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1
Silveira TG, Arraes SM, Bertolini DA, Teodoro U, Lonardoni MV, Roberto AC, Ramos M, Nerilo SA, Ishikawa E, Shaw J, 1999. The laboratory diagnosis and epidemiology of cutaneous leishmaniasis in Parana State, southern Brazil. Rev Soc Bras Med Trop 32 :413–423.
-
2
Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, Keystone JS, Pandey P, Cetron MS, 2006. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354 :119–130.
-
3
Marsden PD, 1986. Mucosal leishmaniasis (“espundia” Escomel, 1911). Trans R Soc Trop Med Hyg 80 :859–876.
-
4
Jones TC, Johnson WD Jr, Barretto AC, Lago E, Badaro R, Cerf B, Reed SG, Netto EM, Tada MS, Franca TF, 1987. Epidemiology of American cutaneous leishmaniasis due to Leishmania braziliensis braziliensis. J Infect Dis 156 :73–83.
-
5
Amato VS, Boulos MI, Amato Neto V, Filomeno LT, 1995. [The use of a silicone T tube for the treatment of a case of American mucocutaneous leishmaniasis with tracheomalacia.]. Rev Soc Bras Med Trop 28 :129–130 [article in Portugese].
-
6
Amato VS, Duarte MI, Nicodemo AC, de Carvalho LV, Pagliari C, da Matta VL, de Oliveira LS, de Castro SM, Uip DE, Amato JG, Amato Neto V, 1998. An evaluation of clinical, serologic, anatomopathologic and immunohistochemical findings for fifteen patients with mucosal leishmaniasis before and after treatment. Rev Inst Med Trop Sao Paulo 40 :23–30.
-
7
Grant A, Spraggs PD, Grant HR, Bryceson AD, 1994. Laryngeal leishmaniasis. J Laryngol Otol 108 :1086–1088.
-
8
Barral A, Pedral-Sampaio D, Grimaldi G Jr, Momen H, McMahon-Pratt D, Ribeiro de Jesus A, Almeida R, Badaro R, Barral-Netto M, Carvalho EM, et al., 1991. Leishmaniasis in Bahia, Brazil: evidence that Leishmania amazonensis produces a wide spectrum of clinical disease. Am J Trop Med Hyg 44 :536–546.
-
9
Osorio LE, Castillo CM, Ochoa MT, 1998. Mucosal leishmaniasis due to Leishmania (Viannia) panamensis in Colombia: clinical characteristics. Am J Trop Med Hyg 59 :49–52.
-
10
Hunt DL, McKibbon KA, 1997. Locating and appraising systematic reviews. Ann Intern Med 126 :532–538.
-
11
Tuon FF, Litvoc MN, Lopes MI, 2006. Adenosine deaminase and tuberculous pericarditis—a systematic review with meta-analysis. Acta Trop 99 :67–74.
-
12
Soto-Mancipe J, Grogl M, Berman JD, 1993. Evaluation of pentamidine for the treatment of cutaneous leishmaniasis in Colombia. Clin Infect Dis 16 :417–425.
-
13
Martinez S, Gonzalez M, Vernaza ME, 1997. Treatment of cutaneous leishmaniasis with allopurinol and stibogluconate. Clin Infect Dis 24 :165–169.
-
14
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 :E57–E61.
-
15
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 :261–267.
-
16
Miranda-Verastegui C, Llanos-Cuentas A, Arevalo I, Ward BJ, Matlashewski G, 2005. Randomized, double-blind clinical trial of topical imiquimod 5% with parenteral meglumine antimoniate in the treatment of cutaneous leishmaniasis in Peru. Clin Infect Dis 40 :1395–1403.
-
17
Llanos-Cuentas A, Echevarria J, Cruz M, La RA, Campos P, Campos M, Franke E, Berman J, Modabber F, Marr J, 1997. Efficacy of sodium stibogluconate alone and in combination with allopurinol for treatment of mucocutaneous leishmaniasis. Clin Infect Dis 25 :677–684.
-
18
Deville WL, Buntinx F, Bouter LM, Montori VM, de Vet HC, van der Windt DA, Bezemer PD, 2002. Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Med Res Methodol 2 :9.
