Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin B.
J Infect
; 51(5): e261-4, 2005 Dec.
Article
en En
| MEDLINE
| ID: mdl-15936088
Multifocal cutaneous leishmaniasis (MCL) is an extremely rare disease in South Europe, and it mainly affects immunosuppressed patients. We report a case of MCL in an immunocompetent patient affected by type II diabetes mellitus that clinically presented with three large ulcers on the legs with a non-linear distribution and several months later with an erythematous-crusty lesion on the left cheek. Diagnosis of leishmaniasis due to Leishmania infantum was formulated by PCR analysis. Given the diffuse and wide lesions, the unresponsiveness to previous local and systemic treatments, a parenteral i.v. therapy with liposomal amphotericin B at a dosage of 3mg/kg/day for 5 days was started and then repeated on the 14th and 21st days, leading to a clear improvement in the clinical picture. The different clinical expression and the evolution of leishmaniasis depend on both the parasite subtype and the host's immunity status. L. infantum manifests with an atypical clinical feature more frequently than other species. The differential diagnosis for multiple ulcers must include several skin diseases, such as cutaneous TBC, bacterial ulcers, traumatic ulcers, deep mycoses, and sarcoidosis. However, an MCL should always be considered in subjects coming from endemic areas. In our case, the multifocality, the size of the lesions and the unresponsiveness to other treatment indicate a short course treatment with liposomal B amphotericin that proved to be a suitable alternative to traditional drugs used in MCL.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Anfotericina B
/
Leishmaniasis Cutánea
/
Leishmania infantum
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Antiprotozoarios
Límite:
Animals
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Infect
Año:
2005
Tipo del documento:
Article
País de afiliación:
Italia
Pais de publicación:
Reino Unido