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Case Report: Diffuse Cutaneous Leishmaniasis by Leishmania infantum in a Patient Undergoing Immunosuppressive Therapy: Risk Status in an Endemic Mediterranean Area.
Alcover, M Magdalena; Rocamora, Vicenç; Guillén, M Carmen; Berenguer, Diana; Cuadrado, Marta; Riera, Cristina; Fisa, Roser.
Afiliación
  • Alcover MM; Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.
  • Rocamora V; Department of Dermatology, Hospital de Manacor, Balearic Islands, Spain.
  • Guillén MC; Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.
  • Berenguer D; Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.
  • Cuadrado M; Department of Pathology, Hospital de Manacor, Balearic Islands, Spain.
  • Riera C; Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.
  • Fisa R; Laboratory of Parasitology, Department of Biology, Health and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.
Am J Trop Med Hyg ; 98(5): 1313-1316, 2018 05.
Article en En | MEDLINE | ID: mdl-29582737
This case report highlights the risk of severe cutaneous leishmaniasis (CL) by Leishmania infantum in patients undergoing immunosuppressant therapy who either live in an endemic area or are visiting in the transmission season. The case patient, resident in Majorca (Balearic Islands), presented 12 disseminated erythematous skin lesions, 1-6 cm in diameter, located on the scalp, cheek, umbilical region, and lower extremities 8 years after undergoing anti-tumor necrosis factor (TNF) therapy. Parasite presence in peripheral blood and high levels of specific antibodies were also observed, indicating a possible risk of CL shifting toward a visceral infection. However, once CL was diagnosed, anti-TNF therapy was discontinued and liposomal amphotericin B was administered, resulting in a complete healing of lesions, no Leishmania DNA detection in blood, and an important serological decrease in antibodies. The lack of data on the supposed epidemiological association between leishmaniasis and immunosuppressive therapy highlights the importance of implementing surveillance systems in endemic areas. No obvious relationship was found based on the data provided by the Balearic Islands Epidemiological System, in contrast with data reported in nearby endemic areas. This indicates that if the suspected association is to be clarified, greater efforts are needed to report information about concomitant diseases and therapies in leishmaniasis patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Psoriasis / Fiebre Reumática / Leishmaniasis Cutánea Difusa / Leishmania infantum / Inmunosupresores Tipo de estudio: Etiology_studies / Risk_factors_studies Límite: Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Am J Trop Med Hyg Año: 2018 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Psoriasis / Fiebre Reumática / Leishmaniasis Cutánea Difusa / Leishmania infantum / Inmunosupresores Tipo de estudio: Etiology_studies / Risk_factors_studies Límite: Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Am J Trop Med Hyg Año: 2018 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos