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Leishmaniasis and fluconazol

Andrea Michelerio, Stefania Barruscotti, Grazia Bossi, Valeria Brazzelli
BACKGROUND: Cutaneous leishmaniasis has an incidence of 0.7-1.2 million cases per year and represents a growing concern in the outpatient dermatologic practice in Europe because of imported cases due to increased travel to risk areas and to immigration phenomena. When dealing with children, the treatment can be challenging because of side effects and pain of classic antimonial therapy leading to poor rates of course completion and requirement of sedation for several children. METHODS: We retrospectively studied three cases of cutaneous leishmaniasis in pediatric patients, between the ages of 3 and 6 years of age, treated with oral fluconazole...
March 26, 2018: Pediatric Dermatology
Vincent Mosimann, Andreas Neumayr, Daniel H Paris, Johannes Blum
Old World cutaneous and mucosal leishmaniasis is a potentially serious disease. Systemic treatment approaches with pentavalent antimonials, liposomal amphotericin B, fluconazole and miltefosine are increasingly used despite the absence of supportive evidence - to date, no prospective clinical trials have been conducted for systemic treatment of these diseases. We performed a literature search to delineate the contemporary evidence for the use of liposomal amphotericin B, and found that although cure rates of 17/20 (85%) were achieved in immune competent patients with Old World cutaneous leishmaniasis and cure rates of 10/13 (77%) for Old World mucosal leishmaniasis due to L...
June 2018: Acta Tropica
Valeska Albuquerque Francesconi, Fabio Francesconi, Rajendranath Ramasawmy, Gustavo Adolfo Sierra Romero, Maria das Graças Costa Alecrim
BACKGROUND: The treatment of Leishmaniasis caused by Leishmania (Viannia) guyanensis is based on a weak strength of evidence from very few clinical trials and some case series reports. Current treatment guidelines recommend pentamidine isethionate or meglumine antimoniate (Glucantime) as the first-line choices. Both are parenteral drugs with a low therapeutic indexes leading to a high risk of undesired effects. Imidazole derivatives interfere with the production of leishmanial ergosterol, an essential component of their membrane structure...
February 2018: PLoS Neglected Tropical Diseases
M Zargaran, M Fatahinia, A Zarei Mahmoudabadi
Background and Purpose: Ozone is an inorganic molecule with effective antimicrobial properties. Clinical treatment of ozonated water was used for the elimination of Candida albicans , Enterococcus faecalis , endotoxins, and biofilms from root canals. In addition, its therapeutic effects for tinea pedis, ulcers, and leishmaniasis were investigated. The purpose of the present study was to evaluate the fungicidal effects of ozone on different forms of C. albicans . In addition, antifungal susceptibility profile of strains was assessed before and after exposure to ozone...
June 2017: Advances in Medical Mycology (Iran)
Elalouani Elmehdi, Bachar Zerkly
Leishmaniases are parasitic diseases occurring in endemic tropical and subtropical areas and caused by protozoa of the genus leishmania, transmitted by a diptera (sand fly). We here report a case of topical cutaneous leishmaniasis discovered in a 15-year old boy with painless ulcer on his left leg, who had been staying in South Africa. Clinical examination showed painless non-itchy ulcer, occurred 1 month before, on the antero-internal part of his left leg with crusts and scars caused by insect bites, all evolving in a context of patient's general health status, without mucosal or visceral lesions...
2017: Pan African Medical Journal
April C Joice, Sihyung Yang, Abdelbasset A Farahat, Heidi Meeds, Mei Feng, Junan Li, David W Boykin, Michael Zhuo Wang, Karl A Werbovetz
Given the limitations of current antileishmanial drugs and the utility of oral combination therapy for other infections, developing an oral combination against visceral leishmaniasis should be a high priority. In vitro combination studies with DB766 and antifungal azoles against intracellular Leishmania donovani showed that posaconazole and ketoconazole, but not fluconazole, enhanced DB766 potency. Pharmacokinetic analysis of DB766-azole combinations in uninfected Swiss Webster mice revealed that DB766 exposure was increased by higher posaconazole and ketoconazole doses, while DB766 decreased ketoconazole exposure...
