A first case of cutaneous leishmaniasis due to Leishmania (Viannia) lainsoni in Bolivia

Abstract

Clinical response to supervised treatment of Colombian patients with cutaneous leishmaniasis was evaluated in a randomized controlled trial comparing 10 days versus 20 days of treatment with meglumine antimonate (20 mg Sb/kg/day). Masked examiners evaluated clinical response defined as 100% re-epithelialization of all lesions at 13 weeks and no relapses during 52 weeks of follow-up. The efficacy of meglumine antimonate for 10 days' treatment was 61% (28 of 46) compared to 67% (24 of 36) for 20 days. There was a significantly lower clinical response for children 5 years in both 10-day (11%) and 20-day (25%) groups compared to patients aged 5-14 years (67% and 75%, respectively) and 15 years or more (81% and 83%, respectively). Overall efficacy of treatment schedules was comparable, but lower than expected, mainly because of low efficacy in children. Pathogenicity of infection and pharmacokinetics may affect the treatment response in children. New therapeutic alternatives should be evaluated in trials that include children and women.

Simultaneous Infection with Leishmania (Viannia) braziliensis and L. (V.) lainsoni in a Peruvian Patient with Cutaneous Leishmaniasis

“…[27][28][29] Thus, this case adds to the scientific literature regarding the epidemiology of this protozoan parasite.…”

“…Leishmania (V.) lainsoni is known to exist in the Brazilian Amazon region, 27 the Department of La Paz, Bolivia, 28 and the sub-Andean or high jungle regions of Peru. 1,29 Although the preferred vector of L. (V.) lainsoni, Lutzomyia ubiquitalis, has been found in Madre de Dios, 27 this report is the first documented case of probable human infection occurring from this region.…”

Human mixed infections of Leishmania spp. and Leishmania-Trypanosoma cruzi in a sub Andean Bolivian area: identification by polymerase chain reaction/hybridization and isoenzyme

“…Recently, patient infection caused by Leishmania (V.) lainsoni has been described (Martinez et al 2001, Bastrenta et al 2002.…”

Leishmaniases in Bolivia: Comprehensive Review and Current Status

“…In Bolivia, CL is mostly caused by L. (Viannia) braziliensis (up to 85% cases), [16][17][18][19][20][21][22][23][24][25] L. (Leishmania) amazonensis, 24,26 and L. (V.) lainsoni 22,[27][28][29] ; recently, some cases have also been found to be caused by L. (V.) guyanensis ( Table 1 ). 22 All parasite isolates that have been characterized to species have primarily been reported in the north, center, and east of the country (i.e., Departments of La Paz, Beni, Pando, Santa Cruz, and Cochabamba) ( Figure 1 ).…”

“…22 All parasite isolates that have been characterized to species have primarily been reported in the north, center, and east of the country (i.e., Departments of La Paz, Beni, Pando, Santa Cruz, and Cochabamba) ( Figure 1 ). [16][17][18][19][20][21][22][23][24][25][26][27][28][29] Leishmania (L.) infantum , the causative agent of VL, was isolated from or detected in patients, [31][32][33] dogs, 34,35 and the insect vector Lutzomyia longipalpis 36 in the Yungas region in the Department of La Paz. To our knowledge, VL remains rare in Bolivia and is restricted to this unique focus in the Yungas region in the Beni department, where the first autochthonous case was diagnosed in 1984.…”