1921
Volume 75, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

A 35-year-old man with a 19-year history of slowly evolving diffuse cutaneous leishmaniasis was treated with oral miltefosine, 50 mg three times a day. The patient responded after four months of miltefosine treatment with clearance of all nodular lesions and plaques from the entire body surface and had negative slit-skin smears and cultures for . However, two months after stopping miltefosine, skin lesions reappeared and parasites were observed in samples. The relapsed lesions did not respond to an additional two-month course of miltefosine. No laboratory or clinical adverse events to miltefosine were observed. Parasites from skin lesions were cultured and identified as () by isoenzyme electrophoresis.

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2006-12-01
2017-09-26
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References

  1. World Health Organization, 1990. Control of the leishmaniases. World Health Organ Tech Rep Ser 793 : 1–158.
  2. Becker I, Volkow P, Velasco-Castrejon O, Salaiza-Suazo N, Berzunza-Cruz M, Dominguez JS, Morales A, Ruiz-Remigio A, Perez-Montfort R, 1999. The efficacy of pentamidine combined with allopurinol and immunotherapy for the treatment of patients with diffuse cutaneous leishmaniasis. Parasitol Res 85 : 165–170.
  3. Neva FA, Petersen EA, Corsey R, Bogaert H, Martinez D, 1984. Observations on local heat treatment for cutaneous leishmaniasis. Am J Trop Med Hyg 33 : 800–804.
  4. Convit J, Castellanos PL, Ulrich M, Castes M, Rondon A, Pinardi ME, Rodriguez N, Bloom BR, Formica S, Valecillos L, Bretana A, 1989. Immunotherapy of localized, intermediate, and diffuse forms of American cutaneous leishmaniasis. J Infect Dis 160 : 104–115.
  5. Convit J, Ulrich M, Polegre MA, Avila A, Rodriguez N, Mazzedo MI, Blanco B, 2004. Therapy of Venezuelan patients with severe mucocutaneous or early lesions of diffuse cutaneous leishmaniasis with a vaccine containing pasteurized Leishmania promastigotes and Bacillus Calmette-Guerin: preliminary report. Mem Inst Oswaldo Cruz 99 : 57–62.
  6. Badaro R, Johnson WD Jr, 1993. The role of interferon in the treatment of visceral and diffuse cutaneous leishmaniasis. J Infect Dis 167 (Suppl 1): S13–S17.
  7. Sundar S, Rosenkaimer F, Makharia MK, Goyal AK, Mandal AK, Voss A, Hilgard P, Murray HW, 1998. Trial of oral miltefosine for visceral leishmaniasis. Lancet 352 : 1821–1823.
  8. Soto J, Arana BA, Toledo J, Rizzo N, Vega JC, Diaz A, Luz M, Gutierrez P, Arboleda M, Berman JD, Junge K, Engel J, Sindermann H, 2004. Miltefosine for New World cutaneous leishmaniasis. Clin Infect Dis 38 : 1266–1272.
  9. Sindermann H, Engel KR, Fischer C, Bommer W, 2004. Oral miltefosine for leishmaniasis in immunocompromissed patients: Compassionate use in 39 patients with HIV infection. Clin Infect Dis 39 : 1520–1523.
  10. Reyna E, Aroca MC, Gomez EA, Nonaka S, Katakura K, Furuya M, Hosokawa A, Hashiguchi Y, 1994. Diffuse cutaneous leishmaniasis: the first report of a parasitologically confirmed case in Ecuador. Hashiguchi Y, ed. Studies on New World Leishmaniasis and its Transmission with Particular Reference to Ecuador. Research Reports Series No. 5. Kochi, Japan: Kyowa Printing, 85–92.
  11. Shaw JJ, 2002. New World leishmaniasis: the ecology of leishmaniasis and the diversity of leishmanial species in Central and South America. Farrel JP, ed. World Class Parasites. Leishmania. Volume 4. Norwell, MA: Kluwer Academic Publishers, 11–31.
  12. Velasco O, Savarino SJ, Walton BC, Gam AA, Neva FA, 1989. Diffuse cutaneous leishmaniasis in Mexico. Am J Trop Med Hyg 41 : 280–288.
  13. Velez I, Agudelo S, Robledo S, Jaramillo L, Segura I, Soccol V, Restrepo S, 1994. Diffuse cutaneous leishmaniasis with mucosal involvement in Colombia, caused by an enzymatic variant of Leishmania panamensis. Trans R Soc Trop Med 88 : 199.
  14. Croft SL, Sundar S, Fairlamb AH, 2006. Drug resistance in leishmaniasis. Clin Microbiol Rev 19 : 111–126.
  15. Gomez EA, Andrial M, Hosokawa A, Nonaka S, Hashiguchi Y, 1995. Oral treatment of new world cutaneous leishmaniasis with anti-malarial drugs in Ecuador: a preliminary clinical trial. Jpn J Trop Med Hyg 23 : 151–157.
  16. Yardley V, Croft SL, De Doncker S, Dujardin JC, Koirala S, Rijal S, Miranda C, Llanos-Cuentas A, Chappuis F, 2005. The sensitivity of clinical isolates of Leishmania from Peru and Nepal to miltefosine. Am J Trop Med Hyg 73 : 272–275.
  17. Sundar S, Murray HW, 2005. Availability of miltefosine for the treatment of Kala-azar in India. Bull World Health Organ 83 : 394–395.
  18. Croft SL, Yardley V, 2002. Chemotherapy of leishmaniasis. Curr Pharm Des 8 : 319–342.
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  • Received : 23 Jun 2006
  • Accepted : 19 Aug 2006

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