Cutaneous leishmaniasis in soldiers returning from deployment to Iraq

Pehoushek, James F.; Quinn, David M.; Crum, William P.

doi:10.1016/j.jaad.2004.06.018

Cited by 18 publications

(10 citation statements)

References 4 publications

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“…[10] The demonstration of plasma cells and Leishmania donovani inside macrophages in the dermis by histopathological examination is another diagnostic tool often employed. [11] In our case, the amastigote form of the parasite was seen in the Giemsa smear and the promastigote form was seen in the culture medium.…”

Section: Discussion Discussionmentioning

confidence: 46%

Ulcerative penile Leishmaniasis in a child

Yeşilova

Turan

Sürücü

et al. 2014

Indian J Dermatol Venereol Leprol

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Penile ulcers may be caused by several different agents. Rarely, cutaneous leishmaniasis may also be accompanied by penile ulcers. We report a five-year-old boy with who had an ulcer on the glans penis. Smears from the ulcer demonstrated amastigotes, biopsy showed histopathological features of leishmaniasis and Leishmania was grown in culture. Treatment with meglumine antimoniate injections led to improvement.

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Section: Discussion Discussionmentioning

confidence: 46%

Ulcerative penile Leishmaniasis in a child

Yeşilova

Turan

Sürücü

et al. 2014

Indian J Dermatol Venereol Leprol

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“…U.S. military personnel deployed to Afghanistan and Iraq in support of Operations Enduring Freedom and Iraqi Freedom are particularly at risk, with infection rates as high as 2.3% (15). Treatment often requires transport to Brook Army Medical Center or Water Reed Army Medical Center for a 10-to 20-day course of Pentostam, with effects ranging from mild rash and myalgia to more severe chemical pancreatitis (23).…”

Section: Discussionmentioning

confidence: 99%

Novel Compounds Active against Leishmania major

George

Bishop

Titus

et al. 2006

Antimicrob Agents Chemother

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Leishmania major is an important trypanosomatid pathogen that causes leishmaniasis, which is a serious disease in much of the Old World. Current treatments include a small number of antimony compounds that, while somewhat effective, are limited by serious side effects. We have screened a small portion of a unique chemical library and have found at least three novel compounds that are effective against L. tarentolae and L. major in vitro and in a murine macrophage model of L. major infection. These compounds were effective in both assays at doses significantly lower than those of sodium stibogluconate (Pentostam) and represent possible candidates for drug development.

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“…It is estimated that the incidence of CL ranges from 0.7 million to 1.2 million cases annually (2). In the United States, CL has been found in southern Texas along the Mexican border (3) and in travelers returning from areas of endemicity (4). In the U.S. military, more than 3,100 cases of CL have been parasitologically confirmed since April 2003 at the Leishmania Diagnostics Laboratory at the Walter Reed Army Institute of Research.…”

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confidence: 99%

Pharmacokinetics and Absorption of Paromomycin and Gentamicin from Topical Creams Used To Treat Cutaneous Leishmaniasis

Ravis

Llanos-Cuentas

Sosa

et al. 2013

Antimicrob Agents Chemother

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This study evaluated the pharmacokinetics of topical creams containing 15% paromomycin ("paromomycin alone") and 15% paromomycin plus 0.5% gentamicin (WR 279,396) in patients with cutaneous leishmaniasis. The investigational creams were applied topically to all lesions once daily for 20 days. Plasma samples were analyzed for simultaneous quantitation of paromomycin and gentamicin isomers and total gentamicin. Pharmacokinetic parameters for gentamicin could not be calculated because detectable levels were rarely evident. After one application, the paromomycin area under the concentration-time curve from 0 to 24 h (AUC 0 -24 ) was 2,180 ؎ 2,621 ng · h/ml (mean ؎ standard deviation [SD]) for the paromomycin-alone group and 975.6 ؎ 1,078 ng · h/ml for the WR 279,396 group. After 20 days of application, the paromomycin AUC 0 -24 and maximum concentration of drug (C max ) were 5 to 6 times greater than those on day 1 for both treatment groups. For the paromomycin-alone group, the AUC 0 -24 was 8,575 ؎ 7,268 ng · h/ml and the C max was 1,000 ؎ 750 ng/ml, compared with 6,037 ؎ 3,956 ng · h/ml and 660 ؎ 486 ng/ml for the WR 279,396 group, respectively. Possibly due to large intersubject variability, no differences (P > 0.05) in the AUC 0 -24 or C max were noted between treatment or between sites on day 1 or 20. The percentage of dose absorbed on day 20 was 12.0% ؎ 6.26% and 9.68% ؎ 6.05% for paromomycin alone and WR 279,396, respectively. Paromomycin concentrations in plasma after 20 days of application were 5 to 9% of those after intramuscular administration of 15 mg/kg of body weight/day to adults for the systemic treatment of visceral leishmaniasis. Effective topical treatment of cutaneous leishmaniasis appears to be possible with limited paromomycin and gentamicin systemic absorption, thus avoiding drug accumulation and toxicity. (The work described here has been registered at ClinicalTrials.gov under registration no. NCT01032382 and NCT01083576.) A combination of paromomycin and gentamicin in a topical cream formulation (WR 279,396) is being investigated for the treatment of uncomplicated cutaneous leishmaniasis (CL), a parasitic infection caused by the bite of a sandfly that results in an ulcerated skin lesion frequently 2 to 5 cm in diameter (1). Leishmaniasis has been found in more than 90 countries worldwide (2). It is estimated that the incidence of CL ranges from 0.7 million to 1.2 million cases annually (2). In the United States, CL has been found in southern Texas along the Mexican border (3) and in travelers returning from areas of endemicity (4). In the U.S. military, more than 3,100 cases of CL have been parasitologically confirmed since April 2003 at the Leishmania Diagnostics Laboratory at the Walter Reed Army Institute of Research. Although CL ultimately self-cures, the infection can create substantial morbidity due to the continued presence of a skin ulcer and the psychological impact of disfigurement (5).Currently, there are no FDA-approved drugs for the treatment of any form of CL in the United Stat...

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Cutaneous leishmaniasis in soldiers returning from deployment to Iraq

Cited by 18 publications

References 4 publications

Ulcerative penile Leishmaniasis in a child

Ulcerative penile Leishmaniasis in a child

Novel Compounds Active against Leishmania major

Pharmacokinetics and Absorption of Paromomycin and Gentamicin from Topical Creams Used To Treat Cutaneous Leishmaniasis

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