[leish-l] L mexicana in the Caribbean?

[Davidson, Robert N]

Dear Leishmaniacs,

 I have beens asked to give advice on a British patient with skin lesions with a possible diagnosis of CL. The ref. lab in London has said the biopsies have a positive PCR for L mexicana sp complex. 
The patient has no co-morbidity, and is not HIV+.

Travel:
1. The patient spent a short time in Antigua, the rest of the time on borad a yacht, and nowhere on the mainland of South or Central America, or even in coastal waters close to land. 
2. The lesions are numerous and superficial, definitely do not look like DCL and nor much like LCL.

I doubt this is CL, and wonder if this is a lab error. So my question is this:
Is there leishmaniasis in Antigua, and what is the distribution in the caribbean?

many thanks
Rob Davidson

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