Himachal Pradesh in India is a newer endemic state with co-existence of cutaneous and visceral leishmaniasis. The cutaneous leishmaniasis cases are on an increase in the region and reported to be unusually caused by Leishmania donovani with limited molecular validation. In order to molecularly characterize the causative parasite of the cutaneous disease, parasite specific Internal-Transcribed Spacer 1 (ITS1) PCR RFLP and sequence analysis was performed on skin lesional biopsies from cutaneous leishmaniasis patients. Interestingly, we found the presence of Leptomonas seymouri in 38.5% (22/57) of the patients along with L. donovani detected in all the samples. L. seymouri is a monoxenous insect trypanosomatid, generally incapable of infecting humans. In recent years, the parasite is also reported to co-infect humans with L. donovani in visceral and post kala-azar dermal leishmaniasis (PKDL) cases prevalent in northeastern India. The finding of L. seymouri-L. donovani co-infection in unusual cutaneous cases from Himachal Pradesh is the first ever to our knowledge and imply a newer disease paradigm. There is an urgent need to understand the biology of Leptomonas co-infection with L. donovani and its possible role in visceral and/or dermotropic disease outcome. Importantly, L. seymouri co-infection in cutaneous cases and previously reported visceral and PKDL cases needs to be recognized as a newer phenomenon by the leishmaniasis surveillance program in India.

印度的喜马偕尔邦是一个较新的流行州，皮肤利什曼病和内脏利什曼病并存。该地区皮肤利什曼病病例呈上升趋势，据报道异常由以下原因引起：杜氏利什曼原虫有限的分子验证。为了对皮肤病的致病寄生虫进行分子表征，对皮肤利什曼病患者的皮肤病变活检进行了寄生虫特异性内转录间隔区 1 (ITS1) PCR RFLP 和序列分析。有趣的是，我们发现存在西摩细单胞菌38.5% (22/57) 的患者同时多诺瓦尼 L.在所有样品中均检测到。L. seymouri是一种单性昆虫锥虫，通常不能感染人类。近年来，据报道，这种寄生虫也会同时感染人类多诺瓦尼 L.印度东北部流行的内脏和黑热病后皮肤利什曼病 (PKDL) 病例。的发现L. seymouri-多诺瓦尼 L.据我们所知，喜马偕尔邦罕见皮肤病例中的双重感染是首次出现，这意味着一种新的疾病模式。迫切需要了解其生物学细单胞菌属合并感染多诺瓦尼 L.及其在内脏和/或皮肤疾病结果中可能发挥的作用。重要的，L. seymouri印度利什曼病监测计划需要将皮肤病例与先前报告的内脏和 PKDL 病例的双重感染视为一种新现象。