“…However, the most enigmatic fact, in this case, was the unexpected sudden clinical and parasitological response to the last rescue treatment. Although DCL caused by L. amazonensis , L. mexicana , and L. aethiopica is curable, albeit challenging [ 16 , 17 , 18 ], this patient was an extreme case: numerous and prolonged treatments had failed, and she was cured after a single ampoule of Sb V applied topically on the nasal mucosa. If resistance mechanisms to antimoniates existed, like lower drug accumulation, lower drug internalization, lower trypanothione concentration, and a lower rate of reduction of Sb V to the trivalent form (Sb III ), they were overcome [ 16 ].…”