This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cruz, I. Articles by Alvar, J. Search for Related Content PubMed PubMed Citation Articles by Cruz, I. Articles by Alvar, J.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, July 2006, p. 2343-2347, Vol. 44, No. 7
0095-1137/06/$08.00+0     doi:10.1128/JCM.02297-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Comparison of New Diagnostic Tools for Management of Pediatric Mediterranean Visceral Leishmaniasis

WHO Collaborating Centre for Leishmaniasis, Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra. Pozuelo-Majadahonda, km 2, 28220 Majadahonda, Madrid, Spain,¹ Hospital Vall d'Hebron, Po. Vall d'Hebron 129, 08035 Barcelona, Spain²

Received 2 November 2005/ Returned for modification 5 January 2006/ Accepted 5 May 2006

New techniques are available for diagnosing leishmaniasis, but their efficacy in the identification of pediatric visceral leishmaniasis (VL) has not been compared with that of traditional methods. Blood, bone marrow, and urine samples were taken from 25 children with VL during their first clinical episode, 22 days after the start of treatment with liposomal amphotericin B (3 mg/kg/day on 6 days over a 10-day period), and when a relapse was suspected during follow-up. The results obtained suggest that antibody detection techniques, the antigen detection in urine (KAtex kit), and Leishmania nested PCR (LnPCR) analysis of the blood could be used for diagnosis of the first clinical episode. After treatment, clinical improvement was associated with negativization of Novy-MacNeal-Nicolle culture and microscopy of bone marrow aspirate, KAtex test, and LnPCR blood analysis results. Interestingly, LnPCR analysis of the bone marrow aspirate showed that sterile cure was not achieved in eight patients, two of which suffered a relapse within 10 to 20 weeks. All of the new noninvasive techniques tested showed high diagnostic sensitivity. However, LnPCR analysis of the bone marrow was the most sensitive; this test was able to detect the persistence of parasites and predict potential relapses.

This article has been cited by other articles:

• Alvar, J., Aparicio, P., Aseffa, A., Den Boer, M., Canavate, C., Dedet, J.-P., Gradoni, L., Ter Horst, R., Lopez-Velez, R., Moreno, J. (2008). The Relationship between Leishmaniasis and AIDS: the Second 10 Years. Clin. Microbiol. Rev. 21: 334-359 [Abstract] [Full Text]  
• Martin-Davila, P., Fortun, J., Lopez-Velez, R., Norman, F., Montes de Oca, M., Zamarron, P., Gonzalez, M. I., Moreno, A., Pumarola, T., Garrido, G., Candela, A., Moreno, S. (2008). Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation. Clin. Microbiol. Rev. 21: 60-96 [Abstract] [Full Text]