[leish-l] Leishmania in Antigua? The final chapter?

[a.bryceson]

Dear Rob,
Thanks for the pictures; the lesions show none of the features of CL. Little dark dots in histological sections are often misinterpreted. 
I have learnt a lot about the distribution of leish in the Caribbean.
Best wishes
Anthony
  ----- Original Message ----- 
  From: Davidson, Robert N 
  To: Antonio Teixeira ; Richard Ashford ; Arias, Jorge Dr. ; leish-l at fat.org.br 
  Sent: Thursday, September 22, 2005 8:21 AM
  Subject: [leish-l] Leishmania in Antigua? The final chapter?


  Dear All,
  Just to update you on this mystery case:
  1. The lesions when swabbed grew Staph aureus, and as I thought
  clinically that these were bacterial lesions (impetigo-like), not CL, I
  recommended antibiotics/ topical antiseptics. The responsible clinician
  (who was hundreds of miles away from me) was initially unconvinced by my
  suggestion, but soon became convinced by the expert opinion of this
  forum, that L mexicana was very very unlikely. They tried my treatment,
  and the lesions have all gone. Let's hope they stay gone. So this is an
  excellent example of how electronic comms can help a person none of us
  have ever met.
  2. The biopsy on which the reference lab in saw amastigotes has been
  reviewed and the amastigotes have not been seen again. I have not been
  shown the slides, but I just wonder whether they may have been looking
  at Gram positive cocci. I can't explain the PCR being positive for L
  mexicana complex, except by suggesting lab error. The lab had no other
  cases of L mexicana around that time.
  3. For interest, I attach some pictures of the skin lesions - I have
  never seen the patient, these were emailed to me.
  All the best, and many thanks for your assistance, I hope you had as
  much fun as I did.
  Rob 
  Dr Robert N Davidson MD  FRCP DTM&H 
  Dept Infection & Tropical Medicine
  Lister Unit, Northwick Park Hospital, 
  Harrow,  Middlesex HA1 3UJ
  Phone (direct) ++ 44 208 869 2830
  Mobile 07881955264 
  Secretary ++ 44 208 869 2833
  FAX   ++ 44 208 869 2836

  ________________________________________________________________________
  Essential facts about burns and blast injuries:
  http://www.doctors.net.uk/burnsandblasts
  _______________________________________________________________________
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