January 2018: Antimicrobial Agents and Chemotherapy
Endi Lanza Galvão, Ana Rabello, Gláucia Fernandes Cota
BACKGROUND: Several controlled and uncontrolled studies addressing azole antifungal drugs for cutaneous and mucosal leishmaniasis have been published with inconclusive results. We conducted a systematic literature review of studies evaluating the efficacy and toxicity associated with azole therapy for tegumentary leishmaniasis. METHODOLOGY: PRISMA guidelines for systematic reviews and the Cochrane manual were followed, and the review methodology was registered (PROSPERO; CRD42016048668)...
2017: PloS One
Kelly Laurent, Jason Susong, Eric Fillman, Simon Ritchie
BACKGROUND: Leishmaniasis is a common parasitic disease seen in many parts of the world, especially in areas where current U.S. and international forces are deployed. Approximately 350 million people are thought to be at risk of cutaneous leishmaniasis (CL) with an annual incidence of 1.5 million cases. Over 90% of cutaneous infections with Leishmania occur in the Middle East, Brazil, and Peru. Outbreaks of CL may occur in military personnel deployed to endemic areas. Since the incubation period for symptomatic CL ranges from weeks to months, symptoms may not appear until well after returning to the United States...
July 2017: Military Medicine
Marine Ginouvès, Stéphane Simon, Mathieu Nacher, Magalie Demar, Bernard Carme, Pierre Couppié, Ghislaine Prévot
AbstractAnti-leishmaniasis drug resistance is a common problem worldwide. The aim of this study was to inventory the general in vitro level of sensitivity of Leishmania isolates circulating in French Guiana and to highlight potential in vitro pentamidine-resistant isolates. This sensitivity study was conducted on 36 patient-promastigote isolates for seven drugs (amphotericin B, azithromycin, fluconazole, meglumine antimoniate, miltefosine, paromomycin, and pentamidine) using the Cell Counting Kit-8 viability test...
May 2017: American Journal of Tropical Medicine and Hygiene
Fernanda V de O Prates, Mayra E F Dourado, Silvana C Silva, Albert Schriefer, Luiz H Guimarães, Maria das Graças O Brito, Juliana Almeida, Edgar M Carvalho, Paulo R L Machado
BACKGROUND:  The treatment of cutaneous leishmaniasis (CL) caused by Leishmania braziliensis in Brazil with pentavalent antimony (Sbv ) is associated with a high rate of failure, up to 45% of cases. In addition, Sbv can only administered parenterally and has important toxic effect. An effective, safe, and oral treatment for CL is required. METHODS:  A randomized controlled clinical trial was conducted to compare the efficacy and safety of high-dosage oral fluconazole (6...
January 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Anila Chacko, Marissa Joseph, Timothy Feltis, Shaun K Morris
It is challenging to find safe, nonscarring and noninvasive treatment of facial cutaneous leishmaniasis (CL) in children. Herein, we report a child with CL from a region endemic for Leishmania tropica, whose lesion persisted after treatment with oral fluconazole but responded to topical paromomycin. Paromomycin should be considered early for treatment of Old World CL and is a well-tolerated and effective mode of therapy for facial lesions.
October 5, 2016: American Journal of Tropical Medicine and Hygiene
Anastácio Queiroz Sousa, Margarida M Lima Pompeu, Richard D Pearson
No abstract text is available yet for this article.
January 2016: American Journal of Tropical Medicine and Hygiene
Gamze Serarslan, Metin Aksakal
Cutaneous leishmaniasis is a protozoan infectious disease and widespread in Mediterranean basin including Turkey. Lesions usually start with erythematous papules, gradually enlarges and afterwards it ulcerates. We present a 12-year-old boy with diffuse persistent lip swelling mimicking granulomatous cheilitis. Systemic glucantime was started. However, severe hypotension and bradycardia was developed after injection. Oral fluconazole was started and the lesion resolved completely. Cutaneous leishmaniasis can have varied clinical manifestations and should be suspected especially in endemic areas...
2015: Annals of Parasitology
Özlem Ekiz, Emine Nur Rifaioǧlu, Bilge Bülbül Şen, Gülnaz Çulha, Tümay Özgür, Asena Çiǧdem Doǧramaci
Leishmaniasis recidiva cutis (LRC) is an unusual form of acute cutaneous leishmaniasis. Herein, we present a case of LRC of the lips mimicking granulomatous cheilitis. An 8-year-old, Syrian child admitted with a swelling and disfigurement of his lips for 4 years. Abundant intra and extracellular Leishmania amastigotes were determined in the smear prepared from the lesion with Giemsa stain. Histopathology showed foamy histiocytes and leishmania parasites within the cytoplasm of macrophages in the epidermis and a dense dermal mixed type inflammatory cell infiltrate composed of lymphocytes, foamy histiocytes with multinucleated giant cells...
