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1.
Rev. Soc. Bras. Med. Trop ; 54: e20200208, 2021. graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1143878

ABSTRACT

Abstract Post-kala-azar dermal leishmaniasis is a skin disorder occurring in 5-10% of visceral leishmaniasis patients after treatment with miltefosine,the first-line drug for this skin disorder. We reported a case of acute anterior uveitis,a rare adverse effect, experienced by a patient treated with miltefosine for post-kala-azar dermal leishmaniasis. This adverse effect developed after 15 days of miltefosine consumption, and the patient himself discontinued the treatment. The ophthalmic complication was completely resolved with antibiotics and steroid eye drops. After recovery from the ophthalmic complication, the patient was successfully treated with liposomal amphotericin B for the skin lesions.


Subject(s)
Humans , Uveitis/chemically induced , Uveitis/drug therapy , Leishmaniasis, Cutaneous/drug therapy , Leishmaniasis, Visceral/complications , Leishmaniasis, Visceral/drug therapy , Antiprotozoal Agents/adverse effects , Phosphorylcholine/analogs & derivatives
2.
Rev. Soc. Bras. Med. Trop ; 54: e20200012, 2021. graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1136924

ABSTRACT

Abstract Ramsay Hunt Syndrome (RHS), also known as herpes zoster oticus, is caused by the reactivation of varicella zoster virus (VZV) in the geniculate ganglion of the facial nerve. Herein, we report a case of Ramsey Hunt Syndrome in a patient after antimonial treatment for Cutaneous Leishmaniasis. The patient presented with microvesicles grouped on an erythematous base, starting in the neck and ascending towards the scalp margin on the right side of the head. The patient also developed grade V peripheral facial palsy the day after initiating the herpes zoster treatment, this outcome corroborated the assumption of Ramsey Hunt Syndrome.


Subject(s)
Humans , Leishmaniasis, Cutaneous/drug therapy , Herpes Zoster Oticus/therapy , Herpes Zoster , United States , Herpesvirus 3, Human
3.
Rev. Soc. Bras. Med. Trop ; 54: e0633-2020, 2021. graf
Article in English | LILACS | ID: biblio-1155602

ABSTRACT

Abstract In this study, we present two cases of cutaneous leishmaniasis in patients with end-stage renal disease, who were treated solely with intramuscular pentamidine. In such cases, treatment implies a fine line between therapeutic efficacy and toxicity. This is suggestive of a knowledge gap; however, findings indicate that this is still the fastest and safest alternative to the treatment with antimonials. Also, it can help avoid the side effects that occur upon using antimonials.


Subject(s)
Humans , Leishmaniasis, Cutaneous/complications , Leishmaniasis, Cutaneous/drug therapy , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Antiprotozoal Agents/therapeutic use , Pentamidine/therapeutic use , Renal Dialysis
4.
Rev. Soc. Bras. Med. Trop ; 54: e0514-2020, 2021. tab, graf
Article in English | LILACS | ID: biblio-1155581

ABSTRACT

Abstract A 31-year-old male patient developed an ulcer on the glans penis that evolved for three months without healing. We diagnosed it as leishmaniasis using polymerase chain reaction. No immunosuppression or associated diseases were observed. The patient was treated with meglumine antimoniate that cured the lesion in a month post-treatment. Here, we report this case of cutaneous leishmaniasis lesion at the unusual location of glans penis in an immunocompetent individual. The lesion likely developed due to the bite of a vector, highlighting the need for considering cutaneous leishmaniasis among differential diagnosis of sexually transmitted diseases in areas endemic for leishmaniasis.


Subject(s)
Humans , Male , Adult , Organometallic Compounds/therapeutic use , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/drug therapy , Antiprotozoal Agents/therapeutic use , Brazil , Polymerase Chain Reaction , Meglumine Antimoniate/therapeutic use , Genitalia , Meglumine/therapeutic use
5.
Rev. Soc. Bras. Med. Trop ; 54: e0305-2020, 2021. graf
Article in English | LILACS | ID: biblio-1155563

ABSTRACT

Abstract Cutaneous leishmaniasis (CL) involves several differential diagnoses as it lacks a gold standard diagnostic test. Its diagnosis is easier in endemic regions; however, many cases come from travelers to endemic areas. A 22-year-old patient, who had recently visited Oaxaca, Mexico, developed two asymptomatic ulcers weeks later on the left auricle and the nose. Leishmania mexicana was identified using polymerase chain reaction. The patient was treated with imiquimod 5% cream three times/week, providing favorable results after 12 weeks, without relapse 2 months after therapy. To our knowledge, this is the first case of CL due to L. mexicana effectively treated with imiquimod.


