{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:35:13Z","timestamp":1788795313028,"version":"build-2803163510"},"reference-count":46,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10,11]]},"abstract":"<jats:p>In Central America, few cases of leprosy have been reported, but the disease may be unrecognized. Diagnosis is based on clinical criteria and histology. Preliminary field work in Nicaragua and Honduras found patients, including many children, with skin lesions clinically suggestive of atypical cutaneous leishmaniasis or indeterminate leprosy. Histology could not distinguish these diseases although acid-fast organisms were visible in a few biopsies. Lesions healed after standard antimicrobial therapy for leprosy. In the present study, patients, family members, and other community members were skin-tested and provided nasal swabs and blood samples. Biopsies were taken from a subgroup of patients with clinical signs of infection. Two laboratories analyzed samples, using local in-house techniques. <jats:italic>Mycobacterium leprae<\/jats:italic>, <jats:italic>Leishmania<\/jats:italic> spp. and <jats:italic>Leishmania infantum<\/jats:italic> were detected using polymerase chain reactions. <jats:italic>Mycobacterium leprae<\/jats:italic> DNA was detected in blood samples and nasal swabs, including some cases where leprosy was not clinically suspected. <jats:italic>Leishmania<\/jats:italic> spp. were also detected in blood and nasal swabs. Most biopsies contained <jats:italic>Leishmania<\/jats:italic> DNA and coinfection of <jats:italic>Leishmania<\/jats:italic> spp. with <jats:italic>M. leprae<\/jats:italic> occurred in 33% of cases. <jats:italic>Mycobacterium leprae<\/jats:italic> DNA was also detected and sequenced from Nicaraguan and Honduran environmental samples. In conclusion, leprosy and leishmaniasis are present in both regions, and leprosy appears to be widespread. The nature of any relationship between these two pathogens and the epidemiology of these infections need to be elucidated.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0622","type":"journal-article","created":{"date-parts":[[2017,8,29]],"date-time":"2017-08-29T07:00:30Z","timestamp":1503990030000},"page":"1103-1110","source":"Crossref","is-referenced-by-count":10,"title":["Leprosy Associated with Atypical Cutaneous Leishmaniasis in Nicaragua and Honduras"],"prefix":"10.4269","volume":"97","author":[{"given":"Lucrecia Acosta","family":"Soto","sequence":"first","affiliation":[{"name":"Sanatorio Fontilles, Alicante, Spain;"},{"name":"Universidad Miguel Hern\u00e1ndez de Elche, Alicante, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Caballero","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n para el Desarrollo de los Pueblos (ADP), Nicaragua;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesny Ruth","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Head of Leprosy Program, Choluteca, Honduras;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Torres","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Sanatorio Fontilles, Alicante, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Ram\u00f3n","family":"G\u00f3mez Echevarr\u00eda","sequence":"additional","affiliation":[{"name":"Sanatorio Fontilles, Alicante, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat P\u00e9rez","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Sanatorio Fontilles, Alicante, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Jorge","family":"Bornay Llinares","sequence":"additional","affiliation":[{"name":"Universidad Miguel Hern\u00e1ndez de Elche, Alicante, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John L.","family":"Stanford","sequence":"additional","affiliation":[{"name":"University College London, London, United Kingdom;"},{"name":"Catriona Hargreaves Charitable Trust, Mill House, Claygate, Kent, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia A.","family":"Stanford","sequence":"additional","affiliation":[{"name":"Catriona Hargreaves Charitable Trust, Mill House, Claygate, Kent, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen D.","family":"Donoghue","sequence":"additional","affiliation":[{"name":"University College London, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"1209","article-title":"Leprosy","volume":"363","author":"Britton","year":"2004"},{"key":"b2","series-title":"Int J Lepr","first-page":"255","article-title":"Histological classification and the immune spectrum of 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