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Treatment of imported New World cutaneous leishmaniasis in Germany.
Int J Dermatol. 2011 Nov; 50(11):1336-42.IJ

Abstract

BACKGROUND

Cutaneous leishmaniasis (CL), a parasitic disease which represents a public health problem, particularly in Central and South America, has become a leading condition in travelers who return from tropical countries with skin disorders. Cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis, the most common causative agent, requires systemic treatment because it is potentially able to disseminate and to cause mucosal or mucocutaneous disease. Although several drugs are available for the systemic treatment of leishmaniases, a definitive treatment regimen for infection caused by species of the Viannia subgenus has yet to be established in many countries, including Germany.

METHODS

We analyzed treatment outcomes in 23 returnees from Central and South America who were diagnosed with L. (V.) braziliensis CL by polymerase chain reaction.

RESULTS

Complete cure within one month following treatment was observed in 18 patients (78%). Cure was achieved with liposomal amphotericin B in 11 of 13 patients, miltefosine in five of eight patients, and meglumine antimoniate in two (of two) patients. Of the five patients (22%) who failed to respond to initial therapy, four were cured with meglumine antimoniate and one with liposomal amphotericin B.

CONCLUSIONS

In this outcome evaluation of treatment of imported L. (V.) braziliensis infections, liposomal amphotericin B, miltefosine, and meglumine antimoniate proved to be effective. Conventional meglumine antimoniate showed high efficacy as a first-line treatment and cured lesions that failed to respond to the other two drugs. A multi-country study using standardized treatment protocols is needed to establish a definitive regimen.

Authors+Show Affiliations

Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Berlin, Germany. gundel.harms@charite.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22004484

Citation

Harms, Gundel, et al. "Treatment of Imported New World Cutaneous Leishmaniasis in Germany." International Journal of Dermatology, vol. 50, no. 11, 2011, pp. 1336-42.
Harms G, Scherbaum H, Reiter-Owona I, et al. Treatment of imported New World cutaneous leishmaniasis in Germany. Int J Dermatol. 2011;50(11):1336-42.
Harms, G., Scherbaum, H., Reiter-Owona, I., Stich, A., & Richter, J. (2011). Treatment of imported New World cutaneous leishmaniasis in Germany. International Journal of Dermatology, 50(11), 1336-42. https://doi.org/10.1111/j.1365-4632.2011.04987.x
Harms G, et al. Treatment of Imported New World Cutaneous Leishmaniasis in Germany. Int J Dermatol. 2011;50(11):1336-42. PubMed PMID: 22004484.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of imported New World cutaneous leishmaniasis in Germany. AU - Harms,Gundel, AU - Scherbaum,Helmut, AU - Reiter-Owona,Ingrid, AU - Stich,August, AU - Richter,Joachim, PY - 2011/10/19/entrez PY - 2011/10/19/pubmed PY - 2012/3/2/medline SP - 1336 EP - 42 JF - International journal of dermatology JO - Int J Dermatol VL - 50 IS - 11 N2 - BACKGROUND: Cutaneous leishmaniasis (CL), a parasitic disease which represents a public health problem, particularly in Central and South America, has become a leading condition in travelers who return from tropical countries with skin disorders. Cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis, the most common causative agent, requires systemic treatment because it is potentially able to disseminate and to cause mucosal or mucocutaneous disease. Although several drugs are available for the systemic treatment of leishmaniases, a definitive treatment regimen for infection caused by species of the Viannia subgenus has yet to be established in many countries, including Germany. METHODS: We analyzed treatment outcomes in 23 returnees from Central and South America who were diagnosed with L. (V.) braziliensis CL by polymerase chain reaction. RESULTS: Complete cure within one month following treatment was observed in 18 patients (78%). Cure was achieved with liposomal amphotericin B in 11 of 13 patients, miltefosine in five of eight patients, and meglumine antimoniate in two (of two) patients. Of the five patients (22%) who failed to respond to initial therapy, four were cured with meglumine antimoniate and one with liposomal amphotericin B. CONCLUSIONS: In this outcome evaluation of treatment of imported L. (V.) braziliensis infections, liposomal amphotericin B, miltefosine, and meglumine antimoniate proved to be effective. Conventional meglumine antimoniate showed high efficacy as a first-line treatment and cured lesions that failed to respond to the other two drugs. A multi-country study using standardized treatment protocols is needed to establish a definitive regimen. SN - 1365-4632 UR - https://www.unboundmedicine.com/medline/citation/22004484/Treatment_of_imported_New_World_cutaneous_leishmaniasis_in_Germany_ L2 - https://doi.org/10.1111/j.1365-4632.2011.04987.x DB - PRIME DP - Unbound Medicine ER -