March 2015: Indian Journal of Dermatology
Daniel P Eiras, Laura A Kirkman, Henry W Murray
Leishmaniasis, a protozoal infection transmitted by sandfly bite, produces a clinical spectrum of disease ranging from asymptomatic infection to ulcerative skin and mucosal lesions to visceral involvement. Leishmaniasis is endemic in regions of Africa, the Middle East, south Asia, southern Europe, northern South America, and Central America. There has been an increase in imported leishmaniasis into developed, non-endemic countries due to increasing global travel. While pentavalent antimonials have been the mainstay of antileishmanial treatment for decades, newer therapeutic options have become available for all forms of infection, including liposomal amphotericin B, miltefosine, fluconazole, and ketoconazole...
March 1, 2015: Current Treatment Options in Infectious Diseases
Wajihullah Khan, Haytham A Zakai
BACKGROUND: Cutaneous leishmaniasis is an annoying and disfiguring disease affecting around 1,500,000 individuals globally. There are endemic pockets of this disease in Taif region. In some patients, lesion often weeps and leads to scar formation. The study was conducted to see the efficacy of fluconazole and itraconazole in the patients of cutaneous leishmaniasis and the effect of these drugs on liver enzymes and kidney markers. METHODS: Positivity of Leishmania was recorded by microscopic examinations of smears...
September 2014: Iranian Journal of Parasitology
Marcela Brito Oliveira, Giovana Calixto, Márcia Graminha, Hugo Cerecetto, Mercedes González, Marlus Chorilli
Cutaneous leishmaniasis (CL) is a resistant form of leishmaniasis that is caused by a parasite belonging to the genus Leishmania. FLU-loaded microemulsions (MEs) were developed by phase diagram for topical administration of fluconazole (FLU) as prominent alternative to combat CL. Three MEs called F1, F2, and F3 (F1-60% 50 M phosphate buffer at pH 7.4 (PB) as aqueous phase, 10% cholesterol (CHO) as oil phase, and 30% soy phosphatidylcholine/oil polyoxyl-60 hydrogenated castor oil/sodium oleate (3/8/6) (S) as surfactant; F2-50% PB, 10% CHO, and 40% S; F3-40% PB, 10% CHO, and 50 % S) were characterized by droplet size analysis, zeta potential analysis, X-ray diffraction, continuous flow, texture profile analysis, and in vitro bioadhesion...
2015: BioMed Research International
Anny Fortin, Diana P Caridha, Susan Leed, Franklyn Ngundam, Jenell Sena, Tom Bosschaerts, Sandi Parriott, Mark R Hickman, Thomas H Hudson, Max Grogl
BACKGROUND: Cutaneous leishmaniasis (CL) represents a range of skin diseases caused by infection with Leishmania parasites and associated with tissue inflammation and skin ulceration. CL is clinically widespread in both the Old and New World but lacks treatments that are well tolerated, effective and inexpensive. Oleylphosphocholine (OlPC) is a new orally bioavailable drug of the alkylphosphocholine family with potent antileishmanial activity against a broad range of Leishmania species/strains...
September 2014: PLoS Neglected Tropical Diseases
Olivier Aerts, Nathalie Duchateau, Peter Willemse, Julien Lambert
We report the successful treatment of cutaneous leishmaniasis in a 6-year-old girl who presented with a solitary lesion on the cheek. A low dose of 3 mg/kg/day of fluconazole was used, with remarkable improvement at 6 weeks and complete regression at 12 weeks, excellent cosmetic results, and no relapse during a follow-up of 1 year.
January 2015: Pediatric Dermatology
K Daly, H De Lima, H Kato, E M Sordillo, J Convit, O Reyes-Jaimes, O Zerpa, A E Paniz-Mondolfi
American cutaneous leishmaniasis is an endemic anthropozoonosis that exhibits a broad spectrum of clinical presentations. Intermediate/borderline disseminated cutaneous leishmaniasis is a distinct clinical condition that comprises cutaneous disease of a chronic nature, usually occurring as multiple lesions with or without mucosal involvement. The disease is usually caused by parasites of the subgenus Viannia, frequently occurs in context of an underlying disease, and is often resistant to standard antileishmanial therapy...
August 2014: Clinical and Experimental Dermatology
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