Leishmaniasis: clinical syndromes and treatment

Abstract

Leishmaniasis is a global term for cutaneous and visceral anthroponotic and zoonotic diseases caused by the vector-borne parasites of the genus Leishmania. These diseases afflict at least 2 million people each year with more than 350 million at risk in 98 countries worldwide. These are diseases mostly of the impoverished making prevention, diagnosis and treatment difficult. Therapy of leishmaniasis ranges from local treatment of cutaneous lesions to systemic, often toxic, therapy for disseminated cutaneous, mucocutaneous and deadly visceral disease. This review is a summary of the clinical syndromes caused by Leishmania and treatment regimens currently used for various forms of leishmaniasis.

Efficacy and Safety of Liposomal Amphotericin B for the Treatment of Mucosal Leishmaniasis from the New World: A Retrospective Study

“…11 Amphotericin B deoxycholate is an effective antileishmanial drug, with low rates of recurrence, but kidney failure and electrolyte abnormalities limit its use in the clinical practice. 12 Lipid-based formulations, an alternative treatment of cutaneous leishmaniasis, are important options.…”

Antimonial drugs entrapped into phosphatidylserine liposomes: physicochemical evaluation and antileishmanial activity

“…Pentavalent antimonials such as sodium stibogluconate (Pentostam®) and meglumine antimoniate (MA, Glucantime®) have been used as the first-line treatment against all forms of leishmaniasis for more than 70 years. However, they have several limitations owing to toxicity, treatment failures, long treatment duration, and drug resistance (3) . Thus, there is a continued need for new leishmaniasis therapies that are safe, effective in inducing a long-term cure, and easy to administer.…”

Estudo do papel dos receptores do tipo Toll (TLRs) na indução de CD200 em macrófagos murinos infectados com <i>Leishmania</i> (<i>Leishmania</i>) <i>amazonensis</i>.

“…A segunda forma, a leishmaniose cutânea difusa (LCD), se manifesta de modo mais severa, causando o aparecimento de múltiplos nódulos não ulcerativos (Figura 1B). Já a forma disseminada da leishmaniose cutânea é caracterizada por múltiplas lesões ulceradas e papulares encontradas em diversas áreas do corpo (Figura 1C), devido a disseminação por meio da via hematogênica ou linfática (McGwire, Satoskar, 2014).…”

“…Devido à grande atividade de defesa imunológica do organismo, a infecção provoca um quadro de hepatoesplenomegalia -aumento do tamanho do baço e do fígado (Figura 1E) -assim como um quadro de trombocitopenia e anemia, devido a supressão da medula. Esta forma da doença, se não tratada devidamente leva à morte do paciente (McGwire, Satoskar, 2014).…”

“…A leishmaniose dérmica pós-calazar (LDPC) ocorre em pacientes clinicamente curados da leishmaniose visceral, podendo surgir até 20 anos após a infecção inicial. Neste caso o paciente apresenta lesões nodulares, maculares ou papulares com desenvolvimento progressivo (Figura 1F) (McGwire, Satoskar, 2014).…”