Case report Canine cutaneous leishmaniasis caused by neotropical Leishmania infantum despite of systemic disease: A case report ☆ , ☆☆ Amanda Cavalcanti a, ⁎ , 1 , Rogério Lobo b, 1 , Elisa Cupolillo a , Fábio Bustamante b , Renato Porrozzi a a Laboratório de Pesquisa em Leishmaniose, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil b Autonomous Clinical Veterinarians, Brazil abstract article info Article history: Received 29 December 2011 Received in revised form 2 May 2012 Accepted 4 May 2012 Available online 11 May 2012 Keywords: Canine leishmaniasis Leishmania infantum Chronic wounds Visceral leishmaniasis is an anthropozoonosis caused by a protozoan Leishmania infantum (syn. Leishmania chagasi). Here, we report a typical case of canine cutaneous leishmaniasis due to L. infantum infection without any other systemic symptom in one dog in the city of Rio de Janeiro, Brazil. A mongrel female dog was admitted in a veterinary clinic with reports of chronic wounds in the body. Physical examination revealed erosive lesions in the limbs, nasal ulcers, presence of ectoparasites and seborrheic dermatitis. Blood samples and fragments of healthy and injured skin were collected. The complete hemogram revealed aregenerative normocytic normochromic anemia and erythrocyte rouleaux, and biochemical analysis revealed normal renal and hepatic functions. Cytology of the muzzle and skin lesions suggested pyogranulomatous inflammatory process. The his- topathology of a skin fragment was performed and revealed suspicion of protozoa accompanied by necrotizing dermatitis. The diagnosis of leishmaniasis was accomplished by positive serology, isolation of Leishmania from the skin lesion, and also by molecular test (PCR targeting the conserved region of Leishmania kDNA). Culture was positive for damaged skin samples. PCR targeting a fragment of Leishmania hsp70 gene was performed employing DNA extracted from damaged skin. RFLP of the amplified hsp70 fragment identified the parasite as L. infantum, instead of Leishmania braziliensis, the main agent of cutaneous leishmaniasis in Rio de Janeiro. Char- acterization of isolated promastigotes by five different enzymatic systems confirmed the species identification of the etiological agent. Serology was positive by ELISA and rapid test. This case warns to the suspicion of viscerotropic Leishmania in cases of chronic skin lesions and brings the discussion of the mechanisms involved in the parasite tissue tropism. © 2012 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Visceral leishmaniasis (VL) is an anthropozoonosis caused by a protozoan Leishmania infantum (syn. Leishmania chagasi). The cycle of leishmaniasis involves invertebrate vectors and vertebrate hosts and a wide variety of mammals, including humans and dogs, which are considered the main domestic reservoir of L. infantum. Both human and canine diseases present clinical polymorphism. The human disease includes fever, anemia, hepatosplenomegaly and progressive weight loss. Leishmaniasis in dogs is characterized by a long asymptomatic period and a marked humoral immune response. Incubation period of up to 23 months was reported [1]. Animals may remain asymptomatic, develop a mild illness or develop the typical symptomatic disease [2,3]. Classical symptoms of canine disease resemble those for human disease and also include skin lesions such as diffuse, non-pruritic, generalized or localized alopecia; dry seborrhea with silver white, scales disseminated all over the body or more localized; cutaneous (essentially on pressure points, footpads and ears) or mucosa ulcers, eczema in nose or ears; loss of weight and appetite, localized or generalized lymphadenopathy, ocular lesions, blepharitis, bilateral keratoconjunctivitis, uveitis and glaucoma (probably as a result of severe uveitis), epistaxis, anemia, kid- ney failure, chronic diarrhea, onychogryphosis, runny nose and swelling of the legs [4]. It has been shown that ulcerative lesions and other skin abnormalities are often accompanied by other signs [2,5]. According to Gálvez and colleagues [6] lymphadenomegaly, exfoliative dermatitis and weight loss emerged as most relevant signals of canine VL on which the veterinarians based their suspicion of infection. In neotropical regions cutaneous canine leishmaniasis, in general, are associated with Leishmania braziliensis infection, although other species have also been reported [7,8]. In endemic areas of tegumentary leishmaniasis in Brazil, dogs represent accidental hosts and their role as a domestic reservoir is not clear. This paper aims to report a case of typical localized cutaneous leishmaniasis due to L. infantum infection in a dog from the city of Rio de Janeiro, Brazil. Parasitology International 61 (2012) 738–740 ☆ Source of funding: CNPq, Faperj, and Fiocruz. ☆☆ Conflict of interest: No conflicts of interest have been declared. ⁎ Corresponding author at: Fundação Oswaldo Cruz, Av. Brasil, 4365 - Manguinhos, Pavilhão 26, sala 509, Rio de Janeiro, RJ, CEP: 21040‐360, Brazil. Tel.: +55 21 3865 8203. E-mail address: amandasc@ioc.fiocruz.br (A. Cavalcanti). 1 These authors have contributed equally to this article. 1383-5769/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.parint.2012.05.002 Contents lists available at SciVerse ScienceDirect Parasitology International journal homepage: www.elsevier.com/locate/parint