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Post-kala-azar dermal leishmaniasis and leprosy: case report and literature review

Overview of attention for article published in BMC Infectious Diseases, November 2015
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Title
Post-kala-azar dermal leishmaniasis and leprosy: case report and literature review
Published in
BMC Infectious Diseases, November 2015
DOI 10.1186/s12879-015-1260-x
Pubmed ID
Authors

Maria Angela Bianconcini Trindade, Lana Luiza da Cruz Silva, Lucia Maria Almeida Braz, Valdir Sabbaga Amato, Bernard Naafs, Mirian Nacagami Sotto

Abstract

Post-kala-azar dermal leishmaniasis (PKDL) is a dermal complication of visceral leishmaniasis (VL), which may occur after or during treatment. It has been frequently reported from India and the Sudan, but its occurrence in South America has been rarely reported. It may mimic leprosy and its differentiation may be difficult, since both diseases may show hypo-pigmented macular lesions as clinical presentation and neural involvement in histopathological investigations. The co-infection of leprosy and VL has been reported in countries where both diseases are endemic. The authors report a co-infection case of leprosy and VL, which evolved into PKDL and discuss the clinical and the pathological aspects in the patient and review the literature on this disease. We report an unusual case of a 53-year-old female patient from Alagoas, Brazil. She presented with leprosy and a necrotizing erythema nodosum, a type II leprosy reaction, about 3 month after finishing the treatment (MDT-MB) for leprosy. She was hospitalized and VL was diagnosed at that time and she was successfully treated with liposomal amphotericin B. After 6 months, she developed a few hypo-pigmented papules on her forehead. A granulomatous inflammatory infiltrate throughout the dermis was observed at histopathological examination of the skin biopsy. It consisted of epithelioid histiocytes, lymphocytes and plasma cells with the presence of amastigotes of Leishmania in macrophages (Leishman's bodies). The diagnosis of post-kala-azar dermal leishmaniasis was established because at this time there was no hepatosplenomegaly and the bone marrow did not show Leishmania parasites thus excluding VL. About 2 years after the treatment of PKDL with liposomal amphotericin B the patient is still without PKDL lesions. Post-kala-azar dermal leishmaniasis is a rare dermal complication of VL that mimics leprosy and should be considered particularly in countries where both diseases are endemic. A co-infection must be seriously considered, especially in patients who are non-responsive to treatment or develop persistent leprosy reactions as those encountered in the patient reported here.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 78 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Sri Lanka 1 1%
Unknown 77 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 14 18%
Student > Bachelor 10 13%
Student > Ph. D. Student 8 10%
Researcher 7 9%
Student > Doctoral Student 4 5%
Other 11 14%
Unknown 24 31%
Readers by discipline Count As %
Medicine and Dentistry 20 26%
Agricultural and Biological Sciences 7 9%
Biochemistry, Genetics and Molecular Biology 7 9%
Immunology and Microbiology 5 6%
Nursing and Health Professions 4 5%
Other 11 14%
Unknown 24 31%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 November 2015.
All research outputs
#18,430,915
of 22,833,393 outputs
Outputs from BMC Infectious Diseases
#5,606
of 7,682 outputs
Outputs of similar age
#278,523
of 386,225 outputs
Outputs of similar age from BMC Infectious Diseases
#116
of 152 outputs
Altmetric has tracked 22,833,393 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,682 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one is in the 15th percentile – i.e., 15% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 386,225 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 16th percentile – i.e., 16% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 152 others from the same source and published within six weeks on either side of this one. This one is in the 7th percentile – i.e., 7% of its contemporaries scored the same or lower than it.