American cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis resistant to meglumine antimoniate, but with good response to pentamidine: a case report

Rev Soc Bras Med Trop. 2011 Mar-Apr;44(2):254-6. doi: 10.1590/s0037-86822011000200026.

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiprotozoal Agents / therapeutic use*
  • Humans
  • Leishmania braziliensis / drug effects*
  • Leishmaniasis, Cutaneous / drug therapy
  • Leishmaniasis, Cutaneous / parasitology*
  • Male
  • Meglumine / therapeutic use*
  • Meglumine Antimoniate
  • Organometallic Compounds / therapeutic use*
  • Parasitic Sensitivity Tests
  • Pentamidine / therapeutic use*
  • Treatment Outcome

Substances

  • Antiprotozoal Agents
  • Organometallic Compounds
  • Pentamidine
  • Meglumine
  • Meglumine Antimoniate