Subject(s)
Humans , Young Adult , Leishmania mexicana , Leishmaniasis, Mucocutaneous , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/drug therapy , Imiquimod , Mexico
6.
Rev. Soc. Bras. Med. Trop ; 53: e20200091, 2020. graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1136875

ABSTRACT

Abstract INTRODUCTION: The drugs currently available for leishmaniasis treatment have major limitations. METHODS: In vitro and in vivo studies were performed to evaluate the effect of a quinoline derivative, Hydraqui (7-chloro-4-(3-hydroxy-benzilidenehydrazo)quinoline, against Leishmania amazonensis. In silico analyses of absorption, distribution, metabolism, excretion, and toxicity (ADMET) parameters were performed. RESULTS: Hydraqui showed significant in vitro anti-amastigote activity. Also, Hydraqui-treated mice exhibited high efficacy in lesion size (48.3%) and parasitic load (93.8%) reduction, did not cause hepatic and renal toxicity, and showed appropriate ADMET properties. CONCLUSIONS: Hydraqui presents a set of satisfactory criteria for its application as an antileishmanial agent.


Subject(s)
Animals , Female , Quinolines/therapeutic use , Leishmania mexicana/drug effects , Leishmaniasis, Cutaneous/drug therapy , Antiprotozoal Agents/therapeutic use , Quinolines/chemistry , Leishmaniasis, Cutaneous/parasitology , Disease Models, Animal , Parasite Load , Mice , Mice, Inbred BALB C
7.
Mem. Inst. Oswaldo Cruz ; 115: e200272, 2020. graf
Article in English | LILACS, SES-SP | ID: biblio-1135255

ABSTRACT

BACKGROUND Metformin (MET) is a hypoglycemic drug used for the treatment of diabetes, despite interference in host immunity against microorganisms. Cutaneous infection caused by pathogens such as Leishmania braziliensis (Lb), the agent responsible for cutaneous leishmaniasis (CL) in Brazil, represents an interesting model in which to evaluate the effects associated with MET. OBJECTIVE To evaluate the modulatory effect of MET in Lb infection. MATERIAL AND METHODS Experimental study of Lb infection and MET treatment in BALB/c mice and Raw 264.7 macrophages. FINDINGS MET treatment interfered with lesion kinetics, increased parasite load and reduced macrophage proliferation. Low concentrations of MET in Lb culture allow for the maintenance of stationary parasite growth phase. Lb-infected cells treated with MET exhibited increased parasite load. While both MET and Lb infection alone promoted the production of intracellular reactive oxygen species (ROS), reduced levels of ROS were seen in MET-treated Lb-infected macrophages. MAIN CONCLUSION Experimental treatment with MET interfered with the kinetics of cutaneous ulceration, increased Lb parasite load, altered ROS production and modulated cellular proliferation. Our experimental results indicate that MET interfere with the evolution of CL.


Subject(s)
Animals , Mice , Leishmaniasis, Cutaneous/drug therapy , Leishmania/drug effects , Metformin/pharmacology , Leishmania braziliensis , Brazil , Mice, Inbred BALB C
8.
Rev. Soc. Bras. Med. Trop ; 53: e20190139, 2020. graf
Article in English | LILACS | ID: biblio-1057288

ABSTRACT

Abstract INTRODUCTION: Leishmaniasis, a disease caused by a parasite endemic to large areas of tropical and subtropical countries, is a growing public health problem. METHODS: Male BALB/c mice were infected with Leishmania amazonensis and treated with extracts isolated from Annona mucosa. RESULTS: Treated groups had significantly reduced footpad swelling. The group treated intraperitoneally with hexane extract showed footpad swelling similar to groups treated with Pentamidine® and Glucantime®. Groups treated with dichloromethane extract and hexane extract presented the recovering phenotype associated with reduced parasite levels. CONCLUSIONS: Extracts of A. mucosa are promising sources of novel antileishmanial compounds.


