1921
Volume 84, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

We used a species-specific approach to treat 10 patients with cutaneous leishmaniasis diagnosed using polymerase chain reaction. Non-antimony treatments (oral miltefosine, ketoconazole, and liposomal amphotericin B) were chosen as an alternative to pentavalent antimony drugs based on likely or proven drug efficacy against the infecting species. was diagnosed in three patients and treated successfully with oral ketoconazole. Miltefosine treatment cured two patients with . A wide variety of responded to liposomal amphotericin B administered for 5–7 days. Three patients with , one patient with , and two patients with were treated successfully. One person with healed slowly because of a resistant bacterial superinfection, and a second patient with relapsed and was retreated with miltefosine. These drugs were reasonably well-tolerated. In this limited case series, alternative non-antimony–based regimens were convenient, safe, and effective.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2011.10-0437
2011-01-05
2017-11-22
Loading full text...

Full text loading...

/deliver/fulltext/14761645/84/1/109.html?itemId=/content/journals/10.4269/ajtmh.2011.10-0437&mimeType=html&fmt=ahah

References

  1. David CV, Craft N, , 2009. Cutaneous and mucocutaneous leishmaniasis. Dermatol Ther 22: 491502.[Crossref]
  2. Herwaldt BL, Berman JD, , 1992. Recommendations for treating leishmaniasis with sodium stibogluconate (Pentostam) and review of pertinent clinical studies. Am J Trop Med Hyg 46: 296306.
  3. Herwaldt BL, , 1999. Leishmaniasis. Lancet 354: 11911199.[Crossref]
  4. Murray HW, Berman JD, Davies CR, Saravia NG, , 2005. Advances in leishmaniasis. Lancet 366: 15611577.[Crossref]
  5. 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]
  6. Tuon FF, Amato VS, Graf ME, Siqueira AM, Nicodemo AC, Amano Neto V, , 2008. Treatment of New World cutaneous leishmaniasis—a systematic review with a meta-analysis. Int J Dermatol 47: 109124.[Crossref]
  7. Arevalo J, Ramirez L, Adaui V, Zimic M, Tulliano G, Miranda-Verástegui C, Lazo M, Loayza-Muro R, De Doncker S, Maurer A, Chappuis F, Dujardin JC, Llanos-Cuentas A, , 2007. Influence of Leishmania (Viannia) species on the response to antimonial treatment in patients with American tegumentary leishmaniasis. J Infect Dis 95: 18461851.[Crossref]
  8. Schwartz E, Hatz C, Blum J, , 2006. New World cutaneous leishmaniasis in travelers. Lancet Infect Dis 6: 342349.[Crossref]
  9. Kreutzer RD, Christensen HA, , 1980. Characterization of Leishmania spp. by isozyme electrophoresis. Am J Trop Med Hyg 29: 199208.
  10. Karamian M, Motazedian MH, Fakhar M, Pakshir K, Jowkar F, Rezanezhad H, , 2008. Atypical presentation of Old-World cutaneous leishmaniasis, diagnosis and species identification by PCR. J Eur Acad Dermatol Venereol 22: 958962.[Crossref]
  11. Wortmann G, Hochberg L, Houng H, Sweeney C, Zapor M, Aronson N, Weina P, Ockenhouse C, , 2005. Rapid identification of Leishmania complexes by a real-time PCR assay. Am J Trop Med Hyg 73: 9991004.
  12. Stevenson LG, Fedorko DP, Zelazny AM, , 2010. An enhanced method for the identification of Leishmania spp. using real-time polymerase chain reaction and sequence analysis of the 7SL RNA gene region. Diagn Microbiol Infect Dis 66: 432435.[Crossref]
  13. Zelazny A, Fedorko DP, Li L, Neva F, Fischer SH, , 2005. Evaluation of 7SL RNA gene sequences for the identification of Leishmania spp. Am J Trop Med Hyg 72: 415420.
  14. el Tai NO, Osman OF, el Fari M, Presber W, Schonian G, , 2000. Genetic heterogeneity of ribosomal internal transcribed spacer in clinical samples of Leishmania donovani spotted on filter paper as revealed by single-strand conformation polymorphisms and sequencing. Trans R Soc Trop Med Hyg 94: 575579.[Crossref]
