Volume 83, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Treatment options for cutaneous leishmaniasis in the United States are problematic because the available products are either investigational, toxic, and/or of questionable effectiveness. A retrospective review of patients receiving liposomal amphotericin B through the Walter Reed Army Medical Center for the treatment of cutaneous leishmaniasis during 2007–2009 was conducted. Twenty patients who acquired disease in five countries and with five different strains of were treated, of whom 19 received a full course of treatment. Sixteen (84%) of 19 experienced a cure with the initial treatment regimen. Three patients did not fully heal after an initial treatment course, but were cured with additional dosing. Acute infusion-related reactions occurred in 25% and mild renal toxicity occurred in 45% of patients. Although the optimum dosing regimen is undefined and the cost and toxicity may limit widespread use, liposomal amphotericin B is a viable treatment alternative for cutaneous leishmaniasis.


Article metrics loading...

Loading full text...

Full text loading...



  1. Magill A, Mandell GL, Bennett JE, Dolin R, , 2010. Leishmania species: visceral (kala-azar), cutaneous, and mucosal leishmaniasis. , eds. Principles and Practices of Infectious Diseases. Seventh edition. Volume 2. Philadelphia, PA: Churchill Livingstone Elsevier, 34633480.
  2. Aronson NE, Wortmann GW, Johnson SC, Jackson JE, Gasser RA, Magill AJ, Endy TP, Coyne PE, Grogl M, Benson PM, Beard JS, Tally JD, Gambel JM, Kreutzer RD, Oster CN, , 1998. Safety and efficacy of intravenous sodium stibogluconate in the treatment of leishmaniasis: recent U.S. military experience. Clin Infect Dis 27: 14571464.[Crossref]
  3. Wortmann G, Miller RS, Oster C, Jackson J, Aronson N, , 2002. A randomized, double-blind study of the efficacy of a 10- or 20- day course of sodium stibogluconate for treatment of cutaneous leishmaniasis in United States military personnel. Clin Infect Dis 35: 261267.[Crossref]
  4. Wortmann GW, Aronson NE, Byrd JC, Grever MR, Oster CN, , 1998. Herpes zoster and lymphopenia associated with sodium stibogluconate therapy for cutaneous leishmaniasis. Clin Infect Dis 27: 509512.[Crossref]
  5. Lawn SD, Armstrong M, Chilton D, Whitty CJ, , 2006. Electrocardiographic and biochemical adverse effects of sodium stibogluconate during treatment of cutaneous and mucosal leishmaniasis among returned travelers. Trans R Soc Trop Med Hyg 100: 264269.[Crossref]
  6. Drug Alert MHRA, , 2006. Available at: https://www.cas.dh.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=100876. Accessed March 15, 2010.
  7. Meyerhoff A, , 1999. U.S. Food and Drug Administration approval of AmBisome (liposomal amphotericin B) for treatment of visceral leishmaniasis. Clin Infect Dis 28: 4248.[Crossref]
  8. Amato VS, Rabello A, Rotondo-Silva A, Kono A, Maldonado T, Alves I, Floeter-Winter L, Neto V, Shikanai-Yasuda M, , 2004. Successful treatment of cutaneous leishmaniasis with lipid formulations of amphotericin B in two immunocompromised patients. Acta Trop 92: 127132.[Crossref]
  9. Brown M, Noursadeghi M, Boyle J, Davidson RN, , 2005. Successful liposomal amphotericin B treatment of Leishmania braziliensis cutaneous leishmaniasis. Br J Dermatol 153: 203205.[Crossref]
  10. Gündüz K, Afsar S, Ayhan S, Kandiloglu A, Turel A, Filiz E, Ok U, , 2000. Recidivans cutaneous leishmaniasis unresponsive to liposomal amphotericin B (AmBisome). J Eur Acad Dermatol Venereol 14: 1113.[Crossref]
  11. Mirzabeigi M, Farooq U, Baraniak S, Dowdy L, Ciancio G, Vincek V, , 2006. Reactivation of dormant cutaneous Leishmania infection in a kidney transplant patient. J Cutan Pathol 33: 701704.[Crossref]