Subject(s)
Animals , Male , Plant Extracts/therapeutic use , Leishmaniasis, Cutaneous/drug therapy , Annona/chemistry , Leishmania/drug effects , Antiprotozoal Agents/therapeutic use , Leishmaniasis, Cutaneous/parasitology , Disease Models, Animal , Mice , Mice, Inbred BALB C , Antiprotozoal Agents/isolation & purification
9.
Mem. Inst. Oswaldo Cruz ; 115: e190361, 2020. tab, graf
Article in English | LILACS | ID: biblio-1091244

ABSTRACT

Genes associated with wound healing have been shown to be risk factors for cutaneous leishmaniasis (CL) which is caused by Leishmania braziliensis. In this study, we examined whether the genes previously associated with CL influenced the clinical outcome. Patients were genotyped and retrospectively classified as responders, who were cured with a single course of pentavalent antimony (Sbv), or as refractories, who did not respond to Sbv. Patients characterised as responders showed a stronger response to the leishmanin skin test (LST) when compared to the refractory subjects (p = 0.0003). Furthermore, we observed an association between the FLI1 CC genotype and an increased size of ulcers (p = 0.0170). We suggest that the leishmanin skin test may be a predictive tool for therapeutic outcome and reinforce FLI1 as a potential influencer of susceptibility and lesion size in CL.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Wound Healing/genetics , Leishmaniasis, Cutaneous/genetics , Antimony/therapeutic use , Antiprotozoal Agents/therapeutic use , Skin Tests , Case-Control Studies , Retrospective Studies , Leishmaniasis, Cutaneous/pathology , Leishmaniasis, Cutaneous/drug therapy , Genetic Predisposition to Disease , Polymorphism, Single Nucleotide , Genotype , Middle Aged
10.
Medicina (B.Aires) ; 79(4): 287-290, ago. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1040524

ABSTRACT

La histoplasmosis y la leishmaniasis son enfermedades olvidadas, endémicas en Argentina, y generalmente se asocian a inmunocompromiso. Presentamos el caso de un varón de 16 años, inmunocompetente, con histoplasmosis del sistema nervioso central y leishmaniasis cutánea. Inicialmente, el paciente presentó una lesión en la pierna de un mes de evolución seguida de paraparesia leve, diagnosticada como un proceso de desmielinización mediante estudios de imágenes. El cuadro fue tratado con altas dosis de corticoides y en 72 horas evolucionó a paraparesia grave con lesiones nodulares en las vértebras cervicales, observadas en las imágenes de resonancia magnética nuclear. Se aisló Histoplasma capsulatum de líquido cefalorraquídeo, genotípicamente identificado como perteneciente a la especie filogenética LamB. El paciente recibió tratamiento intravenoso con anfotericina B deoxicolato durante 30 días y posteriormente fluconazol e itraconazol oral durante un año. A los tres meses de iniciado el tratamiento con antifúngicos se reactivó la lesión de la pierna y en el examen directo se observaron amastigotes de Leishmania. La leishmaniasis cutánea fue tratada con antimoniato de meglumina intramuscular. La respuesta clínica al tratamiento de ambas enfermedades fue favorable.


Histoplasmosis and leishmaniasis are neglected and endemic diseases in Argentina, and generally are found associated with immunosuppression. We report the case of an immunocompetent 16-years-old man with simultaneous occurrence of central nervous system histoplasmosis and cutaneous leishmaniasis. Upon admission, the patient showed a one-month old skin lesion in a leg and mild paraparesis. Imaging studies detected thickening and edema in the spinal cord and the cerebrospinal fluid analysis was within normal range. The case was diagnosed as a demyelinating disorder and treated with high-dose short-term steroids. Seventy-two hours later the patient showed severe paraparesis and nuclear magnetic resonance imaging revealed nodular lesions in the spinal cord. Histoplasma capsulatum belonging to the phylogenetic species LamB was isolated from cerebrospinal fluid samples. The patient received intravenous antifungal therapy with amphotericin B for 30 days, followed by oral fluconazole and itraconazole for one year. Three months after initiation of antifungal treatment, the cutaneous lesion recrudesced and Leishmania amastigotes were observed on microscopic examination. The cutaneous leishmaniasis was treated with intramuscular meglumine antimoniate. The patient´s outcome was favorable after treatment for both diseases.


