mucocutaneous leishmaniasis is a cutaneous disease caused by the flagellate protozoan called the Leishmania Tropica complex.
It is transmitted by the sandfly of the genus PHLEBOTOMUS.
mucocutaneous leishmaniasis caused by
Female Sandfly genus phlebotomus is the causative agent of leishmania cutaneous. This sandfly is the definitive host. Human is the intermediate host.
Cutaneous leishmaniasis has two morphological forms in his life. (a) Amastigote and second one is (b) Promestigote.
The life cycle of mucocutaneous leishmaniasis
leishmania’s first form is called amastigote. It is oval in shape. this form contains a nucleus that closes into a smaller structure called the kinetoplast. In the body of the sandfly, amastigote converts into promastigote.
- Sandflies inject an infective form (promastigote) of leishmania into humans during a blood meal.
- This promastigote engulfed by the macrophage in the human body.
- This Promastigote change into amastigote.
- Amastigote multiple in the macrophage and other cells.
- Infected tissue shows clinical signs of leishmania cutaneous.
- When sandflies take blood from the infected host, it takes infected macrophages. This amastigote multiple in the midgut of sandfly and differentiates it into Promastigate.
- This Promastigote migrates to the proboscis and infects other humans.
Diagnosis of mucocutaneous leishmaniasis
Following laboratory tests are performed for the conformation of leishmaniasis.
- Montenegro Test skin test
- Indirect fluorescent technique
- Leishmania stain
Sample collection mucocutaneous leishmaniasis
- Clean the surface of the ulcer. Make deep incision about 5mm in length with surgical blad.
- Take a corrugated dental needle and insert it into the skin at the margin of the ulcer pointing toward the floor of the ulcer. Takeout needle without rotating. Clean the needle on the glass slide.
- Take a 50 ml syringe with a wide-bore needle. Insert it into the skin 1 cm away from an ulcer. Penetrate the subcutaneous tissue in the direction of the ulcer. When the needle reaches below the ulcer apply suction until exudate appears in the hub of the needle. Blow out the content on the glass slid and prepare a smear.
- Stain that smear and study the morphology of parasite under oil immersion lens.