  12. Paradisi A, Capizzi R, Zampetti A, Proietti I, De Simone C, Feliciani C, Amerio P, , 2005. Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin B. J Infect 51: e261e264.[Crossref]
  13. Rapp C, Imbert P, Darie H, Simon F, Gros P, Debord T, Roue R, , 2003. Liposomal amphotericin B treatment of cutaneous leishmaniasis contracted in Djibouti and resistant to meglumine antimoniate. Bull Soc Pathol Exot 96: 209211.
  14. Rongioletti F, Cannata GE, Parodi A, , 2009. Leishmaniasis due to L. infantum presenting as macrocheilitis and responding to liposomal amphotericin B. Eur J Dermatol 19: 281282.
  15. Del Rosal T, Artigao FB, Miguel MJ, de Lucas R, Del Castillo F, , 2010. Successful treatment of childhood cutaneous leishmaniasis with liposomal amphotericin B: report of two cases. J Trop Pediatr 56: 122124.[Crossref]
  16. Solomon M, Baum S, Barzilai A, Pavlotsky F, Trau H, Schwartz E, , 2007. Liposomal amphotericin B in comparison to sodium stibogluconate for cutaneous infection due to Leishmania braziliensis . J Am Acad Dermatol 56: 612616.[Crossref]
  17. Torre-Cisneros J, Prada JL, Villanueva JL, Valverde F, Sanchez-Guijo P, , 1994. Successful treatment of antimony-resistant cutaneous leishmaniasis with liposomal amphotericin B. Clin Infect Dis 18: 10241025.[Crossref]
  18. Pérez-Ayala A, Norman F, Pérez-Molina JA, Herrero JM, Monge B, López-Vélez R, , 2009. Imported leishmaniasis: a heterogeneous group of diseases. J Travel Med 16: 395401.[Crossref]
  19. Wortmann G, Sweeney C, Houng HS, Aronson N, Stiteler J, Jackson J, Ockenhouse C, , 2001. Rapid diagnosis of leishmaniasis by fluorogenic polymerase chain reaction. Am J Trop Med Hyg 65: 583587.
  20. Kreutzer RD, Christensen HA, , 1980. Characterization of Leishmania spp. by isozyme electrophoresis. Am J Trop Med Hyg 29: 199208.
  21. Kreutzer RD, Souraty N, Semko ME, , 1987. Biochemical identities and differences among Leishmania species and subspecies. Am J Trop Med Hyg 36: 2232.
  22. National Cancer Institute, 2006. Common Terminology Criteria for Adverse Events (CTCAE). Bethesda, MD. Available at: https://webapps.ctep.nci.nih.gov/webobjs/ctc/webhelp/Common_Terminology_Criteria_for_Adverse_Events_CTCAE_v3.htm. Accessed April 22, 2010.
  23. Roden MM, Nelson LD, Knudsen TA, Jarosinki PF, Starling JM, Shiflett SE, Calis K, DeChristoforo R, Donowitz GR, Buell D, Walsh TJ, , 2003. Triad of acute infusion-related reactions associated with liposomal amphotericin B: analysis of clinical and epidemiological characteristics. Clin Infect Dis 36: 121331220.[Crossref]
  24. Llanos-Cuentas A, Tulliano G, Auaujo-Castillo R, Miranda-Verastegui C, Santamaria-Castrellon G, Ramirez L, Lazo M, de Doncker S, Boelaert M, Robays J, Dujarkin J, Arevalo J, Chappuis F, , 2008. Clinical and parasite species risk factors for pentavalent antimonial treatment failure in cutaneous leishmanisis in Peru. Clin Infect Dis 46: 223231.[Crossref]
  25. Hadighi R, Boucher P, Khamesipour A, Meamar AR, Roy G, Ouellette M, Mohebali M, , 2007. Glucantime-resistant Leishmania tropica isolated from Iranian patients with cutaneous leishmaniasis are sensitive to alternative antileishmania drugs. Parasitol Res 101: 13191322.[Crossref]
  26. Yardley C, Croft SL, , 2000. A comparison of the activities of three amphotericin B lipid formulations against experimental visceral and cutaneous leishmaniasis. Int J Antimicrob Agents 13: 243248.[Crossref]
  27. Wortmann GW, Fraser SL, Aronson NE, Davis C, Miller RS, Jackson JD, Oster CN, , 1998. Failure of amphotericin B lipid complex in the treatment of cutaneous leishmaniasis. Clin Infect Dis 26: 10061007.[Crossref]

Data & Media loading...

  • Received : 23 Mar 2010
  • Accepted : 02 Jul 2010

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error