Subject(s)
Humans , Male , Adolescent , Leishmaniasis, Cutaneous/complications , Central Nervous System Fungal Infections/complications , Histoplasmosis/complications , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/drug therapy , Central Nervous System Fungal Infections/diagnosis , Central Nervous System Fungal Infections/drug therapy , Histoplasmosis/diagnosis , Histoplasmosis/drug therapy , Immunocompetence , Anti-Bacterial Agents/administration & dosage , Antifungal Agents/administration & dosage
11.
An. bras. dermatol ; 94(3): 355-357, May-June 2019. graf
Article in English | LILACS | ID: biblio-1011111

ABSTRACT

Abstract: Pentavalent antimonials are the first-line drug treatment for American tegumentary leishmaniasis. We report on a patient with chronic renal failure on hemodialysis who presented with cutaneous lesions of leishmaniasis for four months. The patient was treated with intravenous meglumine under strict nephrological surveillance, but cardiotoxicity, acute pancreatitis, pancytopenia, and cardiogenic shock developed rapidly. Deficient renal clearance of meglumine antimoniate can result in severe toxicity, as observed in this case. These side effects are related to cumulative plasma levels of the drug. Therefore, second-line drugs like amphotericin B are a better choice for patients on dialysis.


Subject(s)
Humans , Male , Adult , Leishmaniasis, Cutaneous/complications , Leishmaniasis, Cutaneous/drug therapy , Renal Insufficiency, Chronic/complications , /adverse effects , Antiprotozoal Agents/adverse effects , Brazil , Amphotericin B/therapeutic use , Renal Dialysis , Leishmaniasis, Cutaneous/pathology , Drug-Related Side Effects and Adverse Reactions , Antiprotozoal Agents/therapeutic use
12.
An. bras. dermatol ; 94(1): 9-16, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-983744

ABSTRACT

Abstract: Disseminated leishmaniasis is a severe and emerging form of American tegumentary leishmaniasis. Disseminated leishmaniasis is defined by the presence of more than 10 polymorphic cutaneous lesions, distributed over more than two noncontiguous parts of the body. Nasal mucosal involvement is observed in almost half of cases. Disseminated leishmaniasis patients present with a decreased production of Th1 cytokines in the peripheral blood due to the attraction of leishmania- activated T cells to the multiple cutaneous lesions. Disseminated leishmaniasis development is poorly understood and is related to a complex network involving environmental, host immune response, and parasite factors, in which L. braziliensis polymorphism plays an important role. Disseminated leishmaniasis is a challenging disease to cure, presenting a high failure rate of 75% to pentavalent antimony therapy. Despite its importance and severity, this form of American tegumentary leishmaniasis has been poorly studied and documented, deserving greater attention from professionals working in endemic areas.


Subject(s)
Humans , Leishmania braziliensis , Leishmaniasis, Cutaneous/pathology , Leishmaniasis, Cutaneous/drug therapy , Amphotericin B/therapeutic use , Treatment Outcome , Leishmaniasis, Cutaneous/immunology , Antiprotozoal Agents/therapeutic use
13.
Rev. Soc. Bras. Med. Trop ; 52: e20180278, 2019. tab, graf
Article in English | LILACS | ID: biblio-1041586

ABSTRACT

Abstract INTRODUCTION: The promising non-clinical antileishmanial effects of gentian violet (GV) encouraged us to evaluate the additive effect of GV on cryotherapy. METHODS: For 8 weeks, 59/161 cutaneous leishmaniasis patients/lesions underwent cryotherapy alone (group 1) or cryotherapy accompanied by 1% GV application (group 2). The primary endpoint was clinical response. RESULTS: Ultimately, 54.7% and 45.3% of the significantly cured lesions belonged to groups 1 and 2, respectively, which was not statistically significant. The clinical response was significantly different between the two groups at the end of the fourth week. CONCLUSIONS: Although the clinical response of the two groups was significantly different at the end of the fourth week, application of GV did not increase the efficacy of cryotherapy.


