Complex cutaneous leishmaniasis in a pediatric patient.

Cutaneous leishmaniasis (CL), a parasitic infection caused by Leishmania protozoa and transmitted by sandfly bites, can be classified into Old World and New World subtypes. We report a case of a 2-year-old female who developed complex CL after travel to Panama. Ultimately, successful treatment required two rounds of liposomal amphotericin B. We report this case for its challenging clinical course and management.

Diagnóstico Parasitológico de la Leishmaniasis Tegumentaria Americana

La demostración directa o indirecta de Leishmania en las muestras patológicas continúa siendo un importante desafío en el diagnóstico parasitológico de esta protozoosis. A pesar de los avances significativos surgidos en investigaciones de biología molecular, muchas de sus técnicas con potencial aplicación diagnóstica, continúan siendo solamente herramientas de los laboratorios de investigación científica. Pocas de ellas se encuentran en fase de valorización clínica y epidemiológica en áreas endémicas, y quizás, de manera optimista, muy pocas estarían a disposición de los laboratorios de diagnóstico de salud pública en la próxima década. Mientras tanto, seguiremos contando con el auxilio de los llamados métodos clásicos de la Parasitología básica que todavía, en las manos de individuos experimentados, diagnostican la gran mayoría de los casos. Este artículo identifica los métodos recomendados por los especialistas del tema, describe los procedimientos consagrados por su sensibilidad y reproductibilidad, concluyendo que éstos continuarán vigentes, siempre que sean correctamente ejecutados.

Direct or indirect demonstration of Leishmania in pathological samples still constitutes a critical challenge when it comes to the parasitological diagnosis of this protozoose. In spite of significant and novel advances in the field of molecular biology of Leishmania, many of the techniques with a real potential diagnostic application, still continue to be the tools for laboratory scientific investigation. Few methods are in the stage of clinical and epidemiological application in endemic areas. Being optimistic, very few techniques would be available at public health laboratories in the next decade in developing countries, where these parasites are prevalent. Meanwhile, we will have to continue to rely on the so called classical methods of Basic Protozoology, which under the supervision of experienced professionals will provide a diagnosis for the great majority of the cases. This overview identifies the methods recommended by experts in this field, it also describes the procedures widely recognized by its sensitiveness and reproducibility, and it demonstrates that these methods will continue to be used if they are appropriately performed.