Coinfection of Leptomonas seymouri and Leishmania donovani in Indian Leishmaniasis

Leishmania donovani is considered the causative organism of visceral leishmaniasis (VL) and post-kala-azar dermal leishmania-sis (PKDL). Testing of 4/29 DNA samples from VL and PKDL patients as well as 2/7 field isolates showed an aberrant internal transcribed spacer 1 (ITS1) restriction fragment length polymorphism (RFLP) pattern, which upon sequencing strongly matched Leptomonas seymouri, thus confirming its presence in Indian leishmaniasis. Visceral leishmaniasis (VL) is a vector-borne disease caused byreplication of parasites of the Leishmania donovani complex (L. donovani and L. infantum) within the macrophage-phagocytic system. In the Indian subcontinent and parts of Africa, its trans-mission is anthroponotic (2), with post-kala-azar dermal leish-maniasis (PKDL) being a sequel of VL, and is characterized by a macular, maculo-papular, or nodular rash (11). Generally, in the Indian subcontinent, patients presentingwith clinical features suggestive of VL/PKDL have the diagnosis con-firmed by the presence of parasites in Giemsa-stained smears and/or culture positivity, serological diagnosis (enzyme-linked immunosorbent assay [ELISA] or rK39 strip test), and, rarely, b