Subject(s)
Humans , Male , Female , Adult , Leishmaniasis, Cutaneous/drug therapy , Cryotherapy/methods , Gentian Violet/administration & dosage , Anti-Infective Agents, Local/administration & dosage , Single-Blind Method , Pilot Projects , Follow-Up Studies , Treatment Outcome
14.
Rev. Soc. Bras. Med. Trop ; 52: e20180211, 2019. tab, graf
Article in English | LILACS | ID: biblio-1003136

ABSTRACT

Abstract Cutaneous leishmaniasis (CL) is a high-morbidity, vector-borne disease endemic to Colombia. Unlike conventional systemic antileishmanial therapy, intralesional meglumine antimoniate administration has fewer adverse effects and can be as effective and safe. We describe 12 patients treated with intralesional meglumine antimoniate: seven with primary and five with recurrent lesions. The majority (11/12) met all cure criteria after 1-7 sessions of meglumine antimoniate administration (1-5 mL). Adverse effects comprised mainly of local pain and edema. Intralesional meglumine antimoniate administration could be an excellent alternative treatment for uncomplicated CL; however, controlled clinical trials are needed to test the efficacy and safety thereof.


Subject(s)
Humans , Male , Female , Infant , Adult , Young Adult , Leishmaniasis, Cutaneous/drug therapy , Meglumine Antimoniate/administration & dosage , Antiprotozoal Agents/administration & dosage , Injections, Intralesional , Treatment Outcome
15.
Rev. Soc. Bras. Med. Trop ; 52: e20180323, 2019. graf
Article in English | LILACS | ID: biblio-1003132

ABSTRACT

Abstract We report the case of a 32-year-old man from Rio de Janeiro, who was infected in the Amazon region of Brazil by Leishmania (Viannia) naiffi. Generally, patients with L. naiffi cutaneous leishmaniasis exhibit a good therapeutic response to either pentavalent antimonials or pentamidine. However, after pentamidine treatment, this patient's infection evolved to therapeutic failure. To understand this clinical outcome, we investigated the presence of the Leishmania RNA virus (LRV) in parasites isolated from the cutaneous lesion; herein, we discuss the possible association between a poor response to pentamidine therapy and the presence of the LRV.


Subject(s)
Humans , Male , Adult , Pentamidine/therapeutic use , RNA Viruses/genetics , Trypanocidal Agents/therapeutic use , Leishmaniasis, Cutaneous/drug therapy , Leishmania/virology , Pentamidine/adverse effects , Trypanocidal Agents/adverse effects , Polymerase Chain Reaction , Treatment Failure
16.
Rev. Soc. Bras. Med. Trop ; 51(6): 769-780, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-977099

ABSTRACT

Abstract INTRODUCTION: Favorable responses in American tegumentary leishmaniasis (ATL) patients to treatment with 5 mg Sbv/kg/day meglumine antimoniate (MA) has been reported in Rio de Janeiro, but little is known regarding the therapeutic response to low doses in patients from other locations. METHODS: A retrospective review of medical records was conducted to compare the therapeutic response to 5 mg Sbv/kg/day MA treatment among 36 patients who acquired ATL in Brazilian states other than Rio de Janeiro (OS group) and 72 patients from Rio de Janeiro (RJ group). RESULTS: One course of 5 mg Sbv/kg/day MA cured 72.8% of 81 cutaneous (CL) and 66.6% of 27 mucosal (ML) leishmaniasis-infected patients: 70% in the CL/RJ group, 81% in the CL/OS group, 50% in the ML/RJ group, and 80% in the ML/OS group. After up to two additional treatment courses at the same dose, 88.9% and 85.2% of the CL and ML patients were cured, respectively. Adverse events were observed in 40% of patients in the CL/RJ group, 57% of the CL/OS group, 58% of the ML/RJ group, and 80% of the ML/OS group. No significant differences were observed in the cure rates or adverse effects between the RJ and OS groups. No patients required permanent discontinuation of treatment due to adverse events. CONCLUSIONS: Patients with ATL acquired in both RJ and OS may respond to low-dose MA. While high-dose MA should remain the standard treatment for ATL, low-dose MA might be preferred when toxicity is a primary concern.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Leishmaniasis, Cutaneous/drug therapy , Meglumine Antimoniate/therapeutic use , Antiprotozoal Agents/therapeutic use , Brazil , Retrospective Studies , Treatment Outcome , Leishmaniasis, Cutaneous/pathology , Geography , Middle Aged
17.
An. bras. dermatol ; 93(3): 347-355, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-949892

