11)
,
Jean-Pierre Gangneux
(12)
,
Jan Clerinx
(13)
,
Sara Karlsson Soebirk
(14)
,
Leo Visser
(15)
,
Laurence Lachaud
(16)
,
Mark N. Bailey
,
Aldert Bart
(11)
,
Christophe Ravel
(16)
,
Gert van Der Auwera
(13)
,
Johannes Blum
(9, 17)
,
Diana Lockwood
(5)
,
Pierre Buffet
(18)
1
Imagine - U1163 -
Imagine - Institut des maladies génétiques (IHU)
2 Hôpital Necker - Enfants Malades [AP-HP]
3 Hôpital privé du Confluent [Nantes]
4 UCLH - University College London Hospitals
5 LSHTM - London School of Hygiene and Tropical Medicine
6 Freie Universität Berlin
7 HU Berlin - Humboldt-Universität zu Berlin = Humboldt University of Berlin = Université Humboldt de Berlin
8 BIH - Berlin Institute of Health
9 JCU - James Cook University
10 Swiss Tropical and Public Health Institute [Basel]
11 UvA - Universiteit van Amsterdam
12 Irset - Institut de recherche en santé, environnement et travail
13 ITM - Institute of Tropical Medicine [Antwerp]
14 Skane University Hospital [Lund]
15 Universiteit Leiden = Leiden University
16 CHU - Hôpital Lapeyronie [Montpellier]
17 Unibas - Université de Bâle = University of Basel = Basel Universität
18 BIGR (UMR_S_1134 / U1134) - Biologie Intégrée du Globule Rouge
2 Hôpital Necker - Enfants Malades [AP-HP]
3 Hôpital privé du Confluent [Nantes]
4 UCLH - University College London Hospitals
5 LSHTM - London School of Hygiene and Tropical Medicine
6 Freie Universität Berlin
7 HU Berlin - Humboldt-Universität zu Berlin = Humboldt University of Berlin = Université Humboldt de Berlin
8 BIH - Berlin Institute of Health
9 JCU - James Cook University
10 Swiss Tropical and Public Health Institute [Basel]
11 UvA - Universiteit van Amsterdam
12 Irset - Institut de recherche en santé, environnement et travail
13 ITM - Institute of Tropical Medicine [Antwerp]
14 Skane University Hospital [Lund]
15 Universiteit Leiden = Leiden University
16 CHU - Hôpital Lapeyronie [Montpellier]
17 Unibas - Université de Bâle = University of Basel = Basel Universität
18 BIGR (UMR_S_1134 / U1134) - Biologie Intégrée du Globule Rouge
Romain Guery
- Fonction : Auteur correspondant
Jean-Pierre Gangneux
- Fonction : Auteur
- PersonId : 756001
- ORCID : 0000-0002-4974-5607
- IdRef : 074162063
Mark N. Bailey
- Fonction : Auteur
Christophe Ravel
- Fonction : Auteur
- PersonId : 173725
- IdHAL : christophe-ravel
- ORCID : 0000-0002-7590-582X
- IdRef : 11799393X
Johannes Blum
- Fonction : Auteur correspondant
Résumé
Background - Cutaneous leishmaniasis (CL) is frequent in travellers and can involve oro-nasal mucosae. Clinical presentation impacts therapeutic management. Methodology - Demographic and clinical data from 459 travellers infected in 47 different countries were collected by members of the European LeishMan consortium. The infecting Leishmania species was identified in 198 patients. Principal findings - Compared to Old World CL, New World CL was more frequently ulcerative (75% vs 47%), larger (3 vs 2cm), less frequently facial (17% vs 38%) and less frequently associated with mucosal involvement (2.7% vs 5.3%). Patients with mucosal lesions were older (58 vs 30 years) and more frequently immunocompromised (37% vs 3.5%) compared to patients with only skin lesions. Young adults infected in Latin America with L. braziliensis or L. guyanensis complex typically had an ulcer of the lower limbs with mucosal involvement in 5.8% of cases. Typically, infections with L. major and L. tropica acquired in Africa or the Middle East were not associated with mucosal lesions, while infections with L. infantum, acquired in Southern Europe resulted in slowly evolving facial lesions with mucosal involvement in 22% of cases. Local or systemic treatments were used in patients with different clinical presentations but resulted in similarly high cure rates (89% vs 86%). Conclusion/significance - CL acquired in L. infantum-endemic European and Mediterranean areas displays unexpected high rates of mucosal involvement comparable to those of CL acquired in Latin America, especially in immunocompromised patients. When used as per recommendations, local therapy is associated with high cure rates.
