Palabras clave: amastigote chagas dermatología Leishmania salud pública

Transcription

1 REDVET - Revista electrónica de Veterinaria - ISSN Cutaneous leishmaniasis in a canine from the Florencia city, Amazonic region of Colombia in South America, a Case Report - Leishmaniasis cutánea en un canino de la ciudad de Florencia, en la región Amazónica de Colombia Motta-Delgado Pablo Andrés (Corresponding author) GIMCCA Group, Misión Verde Amazonia: Corporation for sustainable development and mitigation of climate change Calle 21 N 2-184, Florencia, Caquetá, Colombia South América Tel: (578) pmottamvz@gmail.com Gongora-Cortes Ketty Yasiry helloketty-21@hotmail.com Portela Aguja Cristian René cristportela45@gmail.com González Bejía Leidy Lorena lelogobe@hotmail.es Carvajal Perdomo Daimer Fabian daimers.cp@gmail.com Resumen La leishmaniasis en una enfermedad parasitaria endémica en algunas regiones de Colombia, con un gran impacto sobre la salud pública. El presente documento describe un caso clínico de un canino ubicado en la región amazónica colombiana, que presentó sintomatología y lesiones cutáneas características para chagas o leishmaniasis cutánea. También se describe el procedimiento instaurado para su diagnóstico y manejo como enfermedad de importancia clínica en la salud pública. Palabras clave: amastigote chagas dermatología Leishmania salud pública 1

2 Abstract The leishmaniasis in a parasitic disease endemic in some regions of Colombia, with a great impact on public health. This document describes a clinical case of a canine located in the Amazon region of Colombia, which presented symptoms and characteristic skin lesions for Chagas disease or cutaneous leishmaniasis. It also describes the procedure for its diagnosis and management of importance as disease in the public health. Key Words: amastigot, chagas disease, dermatology, Leishmania, public health. Introduction Leishmaniasis is a parasitic disease of great geographical expansion in the world with occurrence in tropical and subtropical regions, which is transmitted by hematophagous insects of the genus Lutzomyia and Phlebotomus (Slappendel & Green, 1990; Bravo et al., 1993), while the etiologic agent is a protozoan of the genus Leishmania (Moreno et al., 1999) with more than 20 different species (Killick-Kendrick, 1990; WHO 2014). In accordance with the established by Feitosa et al. (2000), leishmaniasis usually is a systemic disease with chronic evolution, clinically apparent within three months to a few years and its severity depends on the immune depression. According to Ferrer et al.., (1988); Slappendel and Greene (1990); Ciaramella & Corona (2003) the leishmaniasis in its chronic stages affects the skin, being the occasional dermatological alterations in the absence of other disorders. The cutaneous leishmaniasis according to the WHO (2014), is the most common form of the disease, causing ulcers in the exposed parts of body, leaving permanent scars. In the pathogenesis of dog and human, there is a very important inmunopathogenic mechanism in the development of the disease. Due to the development of immune complexes, these are deposited in various places such as the spleen, liver, kidney, and in a systematic way the blood vessels, facilitating different characteristic clinical presentations of the disease. The impact of this parasitic disease canine is displayed in the public health implications, for its zoonotic nature, in the levels of incidence of the disease, the difficulty in the rapid and timely diagnosis, in addition to the actual cost of the treatment (Cordero et al., 1999; Miles et al., 1999), because the dog is the main reservoir of L. chagasi in South America. 2

