Diagnostic methods | Pros and cons |
Parasitological diagnosis | |
Direct microscopy of skin biopsies (stained sections or smears) detecting amastigotes has a low sensitivity (50–70%). Somewhat better results – but with a delay – are obtained after cultivation. However, these traditional methods have now been replaced by molecular diagnostic tests. | - Sensitivity of microscopy is not satisfactory
- Cultivation takes 5–8 days and is often not successful
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Molecular diagnosis | |
Early DNA hybridization methods with specific probes have now been replaced by various PCR methods which are reaching “gold standard” status. In contrast to microscopy, molecular methods can distinguish species and subspecies of Leishmania by RFLP analysis of the amplicon. | - High sensitivity and specificity
- Differentiation of species and subspecies is possible
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Antigen detection | |
No tests developed | |
Antibody detection | |
No circulating antibodies can be detected in most cases of cutaneous leishmaniasis | |