{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T16:59:27Z","timestamp":1761929967607},"reference-count":29,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11,7]]},"abstract":"<jats:p>The disseminated form of leishmaniasis is a serious and rare disease, being diagnosed in 2% of the cutaneous cases registered per year in Brazil. The main characteristic is the appearance of multiple pleomorphic lesions on the cutaneous surface. A 68-year-old male from the rural area of Tocantins, Brazil, presented atypical disseminated cutaneous leishmaniasis (ACL). The clinical course and histopathological and immunological findings presented a mixed pattern that hindered diagnosis and therapeutic management. Molecular typing revealed a mixed infection with <jats:italic>Leishmania (V.) guyanensis<\/jats:italic> and <jats:italic>Leishmania (L.) amazonensis<\/jats:italic>. Molecular identification of the agents responsible for ACL is important for adequate therapeutic planning, minimizing the possibility of sequellae that impact the quality of life of the patient.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0760","type":"journal-article","created":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T07:01:03Z","timestamp":1536649263000},"page":"1165-1169","source":"Crossref","is-referenced-by-count":8,"title":["Case Report: Atypical Cutaneous Leishmaniasis in a Patient with Mixed Leishmania guyanensis and Leishmania amazonensis Infection"],"prefix":"10.4269","volume":"99","author":[{"given":"Carina Scolari","family":"Gosch","sequence":"first","affiliation":[{"name":"Department of Microbiology, Immunology and Parasitology, Faculty President Ant\u00f4nio Carlos-Porto Nacional, Tocantins, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruna Silva","family":"Resende","sequence":"additional","affiliation":[{"name":"Faculty President Ant\u00f4nio Carlos-Porto Nacional, Tocantins, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9lia Bastos","family":"Amorim","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Specialized Attention Service of Porto Nacional, Tocantins, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e1lita Pollyanna","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology, Parasitology and Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goi\u00e1s, Goi\u00e1s, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ledice Inacia de Ara\u00fajo","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital of Tropical Diseases Dr. Anuar Auad, Goi\u00e1s, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebasti\u00e3o Alves","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Pathology, Goiano Institute of Oncology and Hematology, Goi\u00e1s, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia Reni Bortolin","family":"Uliana","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Institute of Biomedical Sciences, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriano Cappellazzo","family":"Coelho","sequence":"additional","affiliation":[{"name":"Department of Animal Biology, Institute of Biology, University of Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e1tima","family":"Ribeiro-Dias","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology, Parasitology and Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goi\u00e1s, Goi\u00e1s, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam Leandro","family":"Dorta","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology, Parasitology and Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goi\u00e1s, Goi\u00e1s, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"year":"2017","author":"Brasil Minist\u00e9rio da Sa\u00fade, Secretaria de Vigil\u00e2ncia em Sa\u00fade","key":"b1"},{"key":"b2","series-title":"Am J Trop Med Hyg","first-page":"281","article-title":"Atypical clinical variants in new world cutaneous leishmaniasis: disseminated, erysipeloid, and recidivacutis due to Leishmania (V.) panamensis","volume":"73","author":"Calvopina","year":"2005"},{"key":"b3","series-title":"Rev Inst Med Trop S\u00e3o Paulo","first-page":"1","article-title":"American cutaneous leishmaniasis with unusual clinical presentation and response to treatment","volume":"58","author":"Fernandes","year":"2016"},{"key":"b4","series-title":"Acta Trop","first-page":"31","article-title":"PCR-RFLP to identify Leishmania (Viannia) braziliensis and L. (Leishmania) amazonensis causing American cutaneous leishmaniasis","volume":"90","author":"Volpini","year":"2004"},{"key":"b5","series-title":"Mol Biochem Parasitol","first-page":"145","article-title":"Intergenic region typing (IRT): a rapid molecular approach to the characterization and evolution of Leishmania","volume":"73","author":"Cupolillo","year":"1995"},{"key":"b6","series-title":"BioMed Res Int","first-page":"1","article-title":"Identification and biological characterization of Leishmania (Viannia) guyanensis isolated from a patient with tegumentary Leishmania in Goi\u00e1s, a nonendemic area for this species in Brazil","volume":"2015","author":"Pires","year":"2015"},{"key":"b7","series-title":"Bioinformatics","first-page":"2947","article-title":"Clustal W and clustal X version 2.0","volume":"23","author":"Larkin","year":"2007"},{"key":"b8","series-title":"Embnew News","first-page":"1","article-title":"GeneDoc: analysis and visualization of genetic variation","volume":"4","author":"Nicholas","year":"1997"},{"key":"b9","series-title":"Am