Equine Cutaneous Leishmaniasis: Treatment with Berberine Sulphate

GENEl{AL ARTICLES.

241

EQUINE CUTANEOUS LEISHMANIASIS: TREATMENT WITH BERBERINE SULPHATE By

S. C.

J.

BENNETT, D.SC., l\I.H.. C.V.S.

Veterinary Re!search Officer, Sudan Government

object of this short paper is to describe what appears to be the first recorded case of equine cutaneous leishmaniasis, and treatment with Berberine Sulphate. The patient was a native bred Sudan pony stallion aged about eight years. Smears taken from a persistent ulcer on the belly were received in the laboratory on :May 11th, 1935, for examination as to the presence of cryptococci. These were not detected, but in a Giemsa-stained preparation leishmania bodies were seen. In the original preparation the bodies showed peculiarities both as to morphology and situation. The morphologica\ peculiarity was that the kinetoplast, so far as could be made out in so small a body, was slightly curved instead of being straight, and the situation \vas peculiar in that 1110st of the intracellular bodies were contained in polynuclear leucocytes instead of in mononuclear endothelial cells. Pending an opportunity for examining the horse itself, the original preparations were shown to Dr. :E. S. Horgan, Government Bacteriologist, who confirmed that the parasites themselves, although obviously some kind of leishmania, were in this preparation not exactly similar to those found in a human oriental sore. The horse was later sent to the laboratory for study. No history of any value accompanied it, but the sore had apparently been in existence for some considerable time, as the original smears had been sent to the laboratory on account of its persistent refusal to heal witll ordinary antiseptic and astringc}. dressings. Tile local lesion, which was about a-f) em. in diameter, conformed to tile classical type of leisllmania sore in man, having raised edges and a depressed granulating centre. Similarly its progress was quite typical. When left untreated, as was done for a period of ten days, there was the usual scab formation over the ulcerating area, the scab being easily rubbed off, revealing the underlying tissue no nearer to becoming healed. Leishmania bodies were very plentiful in scrapings from the lesion, but with properly made scrapings from the actual granulating- tissue they proved to be quite indistinguishable, either as to situation or morphology, from L. tropica, having a short straight kinetoplast and being, when intracellular, situated in the usual type of mononuclear cell. Dr. Horgan was kind enough to examine some of these scrapings, and admitted his inability

THE

242

GENERAL ARTICLES.

to distinguish them from L. lropica of man. l\1icrophotographs of both intracellular and free forms are shown in figs. 1 and 2 respectively. It is thus certain that the atypical forms originally seen included in polynuclear leucocytes were undergoing degeneration and phagocytosis. The richness of these original preparations in polynuclear leucocytes would also indicate that they were not made from tissue scrapings but were merely smears from the accumulated exudate. Owing to great pressure of other duties, it "vas not possible to give much attention to this case. It would, for example, have been desirable to attempt the cultivation of the parcasite, if only to acquire the most probable evidence that in its flagellate form it had no distinguishing characteristics, but this could not be undertaken. I n the course of g"eneral discussion of leishmaniasis, howe,"er, Dr. Horgan mentioned recent Indian attempts at treatment with Berberine Sulphate, and it was decided to give this a trial. The technique, as described by Chopra, Dikshit and Chowhan (lBa2) for use in human patients, is that " One to 2 C.c. of a 1 per cent. solution of the acid sulphate is infiltrated into the margins of the sore by means of a fine hypodermic syringe. Four or more punctures are made, and care is taken to see that the infiltration is evenly spread. Injections are given once a week and the sore is dressed with ordinary surgical dressings. ]'
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Fig. I.-Equine Cutaneous Leishmaniasis, Intracellular Forms ( x llOO).

Fig. 2.-Equine Cutaneous Leishmaniasis, Free Forms.