• 1.

    Kaye P, Scott P, 2011. Leishmaniasis: complexity at the host-pathogen interface. Nat Rev Microbiol 9: 604615.

  • 2.

    Conceição-Silva F, Leite-Silva J, Morgado FN, 2018. The binomial parasite-host immunity in the healing process and in reactivation of human tegumentary leishmaniasis. Front Microbiol 9: 1308.

    • Search Google Scholar
    • Export Citation
  • 3.

    van Griensven J, Carrillo E, López-Vélez R, Lynen L, Moreno J, 2014. Leishmaniasis in immunosuppressed individuals. Clin Microbiol Infect 20: 286299.

    • Search Google Scholar
    • Export Citation
  • 4.

    Tuon FF, Gomes-Silva A, Da-Cruz AM, Duarte MI, Neto VA, Amato VS, 2008. Local immunological factors associated with recurrence of mucosal leishmaniasis. Clin Immunol 128: 442446.

    • Search Google Scholar
    • Export Citation
  • 5.

    de Camargo RA, Nicodemo AC, Sumi DV, Gebrim EM, Tuon FF, de Camargo LM, Imamura R, Amato VS, 2014. Facial structure alterations and abnormalities of the paranasal sinuses on multidetector computed tomography scans of patients with treated mucosal leishmaniasis. PLoS Negl Trop Dis 8: e3001.

    • Search Google Scholar
    • Export Citation
  • 6.

    Amato VS, Andrade HF, Amato Neto V, Duarte MI, 2003. Short report: persistence of tumor necrosis factor-alpha in situ after lesion healing in mucosal leishmaniasis. Am J Trop Med Hyg 68: 527528.

    • Search Google Scholar
    • Export Citation
  • 7.

    Amato VS, Tuon FF, Camargo RA, Souza RM, Santos CR, Nicodemo AC, 2011. Can we use a lower dose of liposomal amphotericin B for the treatment of mucosal American leishmaniasis? Am J Trop Med Hyg 85: 818819.

    • Search Google Scholar
    • Export Citation
  • 8.

    Murray HW, 2012. Leishmaniasis in the United States: treatment in 2012. Am J Trop Med Hyg 86: 434440.

  • 9.

    Rocio C, Amato VS, Camargo RA, Tuon FF, Nicodemo AC, 2014. Liposomal formulation of amphotericin B for the treatment of mucosal leishmaniasis in HIV-negative patients. Trans R Soc Trop Med Hyg 108: 176178.

    • Search Google Scholar
    • Export Citation
  • 10.

    Darcis G, Van der Auwera G, Giot JB, Hayette MP, Tassin F, Arrese Estrada J, Cnops L, Moutschen M, de Leval L, Leonard P, 2017. Recurrence of visceral and muco-cutaneous leishmaniasis in a patient under immunosuppressive therapy. BMC Infect Dis 17: 478.

    • Search Google Scholar
    • Export Citation
  • 11.

    Souza RM, Andrade HF Jr., Duarte MI, Braz LM, Schubach AO, Silva FC, Amato VS, 2017. Reactivation of cutaneous and mucocutaneous tegumentary leishmaniasis in rheumatoid arthritis patients: an emerging problem? Rev Inst Med Trop Sao Paulo 59: e6.

    • Search Google Scholar
    • Export Citation
  • 12.

    Mandell MA, Beverley SM, 2017. Continual renewal and replication of persistent Leishmania major parasites in concomitantly immune hosts. Proc Natl Acad Sci U S A Jan 31;114(5).

    • Search Google Scholar
    • Export Citation
  • 13.

    Nicodemo AC, Duailibi DF, Feriani D, Duarte MIS, Amato VS, 2017. Mucosal leishmaniasis mimicking T-cell lymphoma in a patient receiving monoclonal antibody against TNFα. PLoS Negl Trop Dis Sep 21;11(9).

    • Search Google Scholar
    • Export Citation
  • 14.

    Bogdan C, Röllinghoff M, 1998. The immune response to Leishmania: mechanisms of parasite control and evasion. Int J Parasitol 28: 121134.

    • Search Google Scholar
    • Export Citation
  • 15.

    Alvar J, Aparicio P, Aseffa A, Den Boer M, Cañavate C, Dedet JP, Gradoni L, Ter Horst R, López-Vélez R, Moreno J, 2008. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 21: 334359 , table of contents.

    • Search Google Scholar
    • Export Citation
  • 16.

    Monge-Maillo B, Norman FF, Cruz I, Alvar J, López-Vélez R, 2014. Visceral leishmaniasis and HIV coinfection in the Mediterranean region. PLoS Negl Trop Dis 8: e3021.

    • Search Google Scholar
    • Export Citation
  • 17.

    Amato VS, de Andrade HF, Duarte MI, 2003. Mucosal leishmaniasis: in situ characterization of the host inflammatory response, before and after treatment. Acta Trop 85: 3949.

    • Search Google Scholar
    • Export Citation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Secondary Prophylaxis with Liposomal Amphotericin B in a Patient with Mucosal Leishmaniasis Undergoing Immunobiological Therapy for Active Ankylosing Spondylitis

View More View Less
  • 1 Department of Infectious Diseases, University of São Paulo Medical School, Sao Paulo, Brazil;
  • | 2 Department of Pathology, University of São Paulo Medical School, Sao Paulo, Brazil;
  • | 3 Department of Infectious and Parasitic Diseases, Clinical Hospital, University of São Paulo Medical School, Sao Paulo, Brazil
Restricted access

Immunosuppressive treatments for rheumatic diseases present special problems in areas endemic for chronic infectious diseases because of the possibility of reactivation. Leishmaniasis is a significant neglected tropical disease caused by different species of protozoan parasites within the genus Leishmania. Amastigotes live as intracellular parasites in a variety of mammalian cells, most notably within phagocytes such as macrophages, and residual parasites can persist even after treatment and healing of the lesions. We herein report a case of relapsing mucosal leishmaniasis after aggressive immunotherapy for ankylosing spondylitis, with requirement for secondary prophylaxis with amphotericin B to prevent reactivation. This approach can be necessary for patients from endemic areas of tegumentary leishmaniasis, who will undergo aggressive immunotherapy.

Author Notes

Address correspondence to Antonio Carlos Nicodemo, Department of Infectious Diseases, University of São Paulo Medical School, Sao Paulo 01308000, Brazil. E-mail: ac_nicodemo@uol.com.br

Authors’ addresses: Antonio Carlos Nicodemo and Valdir Sabbaga Amato, Department of Infectious Diseases, University of São Paulo Medical School, Sao Paulo, Brazil, E-mails: ac_nicodemo@uol.com.br and valdirsa@netpoint.com.br. Heitor Franco de Andrade Jr., Department of Pathology, University of São Paulo Medical School, Sao Paulo, Brazil, E-mail: hfandrad@usp.br. Pablo Muñoz Torres, Department of Infectious and Parasitic Diseases, Clinical Hospital, University of São Paulo Medical School, Sao Paulo, Brazil, E-mail: pamt90.nap@gmail.com.

Save