Cutaneous leishmaniasis

Abstract

Cutaneous leishmaniasis is a widespread tropical infection caused by numerous different species of Leishmania protozoa that are transmitted by sandflies. Its clinical presentations are extremely diverse and dependent on a variety of parasite and host factors that are poorly understood. Diagnosis should aim to identify the exact species involved, but this requires laboratory investigations that are not widely available. No single ideal treatment has been identified, and those available are limited by variable success rates and toxicity. Clinical guidelines are needed to make better use of the investigations and treatments that do exist. Prevention is currently limited to bite prevention measures.

Thermoterapy effective and safer than miltefosine in the treatment of cutaneous leishmaniasis in Colombia

“…It is estimated that worldwide, around 12 million individuals are infected with Leishmania 35 . Cutaneous Leishmaniasis (CL) is the clinical manifestation presented by the majority of cases around the world, and there is approximately 1 to 1.5 million new cases every year 2,17,35 . In Colombia, a re-emergence of leishmaniasis has been seen since 2005, making the country second in the Americas for highest number of cases.…”

“…Leishmaniasis is a disease produced by parasites of the genus Leishmania; it is transmitted by female insects of the genus Lutzomyia in the Americas or Phlebotomus in the Old World, and it affects humans and domesticated and wild mammals 2,4,17 . It is endemic in over 95 countries, the majority of which are classified as developing.…”

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“…Bei den klinischen Verlaufsformen wird in diesen Leitlinien grundsätzlich zwischen "einfachen" und "komplexen" Lä-sionen unterschieden [6][7]. Als "komplex" wird eine CL definiert, wenn sie sich mit mindestens einem der folgenden Merkmale manifestiert:…”

“…Kein grundsätzlicher Therapieabbruch bei Auftreten dieser UAW. Therapie abbrechen bei: ST-Senkungen, QTc-Verlängerungen über 500 msec [7], Arrhythmien und bei Transaminasen über dem 5fachen bis 10fachen [33] bis 15fachen [7] des Normalwertes und Amylase über dem 3fachen [33] bis 4fachen [7] der Norm bzw. anderen Hinweisen auf eine akute Pankreatitis sowie signifikanten Elektrolyt-und Blutbildveränderungen.…”

“…Die Patienten sollen während der Therapie und bis 1 Woche danach keinen Alkohol trinken und sich körperlich schonen [7]. UAW bei Antimonen treten häufiger bei Immunsupprimierten auf [100].…”