ABSTRACT
BACKGROUND: Studies assessing the efficacy of liposomal amphotericin B (LAB) in the treatment of patients with mucosal leishmaniasis (ML) are very scarce in the literature and an optimal dose regimen has not yet been defined. METHODS: We performed a retrospective and descriptive analysis from records of 16 patients with ML treated with LAB. The mean daily dose of LAB was 2.5 mg/kg/day. RESULTS: Healing of the lesion was observed in 14 (88%) of the 16 patients. The mean cumulative doses, excluding the two treatment failures, were 2265 mg and 33 mg/kg. CONCLUSION: Liposomal amphotericin B in the cumulative dose of 30 to 35 mg/kg was able to achieve 100% effectiveness.
Subject(s)
Amphotericin B/therapeutic use , Antiprotozoal Agents/therapeutic use , Leishmaniasis, Mucocutaneous/drug therapy , Adult , Aged , Aged, 80 and over , Dose-Response Relationship, Drug , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Liposomal amphotericin B has been used as an alternative treatment of mucosal leishmaniasis, but the optimal dose is not established. We retrospectively reviewed the clinical outcome of eight patients with mucosal leishmaniasis treated with liposomal amphotericin B. The mean total dose was 35 mg/kg (range 24-50 mg/kg), which resulted in the healing of all the lesions in all patients and no recurrences were observed during the follow-up period (mean 25 months; range 7-40 months).
Subject(s)
Amphotericin B/administration & dosage , Amphotericin B/therapeutic use , Leishmaniasis, Mucocutaneous/drug therapy , Adult , Aged , Dose-Response Relationship, Drug , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Studies evaluating radiologic aspects, local complications, and structural alterations of the paranasal sinus in patients with mucosal leishmaniasis (ML) are lacking. The aim of this study was to analyze alterations of the paranasal sinuses in patients with ML by using computed tomography (CT) scans. This prospective study evaluated 26 patients in Brazil with ML from December 2008 through June 2009. All patients underwent CT scans of the paranasal sinuses. Paranasal thickening was observed in 25 patients (96%). Nasal perforation was observed in 17 patients (65%). Those patients who received re-treatment showed more abnormalities on CT scan than cured patients (P < 0.05). Complications of ML are not limited to the nasal mucosa but extend to the paranasal sinuses. Mucosal thickening, opacified air cells, bony remodeling, and bony thickening caused by inflammatory osteitis of the sinus cavity walls are CT findings suggestive of chronic sinusitis.