-
19
Jadad AR, McQuay HJ, 1996. Meta-analyses to evaluate analgesic interventions: a systematic qualitative review of their methodology. J Clin Epidemiol 49 :235–243.
-
20
Oxman AD, Guyatt GH, 1991. Validation of an index of the quality of review articles. J Clin Epidemiol 44 :1271–1278.
-
21
Machado-Coelho GL, Caiaffa WT, Genaro O, Magalhaes PA, Mayrink W, 2005. Risk factors for mucosal manifestation of American cutaneous leishmaniasis. Trans R Soc Trop Med Hyg 99 :55–61.
-
22
Larson EE, Marsden PD, 1987. The origin of espundia. Trans R Soc Trop Med Hyg 81 :880.
-
23
Lawn SD, Whetham J, Chiodini PL, Kanagalingam J, Watson J, Behrens RH, Lockwood DN, 2004. New World mucosal and cutaneous leishmaniasis: an emerging health problem among British travellers. QJM 97 :781–788.
-
24
Scope A, Trau H, Anders G, Barzilai A, Confino Y, Schwartz E, 2003. Experience with New World cutaneous leishmaniasis in travelers. J Am Acad Dermatol 49 :672–678.
-
25
Chaudhry Z, Barrett AW, Corbett E, French PD, Zakrzewska JM, 1999. Oral mucosal leishmaniasis as a presenting feature of HIV infection and its management. J Oral Pathol Med 28 :43–46.
-
26
Iborra C, Caumes E, Carriere J, Cavelier-Balloy B, Danis M, Bricaire F, 1998. Mucosal leishmaniasis in a heart transplant recipient. Br J Dermatol 138 :190–192.
-
27
Motta AC, Arruda D, Souza CS, Foss NT, 2003. Disseminated mucocutaneous leishmaniasis resulting from chronic use of corticosteroid. Int J Dermatol 42 :703–706.
-
28
Alrajhi AA, Saleem M, Ibrahim EA, Gramiccia M, 1998. Leishmaniasis of the tongue in a renal transplant recipient. Clin Infect Dis 27 :1332–1333.
-
29
Saenz RE, de Rodriguez CG, Johnson CM, Berman JD, 1991. Efficacy and toxicity of pentostam against Panamanian mucosal leishmaniasis. Am J Trop Med Hyg 44 :394–398.
-
30
Berman JD, 1988. Chemotherapy for leishmaniasis: biochemical mechanisms, clinical efficacy, and future strategies. Rev Infect Dis 10 :560–586.
-
31
Rojas R, Valderrama L, Valderrama M, Varona MX, Ouellette M, Saravia NG, 2006. Resistance to antimony and treatment failure in human Leishmania (Viannia) infection. J Infect Dis 193 :1375–1383.
-
32
Rodrigues AM, Hueb M, Santos TA, Fontes CJ, 2006. Factors associated with treatment failure of cutaneous leishmaniasis with meglumine antimoniate. Rev Soc Bras Med Trop 39 :139–145.
-
33
Rey JA, Travi BL, Valencia AZ, Saravia NG, 1990. Infectivity of the subspecies of the Leishmania braziliensis complex in vivo and in vitro. Am J Trop Med Hyg 43 :623–631.
-
34
Saravia NG, Weigle K, Segura I, Giannini SH, Pacheco R, Labrada LA, Goncalves A, 1990. Recurrent lesions in human Leishmania braziliensis infection—reactivation or reinfection? Lancet 336 :398–402.
-
35
Mebrahtu YB, Lawyer PG, Pamba H, Koech D, Perkins PV, Roberts CR, Were JB, Hendricks LD, 1992. Biochemical characterization and zymodeme classification of Leishmania isolates from patients, vectors, and reservoir hosts in Kenya. Am J Trop Med Hyg 47 :852–892.
-
36
Deps PD, Viana MC, Falqueto A, Dietze R, 2000. Comparative assessment of the efficacy and toxicity of N-methylglucamine and BP88 sodium stibogluconate in the treatment of localized cutaneous leishmaniasis. Rev Soc Bras Med Trop 33 :535–543.
