Emerging Parasitic Infections from the Arabian Gulf

Clinical Laboratory Science, Summer 2004 by Mahon, Connie R

The patient, a 29-year-old Asian-American male soldier, presented with non-suppurative, erythematous, and ulcerated lesions on his right mid-arm, right mid-thigh, and left hand. The patient was in Kuwait for "Operation Enduring Freedom". He disclosed that during his stay in the region, he had experienced heavy sandfly biting activity. Skin scrapings and needle aspirate biopsies were taken within weeks of the development of lesions for histopathology and microbiology studies. Direct smear preparations stained with 30% Giemsa stain revealed several amastigotes at active lesion sites. The patient underwent a 20-day regimen of 20mg/ kg/day of Pentostam therapy without difficulty. The lesions resolved well with moderate scarring. This case study represents the global public health risks we may face in the near future. Our ongoing military involvement in the Arabian Gulf continuously exposes members of the Armed Forces to biological agents and their vectors endemic to the region. As reservists who were called to duty return to their civilian lives, encounters with this infectious disease will not be limited to military hospitals but will occur in the civilian community healthcare environment as well.

Connie R Mahon MS CLS (NCA), Microbiology Consultant, Health Management Systems, Fairfax VA.