  15. Kreutzer RD, Semko ME, Hendricks LD, Wright N, , 1983. Identification of Leishmania spp. by multiple isozyme analysis. Am J Trop Med Hyg 32: 703715.
  16. Sindermann H, Engel K, Fischer C, Bommer W, , 2004. Oral miltefosine for leishmaniasis in immunocompromised patients: compassionate use in 39 patients with HIV infection. Clin Infect Dis 39: 15201523.[Crossref]
  17. Ritmeijer K, Dejenie A, Assefa Y, Hundie TB, Mesure J, Boots G, den Boer M, Davidson RN, , 2006. A comparison of miltefosine and sodium stibogluconate for treatment of visceral leishmaniasis in an Ethiopian population with high prevalence of HIV infection. Clin Infect Dis 43: 357364.[Crossref]
  18. Saenz RE, Paz H, Berman JD, , 1990. Efficacy of ketoconazole against Leishmania braziliensis panamensis cutaneous leishmaniasis. Am J Med 89: 147155.[Crossref]
  19. Solomon M, Baum S, Barzilai A, Scope A, 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: 612661.[Crossref]
  20. Keynan Y, Larios OE, Wiseman MC, Plourde M, Ouellette M, Rubinstein E, , 2008. Use of oral miltefosine for cutaneous leishmaniasis in Canadian soldiers returning from Afghanistan. Can J Infect Dis Med Microbiol 19: 394396.
  21. Killingley B, Lamb LE, Davidson RN, , 2009. Miltefosine to treat cutaneous leishmaniasis caused by Leishmania tropica . Ann Trop Med Parasitol 103: 171175.[Crossref]
  22. Alborzi A, Pouladfar GR, Fakhar M, Motazedian MH, Hatam GR, Kadivar MR, , 2008. Isolation of Leishmania tropica from a patient with visceral leishmaniasis and disseminated cutaneous leishmaniasis, southern Iran. Am J Trop Med Hyg 79: 435437.
  23. Tappe D, Müller A, Stich A, , 2010. Resolution of cutaneous old world and new world leishmaniasis after oral miltefosine treatment. Am J Trop Med Hyg 82: 13.[Crossref]
  24. 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]
  25. 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]
  26. Campos-Muñoz L, Quesada-Cortés A, Martín-Díaz MA, Rubio-Flores C, de Lucas-Laguna R, , 2007. Leishmania braziliensis: report of a pediatric imported case with response to liposomal amphotericin B. Actas Dermosifiliogr 98: 4244.[Crossref]
  27. Sampaio SAP, Castro RM, Dillon NL, Martins JEC, , 1971. Treatment of mucocutaneous (American) leishmaniasis with amphotericin B: report of 70 cases. Int J Dermatol 10: 179181.[Crossref]
  28. Crofts MAJ, , 1976. Use of amphotericin B in mucocutaneous leishmaniasis. J Trop Med 79: 111113.
  29. Di Lella F, Vincenti V, Zennaro D, Afeltra A, Baldi A, Giordano D, Pasanisi E, Bacciu A, Bacciu S, Di Lella G, , 2006. Mucocutaneous leishmaniasis: report of a case with massive involvement of nasal, pharyngeal and laryngeal mucosa. Int J Oral Maxillofac Surg 35: 870872.[Crossref]
  30. Soto J, Rea J, Balderrama M, Toledo J, Soto P, Valda L, Berman JD, , 2008. Efficacy of miltefosine for Bolivian cutaneous leishmaniasis. Am J Trop Med Hyg 78: 210211.
  31. Wöhrl S, Schnedl J, Auer H, Walochnik J, Stingl G, Geusau A, , 2008. Successful treatment of a married couple for American leishmaniasis with miltefosine. J Eur Acad Dermatol Venereol 22: 258259.
  32. Urcuyo FG, Zaias N, , 1982. Oral ketoconazole in the treatment of leishmaniasis. Int J Dermatol 21: 414416.[Crossref]
  33. Weinrauch L, Livshin R, El-On J, , 1983. Cutaneous leishmaniasis: treatment with ketoconazole. Cutis 32: 288294.
  34. Weinrauch L, Livshin R, El-On J, , 1987. Ketoconazole in cutaneous leishmaniasis. Br J Dermatol 117: 666667.[Crossref]
  35. Bellazoug S, Ammar-Khodja A, Belkaid M, Tabett-Derraz O, , 1985. La leishmanisose cutanee du nord de L'Algeria. Bull Soc Pathol Exot 78: 615622.
  36. Viallet J, MacLean JD, Robson H, , 1986. Response to ketoconazole in two cases of longstanding cutaneous leishmaniasis. Am J Trop Med Hyg 35: 491495.
  37. Leitner V, Weingast J, Harmankaya K, Walochnik J, Pehamberger H, Petzelbauer P, Auer H, Binder M, , 2010. Leishmaniasis in the tongue of an immunocompetent man. Am J Trop Med Hyg 82: 597599.[Crossref]