-
37
Saldanha AC, Romero GA, Merchan-Hamann E, Magalhaes AV, Macedo VO, 1999. A comparative study between sodium stibogluconate BP 88R and meglumine antimoniate in the treatment of cutaneous leishmaniasis. I. The efficacy and safety. Rev Soc Bras Med Trop 32 :383–387.
-
38
Oliveira-Neto MP, Mattos M, Pirmez C, Fernandes O, Goncalves-Costa SC, Souza CF, Grimaldi G Jr, 2000. Mucosal leishmaniasis (“espundia”) responsive to low dose of N-methylglucamine (Glucantime) in Rio de Janeiro, Brazil. Rev Inst Med Trop Sao Paulo 42 :321–325.
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39
Roberts WL, McMurray WJ, Rainey PM, 1998. Characterization of the antimonial antileishmanial agent meglumine antimonate (glucantime). Antimicrob Agents Chemother 42 :1076–1082.
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Berman JD, Grogl M, 1988. Leishmania mexicana: chemistry and biochemistry of sodium stibogluconate (Pentostam). Exp Parasitol 67 :96–103.
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Dedet JP, Melogno R, Cardenas F, Valda L, David C, Fernandez V, Torrez ME, Demier-David L, Lyevre P, Villareal ME, 1995. Rural campaign to diagnose and treat mucocutaneous leishmaniasis in Bolivia. Bull World Health Organ 73 :339–345.
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Adler-Moore J, Proffitt RT, 2002. AmBisome: liposomal formulation, structure, mechanism of action and pre-clinical experience. J Antimicrob Chemother 49 (Suppl 1):21–30.
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Nonata R, Sampaio R, Marsden PD, 1997. Mucosal leishmaniasis unresponsive to glucantime therapy successfully treated with AmBisome. Trans R Soc Trop Med Hyg 91 :77.
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44
Sampaio RN, Marsden PD, 1997. Treatment of the mucosal form of leishmaniasis without response to glucantime, with liposomal amphotericin B. Rev Soc Bras Med Trop 30 :125–128.
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45
Amato VS, Tuon FF, Campos A, Bacha HA, Nicodemo AC, Neto VA, Shikanai-Yasuda MA, 2007. Treatment of mucosal leishmaniasis with a lipid formulation of amphotericin B. Clin Infect Dis 44 :311–312.
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46
Sampaio RN, Marsden PD, 1997. Treatment of the mucosal form of leishmaniasis without response to glucantime, with liposomal amphotericin B. Rev Soc Bras Med Trop 30 :125–128.
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47
de Paula CD, Sampaio JH, Cardoso DR, Sampaio RN, 2003. [A comparative study between the efficacy of pentamidine isothionate given in three doses for one week and N-methil-glucamine in a dose of 20mgSbV/day for 20 days to treat cutaneous leishmaniasis.] Rev Soc Bras Med Trop 36 :365–371 [article in Portugese].
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48
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Amato VS, de Paula JG, Imamura R, Amato Neto V, Duarte MI, Boulos MI, Boulos M, Nicodemo AC, de Mendonca JS, 1996. [Treatment of American cutaneous leishmaniasis, with lesions in the mucosa, using pentamidine isethionate.] Rev Soc Bras Med Trop 29 :477–481 [article in Portugese].
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Van den Enden E, Van Gompel A, Stevens A, Vandeghinste N, Le Ray D, Gigase P, De Beule K, Van den Ende J, 1994. Treatment of cutaneous leishmaniasis with oral itraconazole. Int J Dermatol 33 :285–286.
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Gangneux JP, Dullin M, Sulahian A, Garin YJ, Derouin F, 1999. Experimental evaluation of second-line oral treatments of visceral leishmaniasis caused by Leishmania infantum. Antimicrob Agents Chemother 43 :172–174.
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Rodriguez LV, Dedet JP, Paredes V, Mendoza C, Cardenas F, 1995. A randomized trial of amphotericin B alone or in combination with itraconazole in the treatment of mucocutaneous leishmaniasis. Mem Inst Oswaldo Cruz 90 :525–528.
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Viegas AC, Furtado TA, 1968. Therapeutic tests with leishmaniasis Americana. VII. Pyrimethamine. An Bras Dermatol 43 :162–175.
