Teste de montenegro no diagnóstico da leishmniose mucocutânea

Abstract

Cutaneous leishmaniasis is a neglected infectious parasitic disease that occurs in Africa, Europe, Asia and Americas, predominantly in tropical and subtropical regions, presenting different clinical manifestations. In the Americas, leishmaniasis is present in 18 countries and the most common clinical form is cutaneous leishmaniasis (LT). In Brazil six species of Leishmania cause the disease, being L. (Viannia) braziliensis the most widely distributed species and occurs throughout the national territory. LT presents a wide spectrum of clinical manifestations such as localized cutaneous leishmaniasis, mucocutaneous leishmaniasis, diffuse cutaneous leishmaniasis and disseminated leishmaniasis. The Montenegro Intradermal Reaction (IDRM) test evaluates the late cellular hypersensitivity response and represents the main complementary test for the diagnosis of LT, especially for the mucocutaneous form. The objective of this study was to evaluate the Montenegro Intradermal Test (IDRM) performed at the Parasitology Laboratory for the diagnosis of patients suspected of presenting tegumentary leishmaniasis, from 2015 to 2018. The sample consisted of 27 individuals who underwent IDRM from Reference Hospitals for Infectious diseases in Fortaleza, Ceará. The patients were of both sexes, with ages ranging from 2 to 69 years. The IDRM test was positive in 78% and negative in 22% of patients. In 2016, the largest number of exams was performed, with 15 exams in total, and of these, 73.3% were positive and 27% negative. Regarding the positivity of the IDRM test, there was a predominance of positivity in males, although more women performed the exam.Regarding the lesions presented by the patients, a predominance of lesions in the nasal cavity was observed, suggesting the mucocutaneous form. The value of the IDRM test varied among the study patients; however, it was possible to observe a predominance of higher IDRM values in patients with typical lesions of the mucosal form of leishmaniasis. In summary, this study confirms the relevance of the Montenegro Intradermal Reaction (IDRM) test as a fundamental complementary test in association with clinical laboratory tests for the diagnosis of cutaneous leishmaniasis, especially in cases of mucocutaneous leishmaniasis.