The Diagnostic Value of Lesional Skin Smears Performed by Experienced Specialist in Cutaneous Leishmaniasis and Routine Microbiology Laboratory

Abstract

Objective: Leishmaniasis is a common vector-borne infection affecting 12 million people in 98 countries. The most frequently used method in diagnosis is the microscopic investigation of the leishmania smears. The diagnostic value of this method varies according to the experience of the evaluator. In this prospective study, it was aimed to emphasize the importance of experience in the evaluation of lesional smears used in the diagnosis of cutaneous leishmaniasis. Methods: In this study, patients who were admitted to Dicle University Medical Faculty Hospital Dermatological and Venereal Diseases Outpatient Clinic between January and December 2016 and who had lesions with suspicious cutaneous leishmaniasis were included. For all the cases, both in the routine microbiology laboratory and in the diagnosis and treatment of cutaneous leishmaniasis, separate smears were performed by an experienced specialist and evaluated independently from each other. Results: In 70 of 98 cases studied, the diagnosis of cutaneous leishmaniasis was confirmed by laboratory evaluations. The rate of positivity was significantly higher in the smears analyzed by experienced specialist in the clinical and diagnosis of cutaneous leishmaniasis (95.7%) than in the smears analyzed by the routine microbiology laboratory (42.9%) (p<0.001). Conclusion: The data in our study showed that smears should be performed and evaluated by experienced specialists in the clinical and diagnosis of cutaneous leishmaniasis.