THELMA SUELY OKAY

(Fonte: Lattes)
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Lattes
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Departamento de Pediatria, Faculdade de Medicina - Docente
LIM/46 - Laboratório de Parasitologia Médica, Hospital das Clínicas, Faculdade de Medicina

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    Visceral leishmaniasis reactivation diagnosed by molecular technique in blood sample
    (2012) BRAZ, L.; NICODEMO, A.; SOUZA, R.; SANTOS, N.; GODOY, N.; OKAY, T.; AMATO, V.
    Background: It is possible to perform the serological diagnosis of visceral leishmaniasis through k39 immunochromatographic test. However, usually in the co-infection visceral leishmaniasis with HIV k39 strip results are not conclusive. Then, investigation by microscopic examination of smear, culture medium NNN/BHI and PCR can be performed in bone marrow aspirates (gold standard) or blood sample. In this case report PCR in blood sample proved to be useful for monitoring reactivation of visceral leishmaniasis in a patient with HIV. Methods: In four different periods of a patient hospitalization with visceral leishmaniasis, samples of bone marrow aspirates and peripheral blood were examined. They were evaluated by microscopic examination of smear stained by Panóptico, culture medium NNN/BHI and PCR targeting the kDNA. Results: In four different periods of patient hospitalization the samples from bone marrow aspirates and blood sample presented amastigotes after smear microscopic examination. By PCR (kDNA) the samples from bone marrow aspirates and blood sample showed a 120-bp band on the electrophoresis gel. And promastigotes were found in the culture medium NNN/BHI from aspirated bone marrow only in the last hospitalization. Conclusion: Aspiration of bone marrow, the gold-standard diagnostic laboratory of visceral leishmaniasis, is known to be invasive and painful. However, it is possible to diagnose the disease through k39 immunochromatographic test. But usually in patients coinfected with HIV the k39 results are not conclusive. And the microscopic examination of smear is subjective and extremely time consuming. Our results of positive PCR (120 bp) in both bone marrow aspirates and in the blood sample demonstrated the importance of PCR in detection of visceral leishmaniasis reactivation. PCR results in blood samples suggest the possibility of replacing the PCR and even the smear examination in bone marrow aspirates to detect reactivation.