South American cutaneous leishmaniasis: report of ten cases in Israeli travelers.
BACKGROUND
Cutaneous South American leishmaniasis is caused by several species of leishmaniasis. Lack of appropriate treatment may lead to mucocutaneous leishmaniasis, mainly with L. b. braziliensis and L. b. panamensis.


OBJECTIVE
To describe the clinical findings of Israeli travelers infected with cutaneous South American leishmaniasis and to draw attention to this problem.


METHODS
Ten patients were interviewed, examined and treated.


RESULTS
Twenty-two lesions of cutaneous leishmaniasis were found, all in exposed areas. Patients were seen by an average three physicians (range 1-6) before the final diagnosis was confirmed by direct smear, after an average period of 125 days (range 88-270 days). Treatment with Pentostam was started after an average period of 134 days (range 94-275 days). All lesions healed completely, but with scarring.


CONCLUSIONS
Travelers to endemic areas, as well as physicians, should be instructed about the potential risks and the clinical manifestations of cutaneous and mucocutaneous South American leishmaniasis. Such awareness will prevent undue delay in diagnosis and treatment.
Zlotogorski
A
A
Department of Dermatology, Hadassah University Hospital, Jerusalem, Israel. zloto@cc.huji.ac.il
Gilead
L
L
Jonas
F
F
Horev
L
L
Klaus
S N
SN
D000328:Adult; D000818:Animals; D000967:Antimony Sodium Gluconate / Q000009:adverse effects / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007871:Leg Ulcer / Q000188:drug therapy / Q000209:etiology; D007894:Leishmania mexicana / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D008099:Liver / Q000187:drug effects / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008536:Meglumine / Q000009:adverse effects / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D018908:Muscle Weakness / Q000139:chemically induced; D009135:Muscular Diseases / Q000139:chemically induced; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use; D010146:Pain / Q000139:chemically induced; D012189:Retrospective Studies; D012867:Skin / Q000187:drug effects / Q000469:parasitology / Q000473:pathology; D013020:South America; D014195:Travel; D015431:Weight Loss / Q000187:drug effects
D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000967:Antimony Sodium Gluconate