Identification of Leishmania Spp. in the Infected Foot Wounds of Patient with Mycobacterium Fortuitum

A common intramacrophage niche for leishmanial and mycobacterial pathogens, and a similar spectrum of immune response and disease phenotypes, led to the prediction that the same genes/candidate gene regions might be responsible for genetic susceptibility to mycobacterial infections. There are several reports of atypical cutaneous presentation of leishmaniasis such as paronychial, whitlow, lid, scar, palmoplantar and chancriform in immunocompetent patients. Numerous Leishmania organisms were observed within the histiocytes and extracellular in patient suffering from swelling, pain and itching. An unknown strain of mycobacterium was also isolated from biopsy specimen of the patient. Phenotypic and molecular tests carried out for identification of the strain based on standard methods. The susceptibility of the strain to anti-mycobacterial agents was performed by CDC standard Method. Numerous Leishmania organisms were observed within the histiocytes and extracellular space. PCR amplifications tests for detection of leishmania have been positive. Acid-fast staining and culture tests have been positive. PCR amplifications tests for detection of M. tuberculosis and M. avium have been negative. Phenotypic tests mainly including, positive result for growth at 25°C and 37؛C and PNB test, growth on MacConkey agar without crystal violet, arylsulphatase, urease, iron uptake and 68؛C and 22؛C catalase and negative for tween 80 hydrolysis, tolerance to 5% NaCl, niacin production and nitrate reduction test provided evidences that the strain belong to M. fortuitum species. Our findings show that M. fortuitum however rare its incidence may be is capable of causing infection in immune-compromised patients and could be co-infection in the human population.