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Avila JL, Casanova MA, 1982. Comparative effects of 4-aminopyrazolopyrimidine, its 2′-deoxyriboside derivative, and allopurinol on in vitro growth of American Leishmania species. Antimicrob Agents Chemother 22 :380–385.
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Martinez S, Marr JJ, 1992. Allopurinol in the treatment of American cutaneous leishmaniasis. N Engl J Med 326 :741–744.
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Treatment of Mucosal Leishmaniasis in Latin America: Systematic Review
Valdir Sabbaga Amato
Valdir Sabbaga Amato
Infectious and Parasitic Clinic, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Infectious and Parasitic Diseases, University of São Paulo School of Medicine, São Paulo, Brazil; Laboratory of Medical Investigation—Parasitology (LIM 46), Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
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Felipe Francisco Tuon
Felipe Francisco Tuon
Infectious and Parasitic Clinic, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Infectious and Parasitic Diseases, University of São Paulo School of Medicine, São Paulo, Brazil; Laboratory of Medical Investigation—Parasitology (LIM 46), Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
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Andre Machado Siqueira
Andre Machado Siqueira
Infectious and Parasitic Clinic, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Infectious and Parasitic Diseases, University of São Paulo School of Medicine, São Paulo, Brazil; Laboratory of Medical Investigation—Parasitology (LIM 46), Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
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Antonio Carlos Nicodemo
Antonio Carlos Nicodemo
Infectious and Parasitic Clinic, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Infectious and Parasitic Diseases, University of São Paulo School of Medicine, São Paulo, Brazil; Laboratory of Medical Investigation—Parasitology (LIM 46), Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
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Vicente Amato Neto
Vicente Amato Neto
Infectious and Parasitic Clinic, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Infectious and Parasitic Diseases, University of São Paulo School of Medicine, São Paulo, Brazil; Laboratory of Medical Investigation—Parasitology (LIM 46), Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
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Mucosal leishmaniasis (ML) is an important endemic disease and public-health problem in underdeveloped countries because of its significant morbidity and mortality. Increases in ecological tourism have extended this problem to developed countries. This form of leishmaniasis, caused by reactivation after primary cutaneous lesion, has a natural history of progressive destruction of the nasal septa and soft and hard palates, causing facial disfiguration and leading to respiratory disturbances. Treatment of ML, based on several therapies, depends on use of toxic compounds, and few drugs have emerged over the past 40 years. Drug resistance has increased, and the cure rate is no better than 70% in the largest studies. Despite these data, there has been no systematic review of therapies used to treat this important tropical disease. The aim of this study is to determine the best drug management for treatment of ML in Latin America based on the best studies offered by the medical literature. The MEDLINE, LILACS, EMBASE, Web of Science, and Cochrane Library databases were searched to identify articles related to ML and therapy. The studies were independently selected by 2 authors. Articles with sufficient data for cure and treatment failures, internal and external validity information, and > 4 patients in each treatment were included. Validation of this systematic review was based on guidelines to guarantee quality; 22 articles met our inclusion criteria. Stibogluconate achieved a 51% cure rate (76/150 patients), and 88% of patients treated with meglumine were cured (121 patients). Pentamidine and amphotericin were as effective as meglumine. Use of itraconazole and other therapies (pentoxifylline, allopurinol, or interferon-γ) was controversial, and numbers of patients in some studies were insufficient for statistical analysis. Meglumine may be the drug of choice in the treatment of ML, as it offers similar cure rates when compared with amphotericin B and pentamidine. Cost, adverse effects, local experience, and availability of drugs to treat ML are strong points to be considered before determining the best management of this disease, especially in developing countries.
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-
1
Silveira TG, Arraes SM, Bertolini DA, Teodoro U, Lonardoni MV, Roberto AC, Ramos M, Nerilo SA, Ishikawa E, Shaw J, 1999. The laboratory diagnosis and epidemiology of cutaneous leishmaniasis in Parana State, southern Brazil. Rev Soc Bras Med Trop 32 :413–423.
-
2
Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, Keystone JS, Pandey P, Cetron MS, 2006. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354 :119–130.
-
3
Marsden PD, 1986. Mucosal leishmaniasis (“espundia” Escomel, 1911). Trans R Soc Trop Med Hyg 80 :859–876.
