Table 1.
Patient Characteristics, Laboratory Parameters, and Xenodiagnosis Results From 3 Patients With Post–Kala-azar Dermal Leishmaniasis, Bangladesh
| Characteristic or Finding | Patient 1 | Patient 2 | Patient 3 |
|---|---|---|---|
| Sex | Male | Male | Male |
| Age, y | 24 | 40 | 35 |
| Profession | Tailor | Business | Construction |
| History of VL | No | Yes | Yes |
| VL treatment drug | NA | SSG | SSG |
| Time since VL treatment, mo | NA | 180 | 120 |
| Previous PKDL treatment | Yes | No | Yes |
| PKDL treatment drug | AmBisome | NA | SSG |
| Date of PKDL treatment | April 2014 | NA | July 2006 |
| Duration of current lesions, mo | 7 | 174 | 108 |
| Rash type | |||
| Macular | Minor | No | Extensive |
| Papular | Minor | No | No |
| Nodular | No | Abundant | No |
| Score for extent of rash | 2 | 62 | 558 |
| DAT titer | 12 800 | 12 800 | 12 800 |
| rK39 | Positive | Positive | Positive |
| Buffy coat qPCR | Negative | Negative | Negative |
| Skin biopsy results | |||
| Microscopy | Positive 1+ | Positive 1+ | Positive 1+ |
| Cycle thresholda | 25 | 30 | 22 |
| Parasites per micrograma | 21 621 | 1428 | 63 058 |
| Xenodiagnosis results, no./No. (%) | |||
| Hand in cage of sand flies | |||
| Fed/exposed flies | 2/11 (18.2) | 4/15 (26.7) | 6/13 (46.2) |
| Microscopy positive/dissected flies | 0/2 (0) | 0/4 (0) | 0/4 (0) |
| PCR positive/processed flies | 0/2 (0) | 2/4 (50) | 3/6 (50) |
| Tube of sand flies applied to skin | |||
| Fed/exposed flies | 1/7 (14.3) | 7/12 (58.3) | 2/9 (22.2) |
| Microscopy positive/dissected flies | 1/1 (100) | 0/5 (0) | 0/0 (0) |
| PCR positive/processed flies | Not done | 1/7 (14.2) | 0/2 (0) |
| Positive by any method | 1/5 (20) | 3/20 (15) | 3/12 (25) |
Abbreviations: DAT, direct agglutination test; NA, not applicable; qPCR, quantitative polymerase chain reaction; PKDL, post–kala-azar dermal leishmaniasis; SSG, sodium stibogluconate; VL, visceral leishmaniasis.
aMean of 2 assays by qPCR.