Evaluation of PCR for diagnosis of visceral leishmaniasis

An evaluation of Leishmania PCR was performed with bone marrow, lymph node, and blood samples from 492 patients, 60 positive controls, and 90 negative controls, Results were compared with microscopy results for Giemsa-stained smears, PCR and microscopy of lymph node and bone marrow aspirates from patients with microscopically confirmed visceral leishmaniasis (VL) were equally sensitive, However, in patients clinically suspected of having VL and in whom parasites could not be demonstrated bg microscopy, PCR was positive for 12 of 23 (52,2%) lymph node aspirates and 8 of 12 (66.7%) bone marrow aspirates, thus confirming the clinical diagnosis of VL, With PCR on filler paper, Leishmania DNA was detected in the blued of 33 of 47 (70%) patients with confirmed VL and in 2 of 11 (19%) patients suspected of having VL, Positive PCR results were more frequently found for blood samples on filter paper than for samples stored in EDTA. In conclusion PCR is a more sensitive method than microscopy for the detection of Leishmania in lymph node and hone marrow aspirates, being especially useful for the confirmation of cases of suspected VL. Blood from a finger prick may be used for the initial FCR screening of people suspected of having VL. If the PCR of blood is negative, one should perform PCR with lymph node and/or bone marrow material, because PCR with these materials is more often positive.