ABSTRACT

Abstract: BACKGROUND: Pentavalent antimonials remain as the standard drugs in the treatment of cutaneous leishmaniosis. The high cost, difficult administration, long treatment time, toxicity and increasing morbidity are factors that limit the use of these drugs. OBJECTIVES: To describe the response to radiofrequency thermotherapy in the treatment of localized cutaneous leishmaniasis in Brazil, and to evaluate its safety and tolerability. METHODS: We conducted a non-comparative open trial with a total of 15 patients confirmed to have cutaneous leishmaniasis on parasitological examination. A single radiofrequency thermotherapy session at 50ºC for 30 seconds was applied to the lesion and its edges. In patients with more than one lesion, only the largest one was treated initially. If after 30 days there was no evidence of healing, the smaller lesion was also treated with thermotherapy. Clinical cure was defined as visible healing for three months after treatment. The patients were followed-up for six months and there was no follow-up loss. RESULTS: Of all 23 lesions, only two evolved to complete healing without the need of treatment. Of 21 lesions, 18 (85.7%) achieved full healing. The main observed side effects were itching, burning sensation, pain and blisters. STUDY LIMITATIONS: Sample with a small number of patients and short follow-up. CONCLUSION: Thermotherapy can be considered a therapeutic alternative in localized cutaneous leishmaniasis, especially in cases of single cutaneous lesions and with formal contraindications to conventional treatment with pentavalent antimonials.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Leishmaniasis, Cutaneous/therapy , Hyperthermia, Induced/methods , Antiprotozoal Agents/therapeutic use , Radio Waves , Brazil , Drug Resistance , Confidence Intervals , Treatment Outcome , Leishmaniasis, Cutaneous/pathology , Leishmaniasis, Cutaneous/drug therapy , Controlled Before-After Studies , Hyperthermia, Induced/adverse effects , Hyperthermia, Induced/standards , Antiprotozoal Agents/adverse effects
18.
Mem. Inst. Oswaldo Cruz ; 113(2): 71-79, Feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-894896

ABSTRACT

BACKGROUND Despite its recognised toxicity, antimonial therapy continues to be the first-line drug for cutaneous leishmaniasis (CL) treatment. Intralesional administration of meglumine antimoniate (MA) represents an alternative that could reduce the systemic absorption of the drug and its side effects. OBJECTIVES This study aims to validate the standard operational procedure (SOP) for the intralesional infiltration of MA for CL therapy as the first step before the assessment of efficacy and safety related to the procedure. METHODS The SOP was created based on 21 trials retrieved from the literature, direct monitoring of the procedure and consultation with experts. This script was submitted to a formal computer-aided inspection to identify readability, clarity, omission, redundancy and unnecessary information (content validation). For criterion and construct validations, the influence of critical condition changes (compliance with the instructions and professional experience) on outcome conformity (saturation status achievement), tolerability (pain referred) and safety (bleeding) were assessed. FINDINGS The median procedure length was 12 minutes and in 72% of them, patients classified the pain as mild. The bleeding was also classified as mild in 96.6% of the procedures. Full compliance with the SOP was observed in 66% of infiltrations. Despite this, in 100% of the inspected procedures, lesion saturation was observed at the end of infiltration, which means that it tolerates some degree of modification in its execution (robustness) without prejudice to the result. CONCLUSIONS The procedure is reproducible and can be used by professionals without previous training with high success and safety rates.


