Comparison of serological and parasitological methods for cutaneous leishmaniasis diagnosis in the state of Paraná, Brazil.

We evaluated the effectiveness of serological and parasitological methods for cutaneous leishmaniasis (CL) diagnosis in patients from the central region of Paraná state, southern Brazil. Five groups were compared: clinical diagnosis, parasitological diagnosis, communicants, inhabitants of a non-endemic area and carriers of other etiologies. Two antigens were prepared from promastigotes of Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis for indirect immunofluorescence assay, ELISA and immunoblotting. The parasitological approaches detected 79.3% of the patients with a clinical diagnosis; the parasites were identified by PCR as L. (V.) braziliensis. Serological methods showed 95% sensitivity for homologous antigens. Immunoblotting revealed specific proteins for diagnosis of CL and detected 96.6% of the patients when L. (V.) braziliensis was used as an antigen, and 83.3% with L. (L.) amazonensis. This study demonstrated the importance of differential diagnosis for leishmaniasis; the association of two or more indirect methods increased diagnosis sensitivity.