New World cutaneous leishmaniasis: current challenges in diagnosis and parenteral treatment.
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.
Zaghi
Danny
D
Albert Einstein College of Medicine, Bronx, New York, USA. dzaghi@aecom.yu.edu
Panosian
Claire
C
Gutierrez
Miguel A
MA
Gregson
Aric
A
Taylor
Emma
E
Ochoa
Maria Teresa
MT
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
D015507:Drugs, Investigational; D000967:Antimony Sodium Gluconate