%0 Journal Article
%T Occupationally Acquired American Cutaneous Leishmaniasis
%A Maria Edileuza Felinto de Brito
%A Maria Sandra Andrade
%A ¨¦ricka Lima de Almeida
%A £¿ngela Cristina Rapela Medeiros
%A Roberto Pereira Werkh£¿user
%A Ana Isabele Freitas de Ara¨²jo
%A Sinval Pinto Brand£¿o-Filho
%A Alzira Maria Paiva de Almeida
%A Eduardo Henrique Gomes Rodrigues
%J Case Reports in Dermatological Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/279517
%X We report two occupationally acquired cases of American cutaneous leishmaniasis (ACL): one accidental laboratory autoinoculation by contaminated needlestick while handling an ACL lesion sample, and one acquired during field studies on bird biology. Polymerase chain reaction (PCR) assays of patient lesions were positive for Leishmania, subgenus Viannia. One isolate was obtained by culture (from patient 2 biopsy samples) and characterized as Leishmania (Viannia) naiffi through an indirect immunofluorescence assay (IFA) with species-specific monoclonal antibodies (mAbs) and by multilocus enzyme electrophoresis (MLEE). Patients were successfully treated with N-methyl-glucamine. These two cases highlight the potential risks of laboratory and field work and the need to comply with strict biosafety procedures in daily routines. The swab collection method, coupled with PCR detection, has greatly improved ACL laboratory diagnosis. 1. Introduction Health professionals such as physicians, nurses, and laboratory workers and researchers and students in the biological sciences are at risk of a number of occupational infections [1]. Accidents involving contaminated ¡°sharps¡± are, in general, extremely dangerous due to the high likelihood of infectious agent transmission. Exposure to blood-borne pathogens represents an especially serious risk. Needlestick and sharps contamination accidents involving at least 20 different pathogens, most commonly hepatitis B and C or human immunodeficiency virus (HIV), have been reported [1]. Some occupational accidents with Leishmania spp. related to percutaneous injuries, contaminated animal/culture handling, or lesion sample collection have also been reported [2]. ACL diagnosis is based on clinical, epidemiological, and laboratorial criteria. However, clinical diagnosis is often difficult due to the varied presentation of the disease, and the epidemiological criteria may go unnoticed because clinicians are not aware of the existence or nature of the disease [3, 4]. Laboratory diagnosis includes the direct identification of amastigotes through direct examinations of stained smears from imprints or histological sections, isolation of promastigotes by culture, and immune-based methods (e.g., ELISA, Western blot, indirect immunofluorescence (IFAT), and delayed hypersensitivity or Montenegro intradermoreaction (MIDR), [5, 6]. Laboratory procedures may be hindered by the scarcity of amastigotes in the wounds, especially in late stages of the disease and secondary infections, or by the low sensitivity and cross reactivity of serological
%U http://www.hindawi.com/journals/cridm/2012/279517/