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Cutaneous Leishmaniasis During Pregnancy, Preterm Birth, and Neonatal Death: A Case Report



Pokutnaya D1 ; Shirzadi MR2, 3 ; Salari E4 ; Molaei G5, 6, 7
Authors
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Authors Affiliations
  1. 1. Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
  2. 2. Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
  4. 4. Biocontrol and Insect Pathology Laboratory, University of Applied Science and Technology, Kerman, Iran
  5. 5. Department of Environmental Sciences, Center for Vector Biology & Zoonotic Diseases, The Connecticut Agricultural Experiment Station, New Haven, CT, United States
  6. 6. The Northeast Center for Excellence in Vector-Borne Diseases, The Connecticut Agricultural Experiment Station, New Haven, CT, United States
  7. 7. Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States

Source: Iranian Journal of Parasitology Published:2020

Abstract

Cutaneous leishmaniasis (CL) is an emergent public health concern, particularly in tropical and subtropical regions. Reports of pregnancy complications are scarce; however, as the endemic range of CL expands in Iran, there is concern of possible detrimental effects on fetal development amongst infected mothers through pla-cental transmission of the parasite or enhanced maternal immune responses. We herein describe the first known case of persistent anthroponotic CL, plausibly re-sponsible for pregnancy complications, preterm birth, and neonatal death in a healthy Iranian primigravida woman. Diagnosis was based on physical examina-tions of the lesions on the back of both calves of the patient and laboratory anal-yses including direct smear, culture, and PCR. During active CL infection, the patient gave birth to a premature female neonate who passed three days post-delivery due to immature lung development and subsequent respiratory distress syndrome. This report highlights the challenges associated with CL infection during pregnan-cy, exacerbation of lesions, and subsequent complications. © 2020, Tehran University of Medical Sciences. All rights reserved.
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