The influence of treatment on the development of leishmaniasis recidiva cutis: a 17‐year case–control study in Midwestern Brazil

Abstract

The incidence of LRC among ACL patients was 1.34%. The analysis included 105 patients; 82 patients (78%) were in the control group, and 23 patients (22%) were in the LRC case group. The data analysis indicated that the standard treatment N-methylglucamine antimoniate (N-MA) reduced the development of LRC in bivariate (odds ratio (OR) = 0.34; 95% CI = 0.13-0.91) and multivariate analyses (OR = 0.16; 95% CI = 0.03-0.86; P = 0.03). However, no differences in LRC incidence were observed when the standard treatment N-MA and alternative drugs, such as pentamidine and amphotericin B, were considered (OR = 0.47; 95% CI = 0.16-1.35) CONCLUSION: We conclude that the standard treatment N-MA, as proposed by the Brazilian Ministry of Health, is effective in the prevention of LRC. Although other drugs have shown promising results in LRC, more scientific evidence is needed to assess their efficacy compared with N-MA.

The accuracy of the Montenegro skin test for leishmaniasis in PCR-negative patients

“…ATL, in its localized form, is known to induce intense cellular responses and granuloma formation. This immunological reaction may lower the parasite load in the lesion and consequently reduce the sensitivity of parasitological tests and PCR but may be insufficient to cure the disease 9 . This is particularly a problem in South America where Leishmania (Viannia) braziliensis infection is endemic 10 .…”

A randomized, open-label clinical trial comparing the long-term effects of miltefosine and meglumine antimoniate for mucosal leishmaniasis

“…Consistently, three patients had fewer than six months of symptoms. Early leishmaniasis infections are known to respond better to treatment compared to chronic lesions 33 .…”

“…The cure rate was likely underestimated due to the number of patients lost to follow-up. As HUB is the main regional referral hospital for ATL in a region where medical support is scarce, it has been reported that many patients only return for consultations when relapse or treatment failure occurs 33 . Patients older than 70 years or younger than 18 years were not included in the study; additionally, patients with severe heart or kidney disease were also not included.…”

Leishmaniasis Recidiva Cutis

“…Cutaneous leishmaniasis is a vector-borne tropical infection of high prevalence in Latin America, mainly caused by the parasites Leishmania ( Viannia ) braziliensis , Leishmania ( Viannia ) amazonensis , Leishmania ( Viannia ) panamensis , and Leishmania ( Viannia ) guyanensis ; the former is the predominant species in Brazil, and the only detected species in Espiríto Santo State 1,2. Localized cutaneous leishmaniasis (LCL) is the most common clinical form.…”

“…LRC is an infrequent variant of cutaneous leishmaniasis; histologically, diffuse infiltration of lymphocytes, plasma cell, and macrophages are observed, but the parasites are scarce or absent 4. At the same time, LRC is comparatively rare in Latin America (approximately 34 cases have been reported in Brazil in the period of 1993–2011),1,4,5 and such unusual clinical forms of leishmaniasis tend to be more difficult to diagnose and treat 6…”