Visceral Leishmaniasis Caused by Leishmania Tropica

• Published in: Acta parasitologica Vol. 68; no. 3; pp. 699 - 704
• Main Authors: Özbilgin, Ahmet, Tunalı, Varol, Çavuş, İbrahim, Tetik, Aslı Vardarlı, Dinç, Melike, Yalçın, Talat, Gündüz, Cumhur, Beyaz, Merve, Köse, Şükran
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-09-2023; Springer Nature B.V
• Subjects: Animal Systematics/Taxonomy/Biogeography; Biomedical and Life Sciences; Biomedicine; Clinical aspects; Cutaneous leishmaniasis; Ecology; Epidemiology; Female; Gastrointestinal system; Humans; Leishmania; Leishmania infantum; Leishmania tropica - genetics; Leishmaniasis, Cutaneous - epidemiology; Leishmaniasis, Visceral - epidemiology; Male; Medical Microbiology; Microbiology; Pancytopenia; Parasitic diseases; Parasitology; Public health; Short Communication; Signs and symptoms; Splenomegaly; Turkey - epidemiology; Vector-borne diseases; Visceral leishmaniasis; Weight loss; Turkey; Cutaneous leishmaniasis; Turkey; Pathogenesis; Visceral leishmaniasis; Europe; Leishmania tropica
• ISSN: 1230-2821; 1896-1851
• DOI: 10.1007/s11686-023-00695-w

Purpose
In Turkey, the main causative agent of visceral leishmaniasis (VL) is
Leishmania. infantum
and the main causative agent of cutaneous leishmaniasis (CL) is
Leishmania tropica
. In this study, we aimed to discuss the possible mechanisms, clinical aspects, and threat of visceralizing
L. tropica
.
Methods
This study includes seven cases of VL caused by
L. tropica
.Five patients were male (71%) and four were adults (57%).
Results
All the VL patients complained of fever and splenomegaly. Fatigue, pancytopenia, and hepatomegaly were present in six patients each (86%), while weight loss and gastrointestinal system (GIS) symptoms were present in 5 patients (71%).
Conclusions
In this study, we have evaluated seven cases of visceralized
L. tropica
(VLT) in the context of the changing leishmaniasis epidemiology in Turkey. We have evaluated the possible mechanisms of visceralization; inter- and intraspecies genetic exchange with all the old world leishmaniasis agents present in the region, stress induced by inappropriate use of drugs, and possible ongoing adaptation mechanisms of
Leishmania
spp. The threat posed by VLT is significant as
L. tropica
is the most widespread and most common cause of leishmaniasis in Turkey. We do not know the vectorial capacity of the sand flies for the transmission of VLT strains or if these strains are in circulation in Turkey. Future studies should be carried out to investigate these issues as the transition of
L. tropica
from a mild disease-causing agent to a mortal one poses a significant public health concern for Turkey and Europe.