-
4
Jones TC, Johnson WD Jr, Barretto AC, Lago E, Badaro R, Cerf B, Reed SG, Netto EM, Tada MS, Franca TF, 1987. Epidemiology of American cutaneous leishmaniasis due to Leishmania braziliensis braziliensis. J Infect Dis 156 :73–83.
-
5
Amato VS, Boulos MI, Amato Neto V, Filomeno LT, 1995. [The use of a silicone T tube for the treatment of a case of American mucocutaneous leishmaniasis with tracheomalacia.]. Rev Soc Bras Med Trop 28 :129–130 [article in Portugese].
-
6
Amato VS, Duarte MI, Nicodemo AC, de Carvalho LV, Pagliari C, da Matta VL, de Oliveira LS, de Castro SM, Uip DE, Amato JG, Amato Neto V, 1998. An evaluation of clinical, serologic, anatomopathologic and immunohistochemical findings for fifteen patients with mucosal leishmaniasis before and after treatment. Rev Inst Med Trop Sao Paulo 40 :23–30.
-
7
Grant A, Spraggs PD, Grant HR, Bryceson AD, 1994. Laryngeal leishmaniasis. J Laryngol Otol 108 :1086–1088.
-
8
Barral A, Pedral-Sampaio D, Grimaldi G Jr, Momen H, McMahon-Pratt D, Ribeiro de Jesus A, Almeida R, Badaro R, Barral-Netto M, Carvalho EM, et al., 1991. Leishmaniasis in Bahia, Brazil: evidence that Leishmania amazonensis produces a wide spectrum of clinical disease. Am J Trop Med Hyg 44 :536–546.
-
9
Osorio LE, Castillo CM, Ochoa MT, 1998. Mucosal leishmaniasis due to Leishmania (Viannia) panamensis in Colombia: clinical characteristics. Am J Trop Med Hyg 59 :49–52.
-
10
Hunt DL, McKibbon KA, 1997. Locating and appraising systematic reviews. Ann Intern Med 126 :532–538.
-
11
Tuon FF, Litvoc MN, Lopes MI, 2006. Adenosine deaminase and tuberculous pericarditis—a systematic review with meta-analysis. Acta Trop 99 :67–74.
-
12
Soto-Mancipe J, Grogl M, Berman JD, 1993. Evaluation of pentamidine for the treatment of cutaneous leishmaniasis in Colombia. Clin Infect Dis 16 :417–425.
-
13
Martinez S, Gonzalez M, Vernaza ME, 1997. Treatment of cutaneous leishmaniasis with allopurinol and stibogluconate. Clin Infect Dis 24 :165–169.
-
14
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 :E57–E61.
-
15
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 :261–267.
-
16
Miranda-Verastegui C, Llanos-Cuentas A, Arevalo I, Ward BJ, Matlashewski G, 2005. Randomized, double-blind clinical trial of topical imiquimod 5% with parenteral meglumine antimoniate in the treatment of cutaneous leishmaniasis in Peru. Clin Infect Dis 40 :1395–1403.
-
17
Llanos-Cuentas A, Echevarria J, Cruz M, La RA, Campos P, Campos M, Franke E, Berman J, Modabber F, Marr J, 1997. Efficacy of sodium stibogluconate alone and in combination with allopurinol for treatment of mucocutaneous leishmaniasis. Clin Infect Dis 25 :677–684.
-
18
Deville WL, Buntinx F, Bouter LM, Montori VM, de Vet HC, van der Windt DA, Bezemer PD, 2002. Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Med Res Methodol 2 :9.
-
19
Jadad AR, McQuay HJ, 1996. Meta-analyses to evaluate analgesic interventions: a systematic qualitative review of their methodology. J Clin Epidemiol 49 :235–243.
-
20
Oxman AD, Guyatt GH, 1991. Validation of an index of the quality of review articles. J Clin Epidemiol 44 :1271–1278.
-
21
Machado-Coelho GL, Caiaffa WT, Genaro O, Magalhaes PA, Mayrink W, 2005. Risk factors for mucosal manifestation of American cutaneous leishmaniasis. Trans R Soc Trop Med Hyg 99 :55–61.
