Coinfection of Leishmania (Viannia) braziliensis and Streptococcus pneumoniae in multiple cutaneous lesions

PAULO CORTES; LAURA CHIAPELLO; DAVID DIB; MONICA HERRERO; CARMEN NUNCIRA; CARLOS DE PETRIS; JOSE ECHENIQUE

PLOS NEGLECTED TROPICAL DISEASES

PUBLIC LIBRARY SCIENCE

Lugar: San Francisco; Año: 2016

1935-2735

ase presentation: a 12-years-old girl from a northern Argentina region was seen by a physician due to ulcerative lesions in her arms and legs. The first clinical impressions were ulcers caused by group A beta-hemolytic streptococci or staphylococci and she received empirical antibiotic treatments, such as a topical rifampicin treatment concomitantly with penicillin G benzathine and ciprofloxacin, which were administered sequentially due to clinical worsening of the skin lesions. After 2 weeks, and judged by the evolution of the ulcers, the physicians suspected of a Leishmania infection and antibiotic treatment was interrupted. The patient was transferred to a regional children hospital for an accurate diagnosis. Diagnosis: on admission, biological samples were taken from 4 skin ulcers for diagnostic studies. Dermal scrapings revealed amastigotes inside macrophages and cultures of sterile biopsy specimens showed Leishmania promastigotes. By molecular tests, the amastigotes were identif