Leishmaniasis recidivans among school children in Bam, South-east Iran, 1994-2006.

Abstract : BACKGROUND: Leishmaniasis recidivans (LR) is a rare phenomenon in the world with high morbidity in children. METHODS: Overall 22 838 school children were examined during 1994-2006. Diagnosis was performed by combination of methods as clinical appearance, direct smears, cultures, polymerase chain reaction (PCR) and histology. RESULTS: Ninety-eight cases were diagnosed as LR with duration of lesions varying from 2 to 8 years and diameter of lesions 1-5 cm, yellowish-brown appearance with papules around or in the scar. Most of the lesions (95%) were on the face. No amastigote was found in direct smears. Identification of nine random isolates by PCR confirmed all species to be L. tropica. Tissue sections showed typical granulomatous reactions with various inflammatory cells but no visible amastigote was seen. CONCLUSIONS: The presence of LR as an important cause of morbidity has future implications for treatment regimens and immunoprophylaxis.