title: American cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis resistant to meglumine antimoniate, but with good response to pentamidine: a case report.
abstract: This is a case report of a Brazilian soldier with cutaneous leishmaniasis. The lesion relapsed following two systemic treatments with meglumine antimoniate. The patient was treated with amphotericin B, which was interrupted due to poor tolerance. Following isolation of Leishmania sp., six intralesional infiltrations of meglumine antimoniate resulted in no response. Leishmania sp promastigotes were again isolated. The patient was submitted to intramuscular 4 mg/kg pentamidine. Parasites from the first and second biopsies were identified as Leishmania (Viannia) braziliensis; those isolated from the first biopsy were more sensitive to meglumine antimoniate in vitro than those isolated from the second biopsy. No relapse was observed.
authors.affiliation: Laboratório de Vigilância em Leishmanioses, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. maria.pimentel@ipec.fiocruz.br
authors.forename: Maria Inês Fernandes
authors.initials: MI
authors.lastname: Pimentel
authors.forename: Cibele
authors.initials: C
authors.lastname: Baptista
authors.forename: Evelyn Figueiredo
authors.initials: EF
authors.lastname: Rubin
authors.forename: Erica de Camargo Ferreira e
authors.initials: Ede C
authors.lastname: Vasconcellos
authors.forename: Marcelo Rosandiski
authors.initials: MR
authors.lastname: Lyra
authors.forename: Mariza de Matos
authors.initials: Mde M
authors.lastname: Salgueiro
authors.forename: Maurício Naoto
authors.initials: MN
authors.lastname: Saheki
authors.forename: Cláudia Maria Valete
authors.initials: CM
authors.lastname: Rosalino
authors.forename: Maria de Fátima
authors.initials: Mde F
authors.lastname: Madeira
authors.forename: Aline Fagundes da
authors.initials: AF
authors.lastname: Silva
authors.forename: Eliame Mouta
authors.initials: EM
authors.lastname: Confort
authors.forename: Armando de Oliveira
authors.initials: Ade O
authors.lastname: Schubach
mesh_terms: D000328:Adult; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D006801:Humans; D007892:Leishmania braziliensis / Q000187:drug effects*; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy / Q000469:parasitology*; D008297:Male; D008536:Meglumine / Q000627:therapeutic use*; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000627:therapeutic use*; D021261:Parasitic Sensitivity Tests; D010419:Pentamidine / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D010419:Pentamidine; D008536:Meglumine; D000077485:Meglumine Antimoniate