3 Clinical Case In the second quarter of 2012 income to a private veterinary clinic, a female canine of indeterminate race, with an average age of 30 months, from the city of Florence in the Department of Caqueta, located in the Amazon region of Colombia, who at the clinical examination showed lesions itchy in forelimbs, localized alopecia perianal, ventral edema and edema in hind limbs, presenting an evolution of 30 days as reported by the owner. The owner also reported that the patient lived with wild animals such as a parrot (Psitasidae) and a primate of the new world. The animal had recent record of deworming, but not from any vaccination plan, with a mixed diet between feed concentrate and feed prepared in the home. During a first consultation, the patient had normal physiological constants, showed localized alopecia, pruritus, decay and inappetence, in addition to presence of ectoparasites such as mites and ticks Ripicephalus sanguineus, for which he was made an antiparasitic external gender that elimination of the mites and ticks, but there was no improvement in the pruritus, the decay and loss of appetite, for which he was sent again to the small animal veterinary clinic at the Universidad de la Amazonia in Florencia Colombia. During the second consultation the patient presented all the normal physiological constants with the exception of hyperthermia (39.1 C), mucous membranes were pale, with a capillary refill time of four seconds, showing generalized adenopathy, alterations in the skin consisting of ulcerative lesions in forelimbs, localized alopecia in the perianal region and edema chest. Figure 1. Skin changes in the patient. A) condition in the forelimbs, B) ulcer with depressed center and raised edges in right forelimb, C) localized Alopecia Perianal. Based on the previous review was established a presumptive diagnosis for leishmaniasis, which was carried out examination by histopathology and cytology for obtaining samples of the edges of the lesions and popliteal lymph nodes. 3

4 The results of the laboratory examination was positive for Leishmania spp evidencing forms of amastigot in macrophages and in free forms of the parasite by which determined that the skin lesions correspond to cutaneous leishmaniasis. After to the definitive diagnosis the owners were briefed on the situation of the patient, due to their low economic status and the inability to afford a proper treatment and aware of the risk to his health, they decided to and authorized euthanasia was practiced, which was conducted by an overdose of barbiturates, subsequently was performed the autopsy. Results of the autopsy The dissection was found the superficial lymph nodes swollen, showing increase in its volume, in particular the popliteal, inguinal, mesenteric and submaxillary lymph nodes, soft consistency elastic, yellowish color and distinguished a nodal structure clear. In the abdominal cavity was observed ascites peritoneal, liver jaundiced with rounded edges. It was noted splenomegaly moderates with the rounded edges of the spleen. At chest level of observed presence of fluid in the pericardium (hidropericadio). The rest of the organs with the exception of the skin that had obvious alterations were normal. Discussion Cardoso & Cabral (1998) and Ciaramella & Corona (2003), reported that the animals infected with Leishmania develop clinical disease which may include lymphoadenomegaly, loss of weight marked, progressive languor, hepato-splenomegaly, epistaxis, arthropathies, ascites, diarrhea; there are skin lesions as nodules not ulcerated sores, or alopecia, exfoliative dermatitis dry; likewise, ophthalmological disorders type uveitis, keratoconjunctivitis, panophthalmitis, keratoconjunctivitis and panoftalmitis are frequent and progresses the reservoir of immunocomplexes to renal level leading to glomerulonefropatias with protein loss, polydipsia, polyuria, and vomiting, some of whom were evidenced in the present case. In studies conducted by Koutinas et al. (1999); Ciaramella et al. (1997) observed clinical signs associated with the disease in more than 150 dogs, by notifying the same symptoms that the patient already described, in the same way, Zárate-Ramos (2007), they found a similar symptoms to the signs described, who also practiced euthanasia to the patient for not being in a common area for the disease. In this case it was found that the evolution of the disease was rapid after emergence of the first symptoms of skin disease, however, infected animals 4

