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Leishmaniasis, mucosal
Diagnostic Methods
 Diagnostic methods Pros and cons
 Parasitological diagnosis 
 Mucosal leishmaniasis is an important complication of South American cutaneous leishmaniasis.
Diagnosis is made by demonstration of the parasite in affected tissues. In the past, tissue samples were put into special cultures to demonstrate multiplication of promastigotes. Today, PCR offers a more sensitive and rapid alternative.
In rural areas, the Montenegro skin test is still in use. This test has a good sensitivity but cannot discriminate between acute and past infections.
None of the parasitological tests is considered a gold standard anymore
  •  Sensitivity of microscopy and cultivation is unsatisfactory due to low numbers of parasites in infected tissues
 Molecular diagnosis 
 Highly sensitive and specific nested and real-time PCR methods have been developed to detect DNA in mucosal samples. PCR is also possible with formalin-fixed histological samples!
  • Higher sensitivity than microscopy
  • Specific identification of leishmaniae complexes (subgenus Viannia and Leishmania with many species) is possibl
 Antigen detection 
 No tests developed so far 
 Antibody detection 
 Circulating antibodies can be detected in many but not all cases of mucosal leishmaniasis. The specificity of serological methods is rather low.
  • Serology may be helpful in areas where clinicians do not know the disease.