Leishmaniosis tegumentaria americana: efectividad del antimoniato de meglumina en series terapéuticas de 10 días / American tegumentary leishmaniasis: effectiveness of meglumine antimoniate in 10-day treatment series

RESUMEN

La leishmaniosis tegumentaria americana es un problema de salud en el medio rural venezolano. La Cátedra de Medicina Tropical (UCV) y el Hospital Universitario de Caracas reciben pacientes con diagnóstico presuntivo, se realiza el diagnóstico de certeza y son tratados ambulatoria u hospitalariamente con antimoniato de meglumina en series terapéuticas de 10 días, a dosis de 3 000 mg/día a 4 500 mg/día. Se evalúan los resultados de 221 pacientes, la mayoría adultos masculinos, con úlcera única en miembros inferiores, procedentes del medio rural del Estado Miranda. Predominó la variedad cutánea localizada, seguida de la cutáneo mucosa con 4 pacientes y cutáneo difusa con 3. Hubo cicatrización de las úlceras y desaparición de los nódulos cutáneos, excepto en 1 paciente (0,3 por ciento) que requirió anfotericina B por falla terapéutica. En el estudio participan estudiantes del curso regular de la cátedra, integrantes del programa docencia en medicina tropical basada en publicaciones periódicas

ABSTRACT

American tegumentary leishmaniasis (ATL) is a health problem in the rural areas of Venezuela. Patients are referred to the Tropical Medicine Department (UCV) and to the University Hospital of Caracas with presumptive diagnosis of the disease, are studied to confirm the diagnosis and treated with antimoniate of meglumine in 10 days course at dose of 3 000 mg./day to 4 500 mg./day according to complications as outpatients or hospitalized. We report the results of 221 patients treated, mostly male adults from the rural area of the Miranda state with a sole ulcer in the limbs. Among the clinical presentation the cutaneous-localized form was predominating, followed by the localized muco-cutaneous with 4 and cutaneous-diffuse variety with 3. They responded with healing of the ulcers and disappearance of skin nodules, except one (0.3 percent) who required anfotericine B due to lack of response to meglumine therapy. In this investigation there was the participation of students from the Tropical Medicine course learning based on periodic publications with students