5 naturally occur prolonged periods of absence of symptoms (Santos-Gomes et al. 2000). It is important to emphasize that the patient was in one of the areas of the country with an incidence of vectors transmitters of Leishmania as Lutzomyia longipalpis and L. evansi (Corredor et al., 1989; Vélez et al., 1995), some studies also have shown that it is possible the transmission of Leishmania from vectors as Ripicephalus sanguineus and has raised the possibility that mosquitoes of the genus Culicoides also transmit the disease (Bravo et al., 1993). Similarly the fact to live directly with wildlife captive is a predisposing factor for contracting the parasite, since the parasite has a great variability in host species and wild reservoirs vertebrates (Albuquerque, 2007; Silva, 2007; Coelho, 2011; Figueiredo, 2013). Considerations and factors such as the previous enable the spread of the disease to other hosts as a human being, therefore, the adequate epidemiological protocols must be instituted to reduce the risk of zoonosis. References Albuquerque, A.L.; Aragão, F.R.; Faustino, M.A.G.; Gomes, Y.M.; Lira, R.A.; Nakasawa, M., & Alves, L.C. (2007). Aspectos clínicos de cães naturalmente infectados por Leishmania (Leishmania) chagasi na região metropolitana do Recife. Clínica Veterinária, 71: Bravo, I., Frank, L.A., & Brennenman, K.A. (1993). Canine Leishmaniasis in the United States. The compendium 1993, 15: Cardoso, L., & Cabral, M. (1998). Leishmania e leishmaniose canina. Rev. Port. Cs. Vet., 93: Ciaramella, P., Olivia, G., De Luna, R., Gradoni, L., Ambrosio, R., Cortese, L., et al. (1997). A retrospective clinical study of canine leismaniasis in 150 dogs naturally infectec by Leishmania infantum. Vet Rec, 141: Ciaramella, P., & Corona, M. (2003). Canine leishmaniasis: clinical and diagnostic aspects. Comp. Cont. Educ. Pract. Vet., 25: Coelho, H. E., Carvalho, T. F., Alberto, H., Fernandes, J. M., Souza, K. B., Magalhães, A. O. C., & Barbosa, C. H. G. (2011). Ocorrência de Leishmaniose visceral em um cão em Uberaba, Minas Gerais. Revista Científica Eletrônica de Medicina Veterinária, Garça, n. 16. Cordero M, Rojo FA, Martínez AM, Sánchez MC, Hernández S, Navarrete l, et al. (1999). Parasitosis sistémicas, leishmaniosis canina. En: Parasitología Veterinaria, MC Graw Hill Interamericana; p Feitosa, M.M., Ikeda, F.A., Luvizotto, M.C. et al. (2000). Aspectos clínicos de cães com leishmaniose visceral no município de Aracatuba- Sao Paulo (Brasil). Clin. Vet, 28: Ferrer, L.; Rabanal, R.; Fondevila, D.; Ramos, J.; Domingo, M, (1988). Skin lesions in canine leishmaniasis. J. Small Anim. Pract., 29:

6 Killick-Kendrick, R. (1990). Phlebotomine vectors of leishmaniasis: a review. Med. Vet. Entomol. 4: Figueiredo, M.J. de F.M de. (2013). Soroprevalência e avaliação clínica da Leishmaniose visceral canina no Município de Colares, Estado do Pará. Dissertação (Mestrado em Saúde e Produção Animal na Amazônia). Universidad Federal Rural da Amazonia. 90 p. Koutinas, A.F., Polizopaulou, Z.S., Saridomichelakis, M.N., Argyriadis, D., Fytianou, A., Plevraki, K.G. (1999). Clinical considerations on Canine Visceral Leishmaniasis in Greece: A retrospective Study of 158 cases ( ). J Am Anim Hosp Asso. 35: Miles MA. (1999). Canine leishmaniasis in Latin América: Control strategies for visceral leishmaniasis, Canine Leishmaniasis and Update, Barcelona España. Moreno, J., Nieto, J., Chamizo, C., González, F., Blanco, F., Barker, D.C., et al. (1999). The immune response and PBMC subset in canine visceral leishmaniasis before and afte, chemotherapy. Vet. Inmunolol. Pathol. 71: WHO World Health Organization. (2014). Leishmaniasis: Nota descriptiva N 375. [Online] Available: (October, 12, 2014). Santos-Gomes, G., Campino, I., & Abranches, P. (2000). Canine experimental infection: Intradermal inoculation of Leishmania infantum promastigotes. Mem Inst Oswaldo Cruz, 95: Slappendel, M.; & Greene, C. (1990). Leishmaniasis. En: Infectious diseases of the dog and cat (C. Greene, eds.). W.B. Saunders Company, Philadelphia, USA, pp Silva, F. S. (2007). Patologia e patogênese da leishmaniose visceral canina. Revista Tropica - Ciências Agrárias e Biológicas, 1 (1): 20, Zárate-Ramos, J.J., Rodriguez, T.L.E., Ávalos, R.R., Salinas, M.J.A., & Flores, P.F.I. (2007). Descripción de un caso clínico de leishmaniosis canica en el norte de México. Veterinaria México. 38 (2): REDVET: 2017, Vol. 18 Nº 8 Este artículo Ref _REDVET está disponible en concretamente en REDVET Revista Electrónica de Veterinaria está editada por Veterinaria Organización. Se autoriza la difusión y reenvío siempre que enlace con Veterinaria.org y con REDVET - 6