Failure to Detect Leishmania in the Blood of Patients with Old-World Cutaneous Leishmaniasis: Implications for Blood Donation

Michal Solomon Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel;
The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;

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Ariel Gimple Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel;
The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;

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Inbal Fuchs Faculty of Health Sciences, Department of Family Medicine, Ben Gurion University, Clalit Health Services, Southern District, Beersheba, Israel;

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Assi Cicurel Faculty of Health Sciences, Department of Family Medicine, Ben Gurion University, Clalit Health Services, Southern District, Beersheba, Israel;

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Tal Meninger The Institute of Geographic Medicine and Tropical Diseases and the Laboratory for Tropical Diseases Research, Sheba Medical Center, Tel Hashomer, Israel;

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Dror Avni The Institute of Geographic Medicine and Tropical Diseases and the Laboratory for Tropical Diseases Research, Sheba Medical Center, Tel Hashomer, Israel;

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Abed Nasereddin Department Microbiology and Molecular Genetics, Kuvin Center, The Hebrew University - Hadassah Medical Center, Jerusalem, Israel

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Charles L. Jaffe Department Microbiology and Molecular Genetics, Kuvin Center, The Hebrew University - Hadassah Medical Center, Jerusalem, Israel

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Eli Schwartz The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;
The Institute of Geographic Medicine and Tropical Diseases and the Laboratory for Tropical Diseases Research, Sheba Medical Center, Tel Hashomer, Israel;

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ABSTRACT.

Cutaneous leishmaniasis (CL) is endemic in Israel, caused mainly by Leishmania major (L. major) and L. tropica. In addition, returning travelers import another leishmanial species such as L. braziliensis. Although we are dealing with a skin disease, the blood bank in Israel does not accept blood donations from people infected with CL in cases of multiple lesions due to the possibility of transfusion. Our purpose was to investigate the prevalence of Leishmania in the blood of patients with active or previous CL. This pilot study screened patients with active or previous CL for parasites in their blood. All patients were infected in Israel or were returning travelers with leishmaniasis acquired in Latin America. Patients were seen at the Sheba Medical Center. In addition, patients were seen at their homes in L. tropica and L. major endemic regions in Israel. Blood samples were taken from each patient for culture and polymerase chain reaction (PCR). Altogether 62 blood samples were examined (L. tropica = 26, L. major = 33, and L. braziliensis = 3). Twenty-seven patients had an active disease and 35 were recovered. All blood cultures and PCR were negative for parasites except one blood sample that was PCR positive for L. braziliensis. The findings of our study, although a small sample, suggest that people with active or recent CL caused by L. major and L. tropica, do not harbor parasites in their blood. Thus, their exclusion from blood donation should be revisited. Further studies are needed with larger sample size and highly sensitive tests.

Author Notes

Address correspondence to Michal Solomon, Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, 52621 Israel. E-mail: solomondr1@gmail.com

Authors’ addresses: Michal Solomon and Ariel Gimple, Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel, and The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, E-mails: solomondr1@gmail.com and a.gimple@gmail.com. Inbal Fuchs and Assi Cicurel, Faculty of Health Sciences, Department of Family Medicine, Ben Gurion University, Clalit Health Services, Southern District, Beersheba, Israel, E-mails: inbalfp@gmail.com and cicurels@gmail.com. Tal Meninger, The Institute of Geographic Medicine and Tropical Diseases and the Laboratory for Tropical Diseases Research, Sheba Medical Center, Tel Hashomer, Israel, E-mail: talsegman@gmail.com. Dror Avni and Eli Schwartz, The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, and The Institute of Geographic Medicine and Tropical Diseases and the Laboratory for Tropical Diseases Research, Sheba Medical Center, Tel Hashomer, Israel, E-mails: dror.avni@sheba.health.gov.il and elischwa@tauex.tau.ac.il. Abed Nasereddin and Charles L. Jaffe, Department Microbiology and Molecular Genetics, Kuvin Center, The Hebrew University - Hadassah Medical Center, Jerusalem, Israel, E-mails: abedn@ekmd.huji.ac.il and cjaffe@mail.huji.ac.il.

  • 1.

    Herwaldt BL , 1999. Leishmaniasis. Lancet 354: 1191–1199.

  • 2.

    Schlein Y , Warburg A , Schnur LF , Le Blancq SM , Gunders AE , 1984. Leishmaniasis in Israel: reservoir hosts, sandfly vectors and leishmanial strains in the Negev, Central Arava and along the Dead Sea. Trans R Soc Trop Med Hyg 78: 480–484.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Klaus S , Frankenburg S , 1999. Cutaneous leishmaniasis in the Middle East. Clin Dermatol 17: 137–141; discussion 05–6.

  • 4.

    Hepburn NC , 2000. Cutaneous leishmaniasis. Clin Exp Dermatol 25: 363–370.

  • 5.

    Solomon M , Pavlotzky F , Barzilai A , Schwartz E , 2012. Liposomal amphotericin B in comparison to sodium stibogluconate for Leishmania braziliensis cutaneous leishmaniasis in travelers. J Am Acad Dermatol 62: 284–289.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Jimenez-Marco T et al., 2016. Transfusion-transmitted leishmaniasis: a practical review. Transfusion 56 (Suppl 1): S45–S51.

  • 7.