  38. 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.
  39. Paradisi A, Capizzi R, Zampetti A, Proietti I, De Simone C, Feliciani C, Amerio PL, , 2005. Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin B. J Infect 51: e261e264.[Crossref]
  40. Davidson RN, Di Martino L, Gradoni L, Giacchino R, Russo R, Gaeta GB, Pempinello R, Scott S, Raimondi F, Cascio A, Prestileo T, Caldiera L, Wilkinson RJ, Bryceson ADM, , 1994. Liposomal amphotericin B (AmBisome) in Mediterranean visceral leishmaniasis: a multi-centre trial. Q J Med 87: 7581.
  41. Davidson RN, di Martino L, Gradoni L, Giacchino R, Gaeta GB, Pempinello R, Scotti S, Cascio A, Castagnola E, Maisto A, Gramiccia M, di Caprio D, Wilkinson RJ, Bryceson AD, , 1996. Short-course treatment of visceral leishmaniasis with liposomal amphotericin B (AmBisome). Clin Infect Dis 22: 938943.[Crossref]
  42. Seaman J, Boer C, Wilkinson R, de Jong J, de Wilde E, Sondorp E, Davidson R, , 1995. Liposomal amphotericin B (AmBisome) in the treatment of complicated kala-azar under field conditions. Clin Infect Dis 21: 188193.[Crossref]
  43. Russo R, Nigro LC, Minniti S, Montineri A, Gradoni L, Caldeira L, Davidson RN, , 1996. Visceral leishmaniasis in HIV infected patients: treatment with high dose liposomal amphotericin B (AmBisome). J Infect 32: 133137.[Crossref]
  44. Meyerhoff A, , 1999. U.S. Food and Drug Administration approval of liposomal amphotericin B for treatment of visceral leishmaniasis. Clin Infect Dis 28: 4248.[Crossref]
  45. Neub A, Krahl D, Stich A, Amon U, , 2008. Cutaneous infection with Leishmania infantum in an infant successfully treated with miltefosine. J Dtsch Dermatol Ges 6: 10611064.[Crossref]
  46. Ruiz-Villaverde R, Sanchez-Cano D, Villaverde-Gutierrez C, , 2007. Chronic cutaneous leishmaniasis in an immunocompetent patient: response to miltefosine. J Eur Acad Dermatol Venereol 21: 695696.
  47. Sundar S, Jha TK, Thakur CP, Engel J, Sindermann H, Fischer C, Junge K, Bryceson A, Berman J, , 2002. Oral miltefosine for Indian visceral leishmaniasis. N Engl J Med 347: 17391746.[Crossref]
  48. Ritmeijer JK, Dejenie A, Assefa Y, Hundie T, Mesure J, Boots G, den Boer M, Davidson R, , 2006. A comparison of miltefosine and sodium stibogluconate for treatment of visceral leishmaniasis in an Ethiopian population with high prevalence of HIV infection. Clin Infect Dis 43: 357364.[Crossref]
  49. Safaei A, Motazedian MH, Vasei M, , 2002. Polymerase chain reaction for diagnosis of cutaneous leishmaniasis in histologically positive, suspicious and negative skin biopsies. Dermatology 205: 1824.[Crossref]
  50. Bensoussan E, Nasereddin A, Jonas F, Schnur LF, Jaffe CL, , 2006. Comparison of PCR assays for diagnosis of cutaneous leishmaniasis. J Clin Microbiol 44: 14351439.[Crossref]
  51. Shahbazi F, Shahabi S, Kazemi B, Mohebali M, Abadi AR, Zare Z, , 2008. Evaluation of PCR assay in diagnosis and identification of cutaneous leishmaniasis: a comparison with the parasitological methods. Parasitol Res 103: 11591162.[Crossref]
  52. Singh S, Sivakumar R, , 2004. Challenges and new discoveries in the treatment of leishmaniasis. J Infect Chemother 10: 307315.[Crossref]
  53. Jolliffe DS, , 1986. Cutaneous leishmaniasis from Belize—treatment with ketoconazole. Clin Exp Dermatol 11: 6268.[Crossref]
  54. Navin TR, Arana BA, Arana FE, Berman JD, Chajón JF, , 1992. Placebo-controlled clinical trial of sodium stibogluconate (Pentostam) versus ketoconazole for treating cutaneous leishmaniasis in Guatemala. J Infect Dis 165: 528534.[Crossref]
  55. Dan M, Verner E, el-On J, Zuckerman F, Michaeli D, , 1986. Failure of oral ketoconazole to cure cutaneous ulcers caused by Leishmania braziliensis . Cutis 38: 198199.
  56. Dedet JP, Jamet P, Esterre P, Ghipponi PM, Genin C, Lalande G, , 1986. Failure to cure Leishmania braziliensis guyanensis cutaneous leishmaniasis with oral ketoconazole. Trans R Soc Trop Med Hyg 80: 176.[Crossref]
