Imène Ben Abda
Department of Parasitology, Pasteur Institute of Tunis, Tunisia; Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR11IPT-06, University Tunis El-Manar, Pasteur Institute of Tunis, Tunisia
Rym Ben-Abdallah
Department of Parasitology, Pasteur Institute of Tunis, Tunisia; Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR11IPT-06, University Tunis El-Manar, Pasteur Institute of Tunis, Tunisia
Houda Hammami
Department of Dermatology, Habib Thameur Hospital, Tunis, Tunisia
Meriem Ben Abid
Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR11IPT-06, University Tunis El-Manar, Pasteur Institute of Tunis, Tunisia
Hela Mdimagh-Kchir
Private Laboratory of Pathology, Tunis, Tunisia, 5Private Medical office, Infectious Diseases, Tunis, Tunisia
Karim Bahri
Private Medical office, Infectious Diseases, Tunis, Tunisia
Emna Siala
Department of Parasitology, Pasteur Institute of Tunis, Tunisia; Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR11IPT-06, University Tunis El-Manar, Pasteur Institute of Tunis, Tunisia
Karim Aoun
Department of Parasitology, Pasteur Institute of Tunis, Tunisia; Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR11IPT-06, University Tunis El-Manar, Pasteur Institute of Tunis, Tunisia
Aida Bouratbine
Department of Parasitology, Pasteur Institute of Tunis, Tunisia; Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR11IPT-06, University Tunis El-Manar, Pasteur Institute of Tunis, Tunisia
Abstract
We report here a case of simultaneous cutaneous and visceral manifestations due to Leishmania L. infantum diagnosed in an immunocompetent adult. We describe a 74-year-old woman from Tunis, Tunisia, who presented a biologically confirmed visceral leishmaniasis infection concomitant with arm ulceration which appeared 2 years before. Leishmania DNA was detected by ITS PCR in both buffy coat and dermal scrapping of the arm lesion. Sequencing revealed that the 2 isolated strains corresponded to L. infantum and were 100% identical. The symptoms of visceral leishmaniasis responded to amphotericin B with rapid healing. However, the skin lesion did not improve although Leishmania PCR on dermal sample became negative. This location is probably secondarily to lymphatic or blood dissemination during the systemic visceral leishmaniasis infection. It would be favored by the inflammatory environment induced by the basal cell carcinoma subsequently diagnosed.