Subject(s)
Humans , Injections, Intralesional/adverse effects , Leishmaniasis, Cutaneous/drug therapy , Meglumine , Antiprotozoal Agents/administration & dosage , Clinical Protocols/standards , Reproducibility of Results
19.
Bol. latinoam. Caribe plantas med. aromát ; 17(1): 68-83, ene. 2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-915131

ABSTRACT

Los aceites esenciales (AEs), pertenecientes al género Lippia, son candidatos interesantes de formulaciones tópicas en el tratamiento de la leishmaniasis cutánea (LC). El objetivo de este trabajo fue determinar el perfil toxicológico y la actividad anti-Leishmania de AEs obtenidos de plantas colombianas del género Lippia. Ratones BALB/c fueron tratados tópica u oralmente con AEs obtenidos de L. alba quimiotipo citral (AE1) y de L. origanoides quimiotipos timol (AE2), carvacrol (AE3) y felandreno (AE4). El efecto del tratamiento en la irritación de la piel, la toxicidad aguda oral, la genotoxicidad (prueba cometa y micronúcleos), los cambios en la función hepática y renal, la inducción de reacción de hipersensibilidad de contacto y en la actividad contra L. (V) panamensis y L. (V.) braziliensis fueron determinados. Todos los AEs presentaron un perfil toxicológico similar a los parámetros normales, exceptuando los aceites AE2 y AE3 los cuales fueron irritantes y presentaron algunos signos de toxicidad aguda oral al ser utilizados en altas concentraciones (concentraciones bajas no fueron tóxicas). El AE2 mostró actividad antiparasitaria en las formas parasitarias evaluadas. Concentraciones bajas de los AEs podrían utilizarse de forma segura como componentes de formulaciones farmacológicas en LC.


Essential oils (EOs) belonging to the genus Lippia are interesting candidates in pharmaceutical systems for cutaneous leishmaniasis (CL). The aim of this work was to determine both toxicological and antileishmanial activities of EOs obtained from different species of Lippia, a widely distributed Colombian plants. BALB/c mice were treated topically or orally with EOs obtained from L. alba citral chemotype (EO1) and L. origanoides thymol (EO2), carvacrol (EO3) and phellandrene (EO4) chemotypes. The skin irritation, oral acute toxicity, genotoxicity (comet assay and micronucleus test), liver and renal adverse effects, All the EOs showed a toxicological profile similar to the normal parameters, except for oils EO2 and EO3 which were irritant and showed some signs of acute oral toxicity at high concentrations (low concentration were safe). The EO2 showed antiparasitic activity. Low concentrations of the EO could be used safely as components of pharmacological formulations in CL.


Subject(s)
Animals , Female , Mice , Oils, Volatile/pharmacology , Leishmaniasis, Cutaneous/drug therapy , Lippia/chemistry , Leishmania/drug effects , Antiprotozoal Agents/pharmacology , Oils, Volatile/adverse effects , Colombia , Comet Assay , Dermatitis, Contact/etiology , Genotoxicity , Mice, Inbred BALB C , Antiprotozoal Agents/adverse effects
20.
Rev. chil. infectol ; 35(5): 612-616, 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-978078

ABSTRACT

Resumen La leishmaniasis es una infección producida por protozoos del género Leishmania, transmitida por insectos hematófagos. La forma de presentación más frecuente es la leishmaniasis cutánea (LC), en la cual se observan úlceras crónicas e indoloras, usualmente localizadas en el sitio de la picadura del insecto. El diagnóstico y tratamiento de esta enfermedad son especialmente desafiantes en zonas no endémicas como nuestro país, requiriendo el uso de diversas técnicas de laboratorio y el apoyo de expertos. Se reporta el caso clínico importado de un varón de 42 años con LC causada por L. braziliensis con respuesta exitosa al tratamiento con anfotericina B liposomal.


Leishmaniasis is an infection caused by protozoa of the genus Leishmania sp. and transmitted by sandfly vectors. Cutaneous leishmaniasis (CL) is the most frequent form of presentation. Clinically, chronic and painless ulcers are observed, which usually occur at the site of the sandfly bite. The diagnosis and treatment of this disease is specially challenging in non-endemic countries such as Chile, requiring the use of diverse laboratory techniques as well as the support of expert physicians. Herein we report an imported case of a healthy 42-year-old male with CL caused by L. braziliensis with successful response to liposomal amphotericin B.


Subject(s)
Humans , Male , Adult , Amphotericin B/therapeutic use , Leishmaniasis, Cutaneous/drug therapy , Antiprotozoal Agents/therapeutic use , Treatment Outcome
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