  57. Ziaei H, Sadeghian G, Hejazi SH, , 2008. Distribution frequency of pathogenic bacteria isolated from cutaneous leishmaniasis lesions. Korean J Parasitol 46: 191193.[Crossref]
  58. el-On J, Sneier R, Elias E, , 1992. Leishmania major: bacterial contamination of cutaneous lesions in experimental animals. Isr J Med Sci 28: 847851.
  59. Amato VS, Rabello A, Rotondo-Silva A, Kono A, Maldonado TP, Alves IC, Floeter-Winter LM, Neto VA, Shakanai-Yasuda MA, , 2004. Successful treatment of cutaneous leishmaniasis with lipid formulations of amphotericin B in two immunocompromised patients. Acta Trop 92: 127132.[Crossref]
  60. Gregoriadis G, , 1991. Overview of liposomes. J Antimicrob Chemother 28 (Suppl B): 3948.[Crossref]
  61. Yardley V, Croft S, , 1997. Activity of liposomal amphotericin B against experimental cutaneous leishmaniasis. Antimicrob Agents Chemother 41: 752756.
  62. 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]
  63. Yardley V, 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]
  64. Shani-Adir A, Kamil S, Rozenman D, Schwartz E, Ramon M, Zalman L, Nasereddin A, Jaffe CL, Ephros M, , 2005. Leishmania tropica in northern Israel: a clinical overview of an emerging focus. J Am Acad Dermatol 53: 810815.[Crossref]
  65. Escobar P, Yardley V, Croft SL, , 2001. Activities of hexadecylophosphocholine (miltefosine), liposomal amphotericin B, and sodium stibogluconate (Pentostam) against Leishmania donovani in immunodeficient scid mice. Antimicrob Agents Chemother 45: 18721875.[Crossref]
  66. Soto J, Toledo J, Gutierrez P, Nicholls RS, Padilla J, Engel J, Fischer C, Voss A, Berman J, , 2001. Treatment of American cutaneous leishmaniasis with miltefosine, an oral agent. Clin Infect Dis 33: E57E61.[Crossref]
  67. Lewis JH, Zimmerman HJ, Benson GD, Ishak KG, , 1984. Hepatic injury associated with ketoconazole therapy. Analysis of 33 cases. Gastroenterology 86: 503513.
  68. Heiberg JK, Svejgaard E, , 1981. Toxic hepatitis during ketoconazole treatment. Br Med J (Clin Res Ed) 283: 825826.[Crossref]
  69. Duarte PA, Chow CC, Simmons F, Ruskin J, , 1984. Fatal hepatitis associated with ketoconazole therapy. Arch Intern Med 144: 10691070.[Crossref]
  70. Knight TE, Shikuma CY, Knight J, , 1991. Ketoconazole-induced fulminant hepatitis necessitating liver transplantation. J Am Acad Dermatol 25: 398400.[Crossref]
  71. Lake-Bakaar G, Scheuer PJ, Sherlock S, , 1987. Hepatic reactions associated with ketoconazole in the United Kingdom. Br Med J (Clin Res Ed) 294: 419422.[Crossref]
  72. Moen MD, Lyseng-Williamson KA, Scott LJ, , 2009. Liposomal amphotericin B: a review of its use as empirical therapy in febrile neutropenia and in the treatment of invasive fungal infections. Drugs 69: 361392.[Crossref]
  73. Johnson MD, Drew RH, Perfect JR, , 1998. Chest discomfort associated with liposomal amphotericin B: report of three cases and review of the literature. Pharmacotherapy 18: 10531061.
  74. Walsh TJ, Finberg RW, Arndt C, Hiemenz J, Schwartz C, Bodensteiner D, Pappas P, Seibel N, Greenberg RN, Dummer S, Schuster M, Holcenberg JS, , 1999. Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia. National Institute of Allergy and Infectious Diseases Mycoses Study Group. N Engl J Med 340: 764771.[Crossref]
  75. Sundar S, Chakravarty J, Agarwal D, Rai M, Murray HW, , 2010. Single-dose liposomal amphotericin B for visceral leishmaniasis in India. N Engl J Med 362: 504512.[Crossref]
  76. Soto J, Berman J, , 2006. Treatment of New World cutaneous leishmaniasis with miltefosine. Trans R Soc Trop Med Hyg 100 (Suppl 1): S34S40.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2011.10-0437
Loading
/content/journals/10.4269/ajtmh.2011.10-0437
Loading

Data & Media loading...

  • Received : 04 Aug 2010
  • Accepted : 27 Oct 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