The treatment with Glucantime was responsible by ARF diagnosed in this patient. The previous urine osmolarity and serum creatinine levels were normal and the autopsy showed ATN. It should be pointed out if ARF may also be explained by massive deposits of immunocomplexes by leishmania antibodies and antigens due to the antigenic break by the antimonial compound, since our patient presented countless lesions covering the entire tegument, similar to the Hexheimer phenomenon, but at the autopsy no glomerular alterations were seen.
The present study was undertaken after the detection of one case of cutaneous leishmaniasis with presumed infection in one of the three remaining wooded areas in the urban area of the city of Maringá, Southern Brazil; also in view of the lack of knowledge about sand flies and their behavior. From June to September, 1995, sand flies were caught with Falcão traps during the night in the remaining wooded areas (Parque do Ingá, Bosque Dois and Horto Florestal). A total of 2,907 sand flies were caught in Parque do Ingá; 1,723 of them were aught in forest traps and 1,184 in wild animal shelter traps at the zoo. The results show that Lutzomyia whitmani is better adapted to the three areas under study and that it frequently occurs in wild animal shelters within the urban perimeter of Maringá.
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