Leishmania

Detection of Leishmania species (leishmaniasis)
Microbiology
Virology
Visceral form ○ Whole blood ○ Bone marrow aspirate ○ Tissue Cutaneous form ○ Filter paper lesion impression ○ Tissue/biopsy ○ Skin scrapings ○ Lesion aspirate Serology ○ Serum
Other Information
○ Specimens to collect will differ whether the cutaneous or visceral forms of leishmaniasis is suspected.
○ For serology, an acute and convalescent may be required for laboratory diagnosis.
○ Aspirates/skin scrapings: sterile container (min volume 1 mL)
○ Bone marrow aspirate: sterile container with sodium heparin (min volume 1 mL)
○ Tissue: sterile container with small amount of normal saline (min 1 gram)
○ Whole blood: EDTA tube (lavender top) (min volume 5 mL)
○ Serum: Serum separator tubes (clotted blood) (min blood volume 5 mL)

Bone marrow aspirate
○ Collect bone marrow aspirates using a sterile needle and dispense into a clean sterile container containing sodium heparin (min volume 1 mL)
Tissue/biopsy
○ Collect 5-10 mm3 tissue aseptically using surgical technique/punch biopsy. Place in a clean, sterile container with a small amount of sterile saline.

Filter paper lesion impression
○ Remove overlying skin or crust material from ulcer. Gently press filter paper onto moist ulcer base repeatedly to cover the ulcer surface. Place in sterile container with small amount of pure alcohol.

Lesion aspirate:
○ Clean lesion with saline, disrupting vesicle, and aspirate fluid and cells from lesion base or edge with needle. Collect aspirate of wound using a syringe and needle. Dispense aspirated fluid into sterile container.

Skin scrapings
○ Collect skin scrapings from the affected area/lesion with a clean, sterile instrument (e.g. scalpel)

Whole blood/Serum
○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine, collect at least 5 mL of blood

Refer to section Sample Processing / Delivery
PHOL
○ Culture: Up to 30 days, smears and PCR released as available (2 to 3 days)
○ Serology: Up to 42 days
416-586-4800 extension 4550
NO
○ Label specimen container. Place specimens in biohazard bag and seal.

○ Specimens should be stored and transported to the UHN/SH Microbiology Laboratory at room temperature (20-25˚C) immediately after collection.

○ The specimen will be referred to the Public Health Ontario Laboratory for testing. PHO laboratory will refer serology specimens to NRCP for testing.