Studies on the leishmaniases in the Sudan. 2. Clinical and parasitological studies on cutaneous leishmaniasis.
In the Omdurman Hospital for Tropical Diseases, Sudan, from 6 October to 1 December 1986, 736 patients with cutaneous leishmaniasis (CL) were studied. The duration of the lesions varied from a few days to 4 months, usually (56%) 1-3 months. Multiple lesions ranging from one to 50 (mean = 4) were present in 80% of cases. Ulcerative lesions were found in 44%, nodulo-ulcerative in 31%, nodular in 31% and others, including infiltrated, fungating and warty lesions, in 5% of patients. The lower limbs were involved in 66%, upper limbs in 50%, face in 6%, back in 4%, chest in 2%, abdomen in 1% and buttocks in 0.1%. Lesions were also found on the ear, scalp, genitalia and mucocutaneous junctions. Lymphatic involvement was present in 11% of the patients, secondary infection in 18%, fever in 17%, pain in 38% and itching in 61%; 3% of the patients were diabetics. Features of diffuse cutaneous leishmaniasis were noted in one patient and three cases presented with an 'id' reaction. A slit-skin smear was positive in 88% of the cases. Using thin-layer starch gel electrophoresis, 23 stocks from man and one from Arvicanthis niloticus were identified by the characterization of 12 enzymes as Leishmania major zymodeme LON-1. Various therapeutic regimens are discussed. Only patients with severe lesions (approximately 15%) were given 3 to 4 weeks' treatment with intravenous Pentostam, to which all except 2 responded satisfactorily with minimal side effects.
el-Safi
S H
SH
Institute for Tropical Medicine, Khartoum, Sudan.
Peters
W
W
el-Toam
B
B
el-Kadarow
A
A
Evans
D A
DA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D007895:Leishmania tropica / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use; D013397:Sudan; D013997:Time Factors
D008795:Metronidazole; D000967:Antimony Sodium Gluconate; D012293:Rifampin