Successful Treatment of Cutaneous Leishmaniasis with Topical Paramomycin in a Child After Treatment Failure with Systemic Fluconazole

Anila Chacko Division of Infectious Diseases, Hospital for Sick Children, Toronto, Canada.

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Marissa Joseph Department of Pediatrics, University of Toronto, Toronto, Canada.
Division of Dermatology, Women's College Hospital, University of Toronto, Toronto, Canada.

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Timothy Feltis Lifelabs Medical Laboratory Services, Toronto, Canada.

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Shaun K. Morris Division of Infectious Diseases, Hospital for Sick Children, Toronto, Canada.
Department of Pediatrics, University of Toronto, Toronto, Canada.
Centre for Global Child Health, Peter Gilgan Centre for Research and Learning, Hospital for Sick Children Research Institute, Toronto, Canada.

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It is challenging to find safe, nonscarring and noninvasive treatment of facial cutaneous leishmaniasis (CL) in children. Herein, we report a child with CL from a region endemic for Leishmania tropica, whose lesion persisted after treatment with oral fluconazole but responded to topical paromomycin. Paromomycin should be considered early for treatment of Old World CL and is a well-tolerated and effective mode of therapy for facial lesions.

Author Notes

* Address correspondence to Shaun K. Morris, Division of Infectious Diseases, Hospital for Sick Children, 7317 Black Wing, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. E-mail: shaun.morris@sickkids.ca

Authors' addresses: Anila Chacko, Division of Infectious Diseases, Hospital for Sick Children, Toronto, Canada, E-mail: anilachacko@cmcvellore.ac.in. Marissa Joseph, Department of Pediatrics, University of Toronto, Toronto, Canada, and Division of Dermatology, Women's College Hospital, University of Toronto, Toronto, Canada, E-mail: marissa.joseph@mail.utoronto.ca. Timothy Feltis, Pathology, LifeLabs Medical Laboratory Services, Toronto, Canada, E-mail: tim.feltis@lifelabs.com. Shaun K. Morris, Division of Infectious Diseases, Hospital for Sick Children, Toronto, Canada, and Centre for Global Child Health, Peter Gilgan Centre for Research and Learning, Hospital for Sick Children Research Institute, Toronto, Canada, E-mail: shaun.morris@sickkids.ca.

  • 1.

    World Health Organization, 2015. Leishmaniasis: Situation and Trends and Leishmaniasis Resources. Available at: http://www.who.int/neglected_diseases/diseases/en/, http://www.who.int/gho/neglected_diseases/leishmaniasis/en/, and http://www.who.int/leishmaniasis/resources/AFGHANISTAN.pdf. Accessed October 15, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Reithinger R, Dujardin JC, Louzir H, Pirmez C, Alexander B, Brooker S, 2007. Cutaneous leishmaniasis. Lancet Infect Dis 7: 581–596.

  • 3.

    Crogan J, Gunasekera H, Wood N, Sheikh M, Isaacs D, 2010. Management of Old World cutaneous leishmaniasis in refugee children. Pediatr Infect Dis J 29: 357–359.

  • 4.

    Piscopo TV, Mallia AC, 2006. Leishmaniasis. Postgrad Med J 82: 649–657.

  • 5.

    Sklavos AV, Walls T, Webber MT, Watson AB, 2010. Cutaneous leishmaniasis in a child treated with oral fluconazole. Australas J Dermatol 51: 195–197.

  • 6.

    Toubiana J, Armengaud JB, Dupouy Camet J, Gendrel D, 2006. Oral fluconazole treatment for extensive cutaneous leishmaniasis in an 11-year-old child. Pediatr Infect Dis J 25: 1083–1084.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Baron S, Laube S, Raafat F, Moss C, 2004. Cutaneous leishmaniasis in a Kosovan child treated with oral fluconazole. Clin Exp Dermatol 29: 546–547.

  • 8.

    Aerts O, Duchateau N, Willemse P, Lambert J, 2015. Cutaneous leishmaniasis: treatment with low-dose oral fluconazole with an excellent cosmetic result. Pediatr Dermatol 32: 154–155.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Alrajhi AA, Ibrahim EA, De Vol EB, Khairat M, Faris RM, Maguire JH, 2002. Fluconazole for the treatment of cutaneous leishmaniasis caused by Leishmania major. N Engl J Med 346: 891–895.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Emad M, Hayati F, Fallahzadeh MK, Namazi MR, 2011. Superior efficacy of oral fluconazole 400 mg daily versus oral fluconazole 200 mg daily in the treatment of cutaneous Leishmania major infection: a randomized clinical trial. J Am Acad Dermatol 64: 606–608.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Solomon M, Schwartz E, Pavlotsky F, Sakka N, Barzilai A, Greenberger S, 2014. Leishmania tropica in children: a retrospective study. J Am Acad Dermatol 71: 271–277.

  • 12.

    Ben Salah A, Ben Messaoud N, Guedri E, Zaatour A, Ben Alaya N, Bettaieb J, Gharbi A, Belhadj Hamida N, Boukthir A, Chlif S, Abdelhamid K, El Ahmadi Z, Louzir H, Mokni M, Morizot G, Buffet P, Smith PL, Kopydlowski KM, Kreishman-Deitrick M, Smith KS, Nielsen CJ, Ullman DR, Norwood JA, Thorne GD, McCarthy WF, Adams RC, Rice RM, Tang D, Berman J, Ransom J, Magill AJ, Grogl M, 2013. Topical paromomycin with or without gentamicin for cutaneous leishmaniasis. N Engl J Med 368: 524–532.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Neal RA, Allen S, McCoy N, Olliaro P, Croft SL, 1995. The sensitivity of Leishmania species to aminosidine. J Antimicrob Chemother 35: 577–584.

  • 14.

    Kim DH, Chung HJ, Bleys J, Ghohestani RF, 2009. Is paromomycin an effective and safe treatment against cutaneous leishmaniasis? A meta-analysis of 14 randomized controlled trials. PLoS Negl Trop Dis 3: e381.

    • PubMed
    • Search Google Scholar
    • Export Citation
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