Cutaneous leishmaniasis is a skin infection caused by the Leishmania species, an intracellular protozoan parasite that is transmitted by various species of female sandflies. According to the geographic distribution and vectors, leishmaniasis is classified as Old World or New World cutaneous leishmaniasis. In Korea, 24 cases of Old World cutaneous leishmaniasis have been reported, but New World cutaneous leishmaniasis has not been reported as yet. A 37-year-old man presented with a 3-month history of a painful and erythematous nodule with two satellite papules on the left postauricular area and a papule on the left arm after traveling to the Amazon region in Brazil. After we performed skin biopsies of the lesions, diagnosis of cutaneous leishmaniasis was made by the histopathological findings. After intralesional injection of sodium stibogluconate (Pentostam(R), GlaxoSmithKline) twice a week for 4 weeks, the lesions improved with scarring. Herein, we discuss this case of New World cutaneous leishmaniasis that was successfully treated with intralesional injection of sodium stibogluconate (Pentostam(R)) in Korea.
Antimony ; Antimony Sodium Gluconate ; Arm ; Biopsy ; Brazil ; Cicatrix ; Female ; Humans ; Injections, Intralesional ; Korea ; Leishmania ; Leishmaniasis ; Leishmaniasis, Cutaneous ; Parasites ; Psychodidae ; Skin

Cutaneous leishmaniasis is a skin infection caused by the Leishmania species, an intracellular protozoan parasite that is transmitted by various species of female sandflies. According to the geographic distribution and vectors, leishmaniasis is classified as Old World or New World cutaneous leishmaniasis. In Korea, 24 cases of Old World cutaneous leishmaniasis have been reported, but New World cutaneous leishmaniasis has not been reported as yet. A 37-year-old man presented with a 3-month history of a painful and erythematous nodule with two satellite papules on the left postauricular area and a papule on the left arm after traveling to the Amazon region in Brazil. After we performed skin biopsies of the lesions, diagnosis of cutaneous leishmaniasis was made by the histopathological findings. After intralesional injection of sodium stibogluconate (Pentostam(R), GlaxoSmithKline) twice a week for 4 weeks, the lesions improved with scarring. Herein, we discuss this case of New World cutaneous leishmaniasis that was successfully treated with intralesional injection of sodium stibogluconate (Pentostam(R)) in Korea.
Antimony ; Antimony Sodium Gluconate ; Arm ; Biopsy ; Brazil ; Cicatrix ; Female ; Humans ; Injections, Intralesional ; Korea ; Leishmania ; Leishmaniasis ; Leishmaniasis, Cutaneous ; Parasites ; Psychodidae ; Skin

Post kala-azar dermal leishmaniasis (PKDL) is a rare disease. This is a solitary case report from Orissa, India. We describe a case of PKDL in a 55-year-old male who presented with multiple nodular lesions over face, trunk, and extremities. The patient had been to an endemic area of kala-azar and had a previous history of leishmaniasis. Fine needle aspiration cytology samples from skin nodules revealed Leishmania amastigotes.
Antimony Sodium Gluconate/therapeutic use ; Antiprotozoal Agents/therapeutic use ; Humans ; India ; Leishmania/isolation & purification ; Leishmaniasis, Visceral/diagnosis/drug therapy/*parasitology/pathology ; Male ; Middle Aged ; Skin/*parasitology/pathology

Visceral leishmaniasis is a life-threatening systemic infection caused by a protozoa of the genus leishmania and transmitted by sandfly. We report the first case of visceral leishmanaisis in Korea. The patient was a one-year-old girl admitted with the symptoms of fever, abdominal distension, pancytopenia, and purpura. She traveled to Argentina 5 months ago, and has had symptoms such as fever and pale appearance. Laboratory findings were: WBC, 12,680/mm3; Hg, 3.7g/dL; platelet, 100K; total bilirubin, 1.2mg/dL; AST/ALT, 48/10 U/L. CT scan and MRI showed hepato-splenomegaly. On laparotomy, excision of an accessory spleen and splenic hilar lymph nodes were performed. Many amastigotes were microscopically identified in histiocytes from the biopsy tissues. Sodium stibogluconate was administrated for 2 weeks, which did not relieve the symptoms. After administration of the additional Amphotericin B for 3 weeks, symptoms were improved.
Amphotericin B ; Antimony Sodium Gluconate ; Argentina ; Bilirubin ; Biopsy ; Blood Platelets ; Child* ; Female ; Fever ; Histiocytes ; Humans ; Korea ; Laparotomy ; Leishmania ; Leishmaniasis, Visceral* ; Lymph Nodes ; Magnetic Resonance Imaging ; Pancytopenia ; Psychodidae ; Purpura ; Spleen ; Tomography, X-Ray Computed