    Jimenez-Marco T et al., 2018. Strategies for reducing the risk of transfusion-transmitted leishmaniasis in an area endemic for Leishmania infantum: a patient- and donor-targeted approach. Blood Transfus 16: 130–136.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Grogl M , Daugirda JL , Hoover DL , Magill AJ , Berman JD , 1993. Survivability and infectivity of viscerotropic Leishmania tropica from Operation Desert Storm participants in human blood products maintained under blood bank conditions. Am J Trop Med Hyg 49: 308–315.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Dey A , Singh S , 2006. Transfusion transmitted leishmaniasis: a case report and review of literature. Indian J Med Microbiol 24: 165–170.

  • 10.

    Mestra L , Lopez L , Robledo SM , Muskus CE , Nicholls RS , Velez ID , 2011. Transfusion-transmitted visceral leishmaniasis caused by Leishmania (Leishmania) mexicana in an immunocompromised patient: a case report. Transfusion 51: 1919–1923.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Jimenez-Marco T , Girona-Llobera E , 2019. Leucoreduction for preventing parasite transfusion-transmission: an overlooked strategy. Vox Sang 114: 291.

  • 12.

    Jimenez-Marco T , Riera C , Fisa R , Girona-Llobera E , 2012. A possible case of transfusion-transmitted visceral leishmaniasis. Transfusion 52: 1154–1155, author reply 5.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Nakkash-Chmaisse H , Makki R , Nahhas G , Knio K , Nuwayri-Salti N , 2011. Detection of Leishmania parasites in the blood of patients with isolated cutaneous leishmaniasis. Int J Infect Dis 15: e491–e494.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Schönian G , Nasereddin A , Dinse N , Schweynoch C , Schallig HDFH , Presber W , Jaffe CL , 2003. PCR diagnosis and characterization of Leishmania in local and imported clinical samples. Diagn Microbiol Infect Dis 47: 349–358.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Monroy-Ostria A , Nasereddin A , Monteon VM , Guzmán-Bracho C , Jaffe CL , 2014. ITS1 PCR-RFLP Diagnosis and characterization of Leishmania in clinical samples and strains from cases of human cutaneous leishmaniasis in states of the Mexican southeast. Interdiscip Perspect Infect Dis 2014: 607287.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Badaro R , Jones TC , Carvalho EM , Sampaio D , Reed SG , Barral A , Teixeira R , Johnson WD Jr , 1986. New perspectives on a subclinical form of visceral leishmaniasis. J Infect Dis 154: 1003–1011.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Ravel S , Cuny G , Reynes J , Veas F , 1995. A highly sensitive and rapid procedure for direct PCR detection of Leishmania infantum within human peripheral blood mononuclear cells. Acta Trop 59: 187–196.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Kyriakou DS , Alexandrakis MG , Passam FH , Kourelis TV , Foundouli P , Matalliotakis E , Maniatis AN , 2003. Quick detection of Leishmania in peripheral blood by flow cytometry. Is prestorage leucodepletion necessary for leishmaniasis prevention in endemic areas? Transfus Med 13: 59–62.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Mansueto P , Seidita A , Vitale G , Cascio A , 2014. Transfusion transmitted leishmaniasis. What to do with blood donors from endemic areas? Travel Med Infect Dis 12: 617–627.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Centers for Disease Control and Prevention , 2003. Cutaneous leishmaniasis in U.S. military personnel–Southwest/Central Asia, 2002–2003. MMWR Morb Mortal Wkly Rep 52: 1009–1012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Venazzi EA , Roberto AC , Barbosa-Tessmann IP , Zanzarini PD , Lonardoni MV , Silveira TG , 2007. Detection of Leishmania (Viannia) DNA in blood from patients with American cutaneous leishmaniasis. Exp Parasitol 115: 399–402.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    de Oliveira Camera P , Junger J , do Espírito Santo Silva Pires F , Mattos M , Paes Oliveira-Neto M , Fernandes O , Pirmez C , 2006. Haematogenous dissemination of Leishmania (Viannia) braziliensis in human American tegumentary leishmaniasis. Trans R Soc Trop Med Hyg 100: 1112–1117.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Silveira FT , Lainson R , Shaw JJ , Ishikawa EA , Souza AA , Braga RR , 1989. Sensitivity of the culture of circulating leukocytes in the detection of Leishmania in the peripheral blood of patients with tegumentary leishmaniasis. Rev Soc Bras Med Trop 22: 143–146.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Nuwayri-Salti N , Mu’Atassem D , Salman S , Izzedine N , Kibbi AG , 1992. Chronic cutaneous leishmaniasis: Leishmania parasites in blood. Int J Dermatol 31: 562–564.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Magill AJ , Grögl M , Gasser RA Jr , Sun W , Oster CN , 1993. Visceral infection caused by Leishmania tropica in veterans of Operation Desert Storm. N Engl J Med 328: 1383–1387.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Cardo LJ , 2006. Leishmania: risk to the blood supply. Transfusion 46: 1641–1645.

  • 27.

    Solomon M , Pavlotsky F , Leshem E , Ephros M , Trau H , Schwartz E , 2011. Liposomal amphotericin B treatment of cutaneous leishmaniasis due to Leishmania tropica. J Eur Acad Dermatol Venereol 25: 973–977.

    • PubMed
    • Search Google Scholar
    • Export Citation
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