Reactivation

[jshaw at tba.com.br]

There are two possible general forms of reactivation:

1. When a lesion that has apparently been cured becomes active again.

2. The exacerbation of an occult infection which is not related to the site
of the original lesion(s). Such occurrences have been recorded in the
literature on a number of occasions. One of the more famous cases was a
British soldier who had served in the middle east during the second world
war who had no clinical history of leishmaniasis. His young daughter had the
habit of playfully knocking his nose with her toy bear and in time his nose
became read and swollen. After a number of examinations amastigotes were
found in the affected area. The patient made a full recovery with antimony
treatment. Other forms of trauma such as insect bites and wounds have also
been recorded as causing lesions. This has given rise to a folk belief in
some areas that ticks transmit cutaneous leishmaniasis.

	I know of no published records related to skin tests being responsible for
this kind phenomena but it seems quite reasonable that the white cell
infiltration associated with a positive skin test could cause a similar
cellular response to trauma. These cells are invaded by parasites from the
occult infection and the result is a parasitologically positive lesion.