A Comparative Study Of Diagnosis By Polymerase Chain Reaction (PCR), Microbiological, And Histopathological Methods Of Old World Cutaneous Leishmaniasis In Iraq.

Abstract

Background: The diagnosis of cutaneous leishmaniasis (CL) is largely depends on its clinical appearance especially in endemic areas. Diagnostic challenge arises when the lesions appear in nonendemic area, when clinical picture is distorted, or any atypical variant is seen even in endemic regions.Aim: The study was designed to assess the correlation of microbiological and histopathological diagnosis with the Polymerase chain reaction (PCR) findings in clinically diagnosed cases of old world CL.Methods: It was an observational and descriptive study. The patients were collected from the outpatient departments of dermatology in the middle Euphrates region of Iraq, Al-Najaf. Sixty-five patients with clinically suspicious lesions of CL were screened. Fifty-seven clinically diagnosed cases were then subjected to slit skin smear and skin biopsy. PCR examination was conducted in 40 cases.Results: The direct smear examination was positive in slit skin smear in 38 patients (66.7%) compared with 48 specimens (84.2%) of slide-touch method of skin biopsy samples. The histopathological examination showed features suggestive of cutaneous leishmaniasis in 34 specimens (59.6%). The results of polymerase chain reaction examination were positive in 37 cases (92.5%).Conclusion: PCR technique is a highly specific and sensitive test in the diagnosis of CL. In addition to confirmation of the diagnosis, it may be useful to find a relationship between the type of microorganism and the clinical presentation of the disease.