La reacción de inmunofluorescencia indirecta en el diagnóstico de la leishmaniasis tegumentaria americana

Abstract

This paper refers to the study of 380 patients showing dermal or mucous lesions clinically compatible with leishmaniasis. The  following examinations were perfomed to all cases: direct stained smears, cultures in NNN medium, biopsy. Montenegro skin test and indirect immunofluorescence (I.I.F.). The main objetive of the study was to evaluate the I.I.F. test in the different forms of the disease and to determine its value as a diagnostic method. The test was used in 50 patients with malaria and in 50 normal individuals. Positive results were obtained in 98.7% of the patients that had positive findings for Leishmania parasites, which means a high sensitivity. In 37.4% the test was positive, when parasites were not visualized, a finding interpreted as diagnostic. In 21% of the cases the negative results discarded the diagnosis. No cross reactions were observed when the titers were 1:16 or higher. The specificity was 97.2% The antibody titers did not show any significant variations in relation to the time of evolution of the lesions, its number and the tissue invasiveness. It can be concluded that the I.I.F test is a great diagnostic aid in American mucocutaneous leishmaniasis, for which it is the orly way to make the diagnoses in a considerable number of cases. It is suggested that similar studies should be performed in endemic areas for other parasitic infections, such as Chagas disease.