title: New World cutaneous leishmaniasis: current challenges in diagnosis and parenteral treatment.
abstract: Many physicians in the United States and other nonendemic countries lack familiarity with New World cutaneous leishmaniasis (CL) and fail to include it in their differential diagnosis when seeing patients with suggestive lesions and recent high-risk travel. Moreover, even when the diagnosis of New World CL is considered and confirmed, physicians in the United States still face obstacles in obtaining appropriate treatment. In this report, we present 3 cases of New World CL that were either initially misdiagnosed or faced significant delays in therapy. We also discuss the optimal approach by which to confirm New World CL and to collaborate with professional colleagues at the Centers for Disease Control and Prevention in treating individual patients. In particular, when pentavalent antimonial treatment is needed for treatment, physicians must obtain appropriate diagnostic studies, communicate with experts at the Centers for Disease Control and Prevention, complete necessary paperwork, and obtain approval from their local institutional review board to administer it.
authors.affiliation: Albert Einstein College of Medicine, Bronx, New York, USA. dzaghi@aecom.yu.edu
authors.forename: Danny
authors.initials: D
authors.lastname: Zaghi
authors.forename: Claire
authors.initials: C
authors.lastname: Panosian
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Gutierrez
authors.forename: Aric
authors.initials: A
authors.lastname: Gregson
authors.forename: Emma
authors.initials: E
authors.lastname: Taylor
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Ochoa
mesh_terms: D000328:Adult; D000967:Antimony Sodium Gluconate / Q000008:administration & dosage*; D002487:Centers for Disease Control and Prevention, U.S.; D003364:Costa Rica; D015507:Drugs, Investigational / Q000627:therapeutic use; D004484:Ecuador; D028744:Ethics Committees, Research; D006801:Humans; D007263:Infusions, Parenteral; D007897:Leishmaniasis, Mucocutaneous / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D010568:Peru; D014195:Travel; D014481:United States
chemical_list: D015507:Drugs, Investigational; D000967:Antimony Sodium Gluconate