Leishmania tropica in children: a retrospective study

J Am Acad Dermatol. 2014 Aug;71(2):271-7. doi: 10.1016/j.jaad.2013.12.047. Epub 2014 Apr 26.

Abstract

Background: Limited data are available regarding topical and systemic therapies for Leishmania tropica in children.

Objective: We sought to characterize the clinical presentation and evaluate the efficacy and safety of topical and systemic treatments in pediatric patients infected with L tropica.

Methods: A retrospective study was performed on 47 children with L tropica cutaneous leishmaniasis. Treatments included topical or systemic therapy with liposomal amphotericin B or pentavalent antimony.

Results: Seventy patients with L tropica cutaneous leishmaniasis were treated at our center between 2008 and 2012, of which 47 (67%) were children. The average age of the pediatric population was 8.8 years, and the face was the most common site of involvement (76%). The average number of lesions was 2.6. 24 children (51%) required systemic therapy. The patients were treated with 3 to 5 mg/kg/d of intravenous liposomal amphotericin B, and a response was observed in 83% of the patients within 3 months.

Limitations: This was a retrospective study.

Conclusion: The disease burden of L tropica in children is high, and because of facial involvement and a low response to topical therapies, systemic therapy is often required. In our experience, liposomal amphotericin B treatment in children is safe and effective and is required for a considerably shorter duration than treatment with pentavalent antimony.

Keywords: Leishmania tropica; children; cryotherapy; intralesional; liposomal amphotericin B; paromomycin ointment; sodium stibogluconate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Administration, Intravenous
  • Adolescent
  • Amphotericin B / administration & dosage*
  • Amphotericin B / adverse effects
  • Antimony Sodium Gluconate / administration & dosage*
  • Child
  • Child, Preschool
  • Cryotherapy
  • Facial Dermatoses / drug therapy*
  • Facial Dermatoses / parasitology
  • Facial Dermatoses / therapy
  • Female
  • Humans
  • Infant
  • Injections, Intralesional
  • Leishmania tropica*
  • Leishmaniasis, Cutaneous / drug therapy*
  • Leishmaniasis, Cutaneous / parasitology
  • Leishmaniasis, Cutaneous / therapy
  • Male
  • Paromomycin / administration & dosage
  • Retrospective Studies
  • Trypanocidal Agents / administration & dosage*
  • Trypanocidal Agents / adverse effects

Substances

  • Trypanocidal Agents
  • liposomal amphotericin B
  • Paromomycin
  • Amphotericin B
  • Antimony Sodium Gluconate