دراسة لتطوير أداء الطريقة المجهرية في استقصاء اللايشمانيا الجلدية

Introduction and objectives: Cutaneous leishmania is spreading fast in the Middle East. New foci are being discovered continually. In order to achieve treatment, it is then, important to find easy, cheap and highly sensitive diagnostic methods that can help in diagnosing the cutaneous leishmania. Though, the traditional microscopic method is considered the reference method in leishmania diagnosis, its sensitivity is considered low, and the method cannot detect more than 70% of the true positive cases. This study aims at developing the microscopic method to achieve a full detection of all positive cases of leishmania. Methods: 50 human cases had been studied, 43 cases were males and 7 were females. Samples were taken from the secretions of the skin lesion. The slides were investigated for any unfamiliar microscopic structures or components that may have a possible diagnostic significance. Microscopic photos were taken for the presumed unfamiliar figures and structures and they were identified, classified according their presence rate among the different cases in a specified table. Results: The mononuclear cells with tails are present in cutaneous leishmania samples at (98% rate). They are associated with LD bodies in 50% of the cases studied. The polygonic figures and the spherical forms are present in cutaneous leishmania samples at the same rate (60%). They both are associated with LD bodies in 24% of the cases studied. The small promastigote like forms are seen in cutaneous leishmania samples at (76%) rate. They are usually associated with LD bodies in 26% of the cases studied. While the giant promastigotes like forms are available in (80% rate) and are associated with LD bodies in 28% of the cases studied. Candle flame forms are present at (40% rate) and are associated with the LD bodies in 21% of the cases. Discussion: It is possible to make use of those discovered figures and microscopic structures in diagnosing cutaneous leishmania especially in cases when the LD bodies are totally absent in the microscopic slide. The presence of those microscopic structures and figures and their association with the LD bodies availability is an absolute clue that the infection with cutaneous leishmania is associated with those figures appearance and hens, they can be considered as signs of exposure to the cutaneous leishmania. When performing the microscopic procedure for leishmania diagnosis, it is suggested that, not only one, but at least, three different types or even more of those figures must be seen in the microscopic slide in order to diagnose the disease in case of LD bodies absence. In case LD bodies are present, then it is sufficient enough to only observe them in order to diagnose the disease. It is then; appropriate to say that this study helped in elevating the classical microscopic method sensitivity into 100% in addition to increasing the specificity in to a higher rate.