Domaines
Sciences du Vivant [q-bio]Format du dépôt | Fichier |
---|---|
Type de dépôt | Article dans une revue |
Résumé |
en
Background - Cutaneous leishmaniasis (CL) is frequent in travellers and can involve oro-nasal mucosae. Clinical presentation impacts therapeutic management. Methodology - Demographic and clinical data from 459 travellers infected in 47 different countries were collected by members of the European LeishMan consortium. The infecting Leishmania species was identified in 198 patients. Principal findings - Compared to Old World CL, New World CL was more frequently ulcerative (75% vs 47%), larger (3 vs 2cm), less frequently facial (17% vs 38%) and less frequently associated with mucosal involvement (2.7% vs 5.3%). Patients with mucosal lesions were older (58 vs 30 years) and more frequently immunocompromised (37% vs 3.5%) compared to patients with only skin lesions. Young adults infected in Latin America with L. braziliensis or L. guyanensis complex typically had an ulcer of the lower limbs with mucosal involvement in 5.8% of cases. Typically, infections with L. major and L. tropica acquired in Africa or the Middle East were not associated with mucosal lesions, while infections with L. infantum, acquired in Southern Europe resulted in slowly evolving facial lesions with mucosal involvement in 22% of cases. Local or systemic treatments were used in patients with different clinical presentations but resulted in similarly high cure rates (89% vs 86%). Conclusion/significance - CL acquired in L. infantum-endemic European and Mediterranean areas displays unexpected high rates of mucosal involvement comparable to those of CL acquired in Latin America, especially in immunocompromised patients. When used as per recommendations, local therapy is associated with high cure rates.
|
Titre |
en
Clinical diversity and treatment results in Tegumentary Leishmaniasis: A European clinical report in 459 patients
|
Auteur(s) |
Romain Guery
1, 2, 3
, Stephen Walker
4, 5
, Gundel Harms
6, 7, 8
, Andreas Neumayr
9, 10
, Pieter van Thiel
11
, Jean-Pierre Gangneux
12
, Jan Clerinx
13
, Sara Karlsson Soebirk
14
, Leo Visser
15
, Laurence Lachaud
16
, Mark N. Bailey
, Aldert Bart
11
, Christophe Ravel
16
, Gert van Der Auwera
13
, Johannes Blum
9, 17
, Diana Lockwood
5
, Pierre Buffet
18
1
Imagine - U1163 -
Imagine - Institut des maladies génétiques (IHU)
( 1004662 )
- IHU Imagine,
156 rue de Vaugirard, 75015 PARIS
et
24 Boulevard du Montparnasse, 75015 Paris
- France
2
Hôpital Necker - Enfants Malades [AP-HP]
( 414766 )
- 149 Rue de Sèvres 75015 Paris
- France
3
Hôpital privé du Confluent [Nantes]
( 558004 )
- 2-4 Rue Éric Tabarly, 44277 Nantes Cedex 2
- France
4
UCLH -
University College London Hospitals
( 333769 )
- 235 Euston Rd, Fitzrovia, London NW1 2BU
- Royaume-Uni
5
LSHTM -
London School of Hygiene and Tropical Medicine
( 353798 )
- Keppel Street
London
WC1E 7HT
- Royaume-Uni
6
Freie Universität Berlin
( 307126 )
- Kaiserswerther Str. 16-18, 14195 Berlin
- Allemagne
7
HU Berlin -
Humboldt-Universität zu Berlin = Humboldt University of Berlin = Université Humboldt de Berlin
( 139189 )
- Humboldt-Universität zu Berlin – Unter den Linden 6 – 10099 Berlin – Bundesrepublik Deutschland
- Allemagne
8
BIH -
Berlin Institute of Health
( 455354 )
- Allemagne
9
JCU -
James Cook University
( 303225 )
- Australie
10
Swiss Tropical and Public Health Institute [Basel]
( 175130 )
- Socinstrasse 57, CH 4002, Basel
- Suisse
11
UvA -
Universiteit van Amsterdam
( 146643 )
- Spui 21, 1012 WX Amsterdam - Postbus 19268, 1000 GG Amsterdam
- Pays-Bas
12
Irset -
Institut de recherche en santé, environnement et travail
( 182194 )
- 263 avenue Général Leclerc 35042 Rennes Cedex
- France
13
ITM -
Institute of Tropical Medicine [Antwerp]
( 479440 )
- Nationalestraat 155, 2000 Antwerp
- Belgique
14
Skane University Hospital [Lund]
( 344927 )
- Getingevägen 4, 222 41 Lund
- Suède
15
Universiteit Leiden = Leiden University
( 121723 )
- Leiden University | 2300 RA Leiden
The Netherlands
- Pays-Bas
16
CHU -
Hôpital Lapeyronie [Montpellier]
( 14059 )
- 371, avenue du Doyen Gaston Giraud 34295 MONTPELLIER cedex 5
- France
17
Unibas -
Université de Bâle = University of Basel = Basel Universität
( 149966 )
- Petersplatz 1, P. O. Box
4001 Basel
- Suisse
18
BIGR (UMR_S_1134 / U1134) -
Biologie Intégrée du Globule Rouge
( 1005032 )
- 6 rue Alexandre Cabanel - 75739 Paris cedex 15
- France
|
Nom de la revue |
|
Date de publication |
2021-10
|
Date de publication électronique |
2021-10-13
|
Licence |
Paternité
|
Langue du document |
Anglais
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Audience |
Internationale
|
Volume |
15
|
Numéro |
10
|
Page/Identifiant |
-
|
Domaine(s) |
|
DOI | 10.1371/journal.pntd.0009863 |
Pubmed Id | 34644288 |
Origine :
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