[Open therapeutic study with aminosidine sulfate in mucosal leishmaniasis caused by Leishmania (Viannia) braziliensis]. / Estudo terapêutico aberto com sulfato de aminosidine na leishmaniose mucosa causada por Leishmania (Viannia) braziliensis.

From September to November 1994. 21 patients with active mucosal leishmaniasis were treated with aminosidine sulphate 16 mg/kg/day by intramuscular injection for 20 days. They were principally adult male agricultural workers. Thirteen patients had not received specific treatment and eight had failed to respond to Glucantime therapy. Diagnosis was based on clinical and epidemiological observations, a search for the parasite, leishmanin skin sensitivity and indirect fluorescent antibody serological tests. Sixty seven percent of patients had leishmania parasites isolated from inoculated hamsters or visualized in imprints or histopathological sections. The mean follow-up period was 12.6 months. All patients completed treatment. Side effects were pain at the injection site (86%); mild proteinuria (24%), elevated serum creatinine (.5%) and subclinical bearing loss in one of two patients who did audiometric tests. Clinical cure was achieved in 48% and the accumulated relapse rate was 29% (4/14).

[Comparative study of meglumine antimoniate, pentamidine isethionate and aminosidine sulfate in the treatment of primary skin lesions caused by Leishmania (Viannia) braziliensis]. / Estudo comparativo entre antimoniato de meglumina, isotianato de pentamidina e sulfato de aminosidine, no tratamento de lesões cutâneas primárias causadas por Leishmania (Viannia) braziliensis.

With the aim of comparing the therapeutic efficacy, tolerability and toxicity of meglumine antimoniate, aminosidine sulphate and pentamidine isethionate, a field study was conducted on randomized treatment of patients with primary cutaneous leishmaniasis due to Leishmania (Viannia) braziliensis (L(V)b), in Corte de Pedra, BA, from October 1992 up to January 1993. Forty six patients were treated and distributed into three groups, two with 15 and one with 16 subjects. All patients were submitted to clinical examination, histopathological and immunological investigations, as diagnostic criterium. All patients were treated by intramuscular route. Group 1 received pentamidine 4 mg/kg/every 2 days, for 8 applications; Group 2 received aminosidine 20 mg/kg/day, for 20 days, and Group 3 received meglumine 10 mg Sbv/kg/day, for 20 days. Failure of therapy was defined as ulceration of the skin lesion four months after treatment. Such failure occurred in five cases as follows: two cases in patients of group 1 one case in patients of group 2, and two cases in group 3, after the first year of follow up. In the evaluation after three years we reviewed fifteen patients, five in each group; except for one in Group 3, all of them were cured. Statistical significance of the results between the three schedules used was not verified.

[An evolutionary study of mucosal leishmaniasis (a 7- to 17-year follow-up) due to Leishmania (Viannia) braziliensis in Tres Braços, Bahia]. / Estudo evolutivo da leishmaniose mucosa (7 a 17 anos de seguimento) causada por Leishmania (Viannia) braziliensis em Três Braços, Bahia.

Seventy seven (68%) patients with mucosal leishmaniasis recorded during the period 1976-1986 in the region of Três Braços, Bahia were traced and re-evaluated clinically, diagnostically and therapeutically. Sixty-five patients were alive. The families of 12 dead patients were interviewed about probable cause of death. The 65 patients had a fresh clinical examination supplemented when necessary by a skilled ENT examination. All had a titre of circulating immunofluorescent antibodies estimated at the time. Eight patients with active mucosal lesions had triturated biopsies which were cultivated in NNN medium and inoculated in hamsters to attempt to recover Leishmania. The isolates were identified by monoclonal antibodies as Leishmania (Viannia) braziliensis. Fifty-six (86%) patients were judged clinically cured. Nine (13%) had active lesions. Of the 12 patients who died 5 (41%) had no signs of activity at death. Mucosal leishmaniasis was thought to be the direct cause of death in 3 patients. The field treatment programme at Três Braços has managed to clinically cure 61 patients (79%) during 17 years. Follow-up periods were a mean of 10 years (range 7-17).