Epidemiology, pathology and treatment of cutaneous leishmaniasis in Taif Region of Saudi Arabia

Cutaneous leishmaniasis is an annoying and disfiguring disease affecting around 1,500,000 individuals globally. There are endemic pockets of this disease in Taif region. In some patients, lesion often weeps and leads to scar formation. The study was conducted to see the efficacy of fluconazole and itraconazole in the patients of cutaneous leishmaniasis and the effect of these drugs on liver enzymes and kidney markers. Positivity of Leishmania was recorded by microscopic examinations of smears. Specific diagnosis for Leishmania major and L. tropica was made with the help of nested polymerase chain reaction. Fluconazole was given at the rate of 200mg/day while itraconazole was given at 150mg/day for six weeks. AST, ALT, creatinine and urea were estimated during medication. Leishmania major and L. tropica were the species responsible for cutaneous leishmaniasis in Taif region. 81% patients had single lesions, mostly on face followed by hands and legs. 15% of the lesions had bacterial contamination. In terms of efficacy, fluconazole gave slightly better results compared to itraconazole. After 6 weeks of medications, slightly elevated values were recorded for liver enzymes and creatinine. Transmission of leishmaniasis in Taif region is probably because of poor coverage of residual insecticides spraying at hiding places in pile-ups of rocks and abandoned houses from where sand flies visit nearby houses and cattle sheds during night. Fluconazole and itraconazole may be used for the treatment of cutaneous leishmaniasis with good recovery rate and fewer side effects

Effect of itraconazole and terbinafine on leishmania promastigotes

The antiproliferative effect induced in vitro by two antifungal compounds, the azole itraconazole and the allylamine terbinafine on Leishmania major, L. Donovani and L. Mexicana promastigotes was reported. Treatment of promastigotes cultures with itraconazole or with terbinafine induced growth arrest with L. major, but neither with L. Donovani nor with L. mexicana concentrations of 0.75 mul/l or more of itraconazole induced cell lysis after 72 hours with L major. However, even relatively large concentrations of terbinafine [2.0 mul/l] did not induce cell lysis. For L. major, the IC50 for itraconazole and terbinafine were 0.31 mul/l and 3.3 mul/l, respectively

Methods used in the diagnosis of malaria: where do we stand?

In the developing nations, the limited resources lead to an inadequate malaria diagnosis. In the developed countries, a poor familiarity with malaria may lead to a clinical and laboratory misdiagnosis. Giemsa thick and thin blood films remain the current standard for diagnosis. Although it has a good sensitivity and allows a species identification and parasite counts, it is time-consuming and requires microscopic expertise and maintenance of equipment. Microscopy with fluorescent stains [QBC], dipstick antigen detection of HRP2 and pLDH [Parasight-F, ICT malaria Pf, OptiMAL], polymerase chain reaction assays and some automated blood cell analyzers offer new approaches and were reviewed in this study with an emphasis on the clinical relevance and the potential to complement conventional microscopy