Cutaneous leishmaniasis (CL) has been one of the most common parasitic diseases in Saudi Arabia. This study exhibits the clinical features, diagnosis, cytokine profile and treatment of CL patients in Al-Taif province. Ninety CL suspects at a tertiary care general hospital were enrolled in one-year study. Patients were interviewed, clinically-examined, and subjected to laboratory tests: skin scraping smear microscopy, OligoC-TesT commercial PCR (Coris BioConcept) and kinetoplast DNA (kDNA) PCR for Leishmania diagnosis. Interferon-gamma (RayBio; Human IFN-γ) and nitric oxide (NO) levels in patients' sera were evaluated before treatment with sodium stibogluconate (pentostam) with 20-day intramuscular drug regimen. Positive rates of microscopy, commercial PCR and kDNA PCR were 74.4%, 95.5% and 100%, respectively. Patients came to hospital mostly in winter (45.0%). CL was frequently exhibited in Saudi patients (78.8%), male gender (70.7%), age < 20 years (50.0%), rural-dwellers (75.5%) and patients with travel history (86.6%). Lesion was mostly single ulcer (93.3%), occurred in the face (67.7%). Upon pentostam treatment, 85.1% of ulcers showed rapid healing signs. Levels of IFN-γ and NO were significantly higher in the healing than the non-healing cases (P < 0.001). The kDNA PCR proved more sensitive than microscopy and OligoC-TesT commercial PCR. Our results open perspectives for IFN-γ use as a biomarker predicting treatment response.
Antimony Sodium Gluconate ; Diagnosis ; DNA, Kinetoplast ; Hospitals, General ; Humans ; Interferon-gamma ; Leishmania ; Leishmaniasis, Cutaneous ; Male ; Microscopy ; Nitric Oxide ; Parasitic Diseases ; Polymerase Chain Reaction ; Saudi Arabia ; Skin ; Tertiary Healthcare ; Ulcer

BACKGROUND: Cutaneous leishmaniasis is a tropical infection of public health importance. Numerous treatment approaches are in practice with variable degree of success however its management has no universal consensus or practice guidelines to follow. OBJECTIVE: Analyze the management of cutaneous leishmaniasis retrospectively at a central hospital of Jazan Province, Kingdom of Saudi Arabia to identify the current treatment pattern and compare the outcomes. METHODS: This cross-sectional study was conducted based on the hospital records of patients who attended the dermatology clinic for cutaneous leishmaniasis during the year 2012 to 2015. RESULTS: Forty three patients were included in the study. There was a male preponderance (65.1%) among the patients and 60.5% of them were of pediatric age group. Monotherapy was the initial choice for 58.1% of the patients. Intralesional sodium stibogluconate (SS-IL) was the most preferred treatment for initial therapy, as monotherapy and as part of combination therapy. A complete response was achieved in 22 patients (51.2%) with initial therapy. Among the different treatment groups, SS-IL+itraconazole showed significantly higher complete response rate compared to other treatments offered as initial therapy (p<0.01). Initial SS-IL monotherapy provided complete response in 41.2% patients receiving it, while itraconazole monotherapy provided complete response in 75% and 90.9% of the patients receiving initial itraconazole+SS-IL combination therapy with achieved complete response. CONCLUSION: The findings and observations suggest that initial combination therapy with SS-IL+itraconazole significantly improved the complete response rates and thus reduced the need for additional or prolonged therapies.
Antimony Sodium Gluconate ; Consensus ; Cross-Sectional Studies ; Dermatology ; Hospital Records ; Humans ; Injections, Intralesional ; Itraconazole ; Leishmania major ; Leishmania tropica ; Leishmaniasis, Cutaneous* ; Male ; Observational Study* ; Public Health ; Retrospective Studies ; Saudi Arabia