J Trop Med Hyg","first-page":"558","article-title":"Disseminated cutaneous leishmaniasis due to Leishmania guyanensis: case of a patient with 425 lesions","volume":"71","author":"Couppi\u00e9","year":"2004"},{"key":"b10","series-title":"Trop Med Health","first-page":"1","article-title":"Diffuse and disseminated cutaneous leishmaniasis: clinical cases experienced in Ecuador and a brief review","volume":"44","author":"Hashiguchi","year":"2016"},{"key":"b11","series-title":"Acta Trop","first-page":"315","article-title":"Clinical and immunopathological aspects of disseminated cutaneous leishmaniasis","volume":"56","author":"Carvalho","year":"1994"},{"key":"b12","series-title":"Mem Inst Oswaldo Cruz","first-page":"239","article-title":"Clinical and immunopathological spectrum of American cutaneous leishmaniasis with special reference to the disease in Amazonian Brazil\u2014a review","volume":"99","author":"Silveira","year":"2004"},{"key":"b13","series-title":"Trop Med Health","first-page":"1","article-title":"Diffuse and disseminated cutaneous leishmaniasis: clinical cases experienced in Ecuador and a brief review","volume":"44","author":"Hashiguchi","year":"2016"},{"key":"b14","series-title":"Trans R Soc Trop Med Hyg","first-page":"1075","article-title":"Reviewing the role of the dendritic Langerhans cell in the immunopathogenesis of American cutaneous leishmaniasis","volume":"102","author":"Silveira","year":"2008"},{"key":"b15","series-title":"Trop Med Research","first-page":"1","article-title":"A clinical case of disseminated cutaneous leishmaniasis in a young infant: early diagnosis","volume":"1","author":"Ferreira","year":"2016"},{"key":"b16","series-title":"Braz J Infect Dis","first-page":"201","article-title":"Disseminated cutaneous leishmaniasis: ulcerovegetative and ulcero-crusted lesions","volume":"21","author":"Sgarbi","year":"2017"},{"year":"2001","author":"Chagas","key":"b17"},{"key":"b18","series-title":"Mem Inst Oswaldo Cruz","first-page":"525","article-title":"Further observations on clinical, histopathological and immunological features of borderline disseminated cutaneous leishmaniasis caused by Leishmania (Leishmania) amazonensis","volume":"100","author":"Silveira","year":"2005"},{"key":"b19","series-title":"J Trop Med Hyg","first-page":"319","article-title":"Disseminated cutaneous leishmaniasis in a field clinic in Bahia, Brazil: a report of eight cases","volume":"86","author":"Costa","year":"1986"},{"key":"b20","series-title":"An Bras Dermatol","first-page":"1092","article-title":"A randomized clinical trial comparing meglumine antimoniate, pentamidine and amphotericin B for the treatment of cutaneous leishmaniasis by Leishmania guyanensis","volume":"86","author":"Neves","year":"2011"},{"key":"b21","series-title":"Am J Trop Med Hyg","first-page":"255","article-title":"Randomized controlled clinical trial to access efficacy and safety of miltefosine in the treatment of cutaneous leishmaniasis caused by Leishmania (Viannia) guyanensis in Manaus, Brazil","volume":"84","author":"Chrusciak-Talhari","year":"2011"},{"key":"b22","series-title":"Trans R Soc Trop Med Hyg","first-page":"712","article-title":"Atypical manifestations of tegumentary leishmaniasis in a transmission area of Leishmania braziliensis in the state of Bahia, Brazil","volume":"103","author":"Guimar\u00e3es","year":"2009"},{"key":"b23","series-title":"Am J Trop Med Hyg","first-page":"339","article-title":"Leishmania (Viannia) guyanensis induces low immunologic responsiveness in leishmaniasis patients from an endemic area of the Brazillian Amazon Highland","volume":"80","author":"Matta","year":"2009"},{"key":"b24","series-title":"Nature","first-page":"581","article-title":"Cutaneous leishmaniasis: immune responses in protection and pathogenesis","volume":"16","author":"Scott","year":"2016"},{"key":"b25","series-title":"Z Parasitenkd","first-page":"159","article-title":"Depletion of secondary lysosomes in mouse macrophages infected with Leishmania mexicana amazonensis: a cytochemical study","volume":"71","author":"Barbieri","year":"1985"},{"key":"b26","series-title":"J Cell Sci","first-page":"3065","article-title":"Fusion between large phagocytic vesicles: targeting of yeast and other particulates to phagolysosomes that shelter the bacterium Coxiella burnetii or the protozoan Leishmania amazonensis in Chinese hamster ovary cells","volume":"107","author":"Veras","year":"1994"},{"key":"b27","series-title":"Mem Inst Oswaldo Cruz","first-page":"247","article-title":"Utiliza\u00e7\u00e3o da rea\u00e7\u00e3o de imunofluoresc\u00eancia indireta no acompanhamento da terap\u00eautica da leishmaniose tegumentar americana","volume":"77","author":"Souza","year":"1982"},{"key":"b28","series-title":"Rev Soc Med Trop","first-page":"26","article-title":"Avalia\u00e7\u00e3o da resposta imune humoral atrav\u00e9s do teste de imunofluoresc\u00eancia indireta na leishmaniose cut\u00e2nea causada por Leishmania (L.) amazonensis na regi\u00e3o Amaz\u00f4nica do Brasil","volume":"32","author":"Chagas","year":"1999"},{"key":"b29","series-title":"Br J Dermatol","first-page":"111","article-title":"Unusual clinical variants of cutaneous leishmaniasis in Pakistan","volume":"139","author":"Raja","year":"1998"}],"container-title":["The American Journal of Tropical Medicine and 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