-
22
Larson EE, Marsden PD, 1987. The origin of espundia. Trans R Soc Trop Med Hyg 81 :880.
-
23
Lawn SD, Whetham J, Chiodini PL, Kanagalingam J, Watson J, Behrens RH, Lockwood DN, 2004. New World mucosal and cutaneous leishmaniasis: an emerging health problem among British travellers. QJM 97 :781–788.
-
24
Scope A, Trau H, Anders G, Barzilai A, Confino Y, Schwartz E, 2003. Experience with New World cutaneous leishmaniasis in travelers. J Am Acad Dermatol 49 :672–678.
-
25
Chaudhry Z, Barrett AW, Corbett E, French PD, Zakrzewska JM, 1999. Oral mucosal leishmaniasis as a presenting feature of HIV infection and its management. J Oral Pathol Med 28 :43–46.
-
26
Iborra C, Caumes E, Carriere J, Cavelier-Balloy B, Danis M, Bricaire F, 1998. Mucosal leishmaniasis in a heart transplant recipient. Br J Dermatol 138 :190–192.
-
27
Motta AC, Arruda D, Souza CS, Foss NT, 2003. Disseminated mucocutaneous leishmaniasis resulting from chronic use of corticosteroid. Int J Dermatol 42 :703–706.
-
28
Alrajhi AA, Saleem M, Ibrahim EA, Gramiccia M, 1998. Leishmaniasis of the tongue in a renal transplant recipient. Clin Infect Dis 27 :1332–1333.
-
29
Saenz RE, de Rodriguez CG, Johnson CM, Berman JD, 1991. Efficacy and toxicity of pentostam against Panamanian mucosal leishmaniasis. Am J Trop Med Hyg 44 :394–398.
-
30
Berman JD, 1988. Chemotherapy for leishmaniasis: biochemical mechanisms, clinical efficacy, and future strategies. Rev Infect Dis 10 :560–586.
-
31
Rojas R, Valderrama L, Valderrama M, Varona MX, Ouellette M, Saravia NG, 2006. Resistance to antimony and treatment failure in human Leishmania (Viannia) infection. J Infect Dis 193 :1375–1383.
-
32
Rodrigues AM, Hueb M, Santos TA, Fontes CJ, 2006. Factors associated with treatment failure of cutaneous leishmaniasis with meglumine antimoniate. Rev Soc Bras Med Trop 39 :139–145.
-
33
Rey JA, Travi BL, Valencia AZ, Saravia NG, 1990. Infectivity of the subspecies of the Leishmania braziliensis complex in vivo and in vitro. Am J Trop Med Hyg 43 :623–631.
-
34
Saravia NG, Weigle K, Segura I, Giannini SH, Pacheco R, Labrada LA, Goncalves A, 1990. Recurrent lesions in human Leishmania braziliensis infection—reactivation or reinfection? Lancet 336 :398–402.
-
35
Mebrahtu YB, Lawyer PG, Pamba H, Koech D, Perkins PV, Roberts CR, Were JB, Hendricks LD, 1992. Biochemical characterization and zymodeme classification of Leishmania isolates from patients, vectors, and reservoir hosts in Kenya. Am J Trop Med Hyg 47 :852–892.
-
36
Deps PD, Viana MC, Falqueto A, Dietze R, 2000. Comparative assessment of the efficacy and toxicity of N-methylglucamine and BP88 sodium stibogluconate in the treatment of localized cutaneous leishmaniasis. Rev Soc Bras Med Trop 33 :535–543.
-
37
Saldanha AC, Romero GA, Merchan-Hamann E, Magalhaes AV, Macedo VO, 1999. A comparative study between sodium stibogluconate BP 88R and meglumine antimoniate in the treatment of cutaneous leishmaniasis. I. The efficacy and safety. Rev Soc Bras Med Trop 32 :383–387.
-
38
Oliveira-Neto MP, Mattos M, Pirmez C, Fernandes O, Goncalves-Costa SC, Souza CF, Grimaldi G Jr, 2000. Mucosal leishmaniasis (“espundia”) responsive to low dose of N-methylglucamine (Glucantime) in Rio de Janeiro, Brazil. Rev Inst Med Trop Sao Paulo 42 :321–325.
-
39
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