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Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin B.
J Infect. 2005 Dec; 51(5):e261-4.JI

Abstract

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.

Authors+Show Affiliations

Department of Dermatology, Catholic University of Rome, Rome, Italy. iclde@rm.unicatt.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15936088

Citation

Paradisi, A, et al. "Atypical Multifocal Cutaneous Leishmaniasis in an Immunocompetent Patient Treated By Liposomal Amphotericin B." The Journal of Infection, vol. 51, no. 5, 2005, pp. e261-4.
Paradisi A, Capizzi R, Zampetti A, et al. Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin B. J Infect. 2005;51(5):e261-4.
Paradisi, A., Capizzi, R., Zampetti, A., Proietti, I., De Simone, C., Feliciani, C., & Amerio, P. L. (2005). Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin B. The Journal of Infection, 51(5), e261-4.
Paradisi A, et al. Atypical Multifocal Cutaneous Leishmaniasis in an Immunocompetent Patient Treated By Liposomal Amphotericin B. J Infect. 2005;51(5):e261-4. PubMed PMID: 15936088.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin B. AU - Paradisi,A, AU - Capizzi,R, AU - Zampetti,A, AU - Proietti,I, AU - De Simone,C, AU - Feliciani,C, AU - Amerio,P L, Y1 - 2005/06/02/ PY - 2005/01/24/received PY - 2005/03/22/accepted PY - 2005/6/7/pubmed PY - 2006/6/29/medline PY - 2005/6/7/entrez SP - e261 EP - 4 JF - The Journal of infection JO - J Infect VL - 51 IS - 5 N2 - 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. SN - 1532-2742 UR - https://www.unboundmedicine.com/medline/citation/15936088/Atypical_multifocal_cutaneous_leishmaniasis_in_an_immunocompetent_patient_treated_by_liposomal_amphotericin_B_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-4453(05)00100-3 DB - PRIME DP - Unbound Medicine ER -