ReportLiposomal amphotericin B in comparison to sodium stibogluconate for cutaneous infection due to Leishmania braziliensis
Section snippets
Background
In the last decade, travel to South and Central America has become increasingly common among young Israeli adults. New World cutaneous leishmaniasis, endemic to the Americas, is caused by Leishmania viannia (V.) and L mexicana species complexes.1 Infection by the Viannia species, particularly L viannia (V.) braziliensis, results in skin lesions that tend to be more persistent and may be further complicated by mucocutaneous involvement.2, 3
Almost all cases of South American leishmaniasis
Patients and methods
Patients with New World cutaneous leishmaniasis were included in this study. All the patients were travelers referred to the Center for Geographic Medicine and treated at the Department of Dermatology at Sheba Medical Center in Israel between May 2004 and November 2005. New World cutaneous leishmaniasis was defined as (1) presence of cutaneous lesions (ulcers, nodules, papules) clinically compatible with leishmaniasis; (2) history of recent travel to South America (New World); (3) smear or
Results
Seven consecutive patients with L (V.) braziliensis infection received this treatment. All were individual travelers, trekking and boating for several days in Madidi National Park in the Amazon region of Bolivia. The clinical and epidemiological data of the patients are shown in Table I. Five were men and 2 women; their mean age was 23.1 years (range, 21-24 years); the patients had a mean of 1.5 cutaneous lesions (range, 1-3). The distribution of the lesions was 57% on the upper aspect of limbs
Discussion
Travel to Latin America has become more common in recent years, where New World leishmaniasis is endemic, including the L viannia complexes. It is well established that L (V.) braziliensis requires systemic treatment because of the risk of mucocutaneous leishmaniasis developing.2 The traditional treatment has been pentavalent antimony (SSG or meglumine antimoniate 20 mg/kg per day given as an IV or intramuscular dose over 20 days).9 This regimen showed cure rates of 85% to 90% in studies of
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Conflicts of interest: None identified.