Dissemination of localized cutaneous leishmaniasis in an organ transplant recipient: case report and literature review

Zandieh, Ali; Zandieh, Basira; Dastgheib, Ladan

doi:10.1111/j.1365-4632.2012.05615.x

Cited by 16 publications

(19 citation statements)

References 27 publications

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“…This patient had diabetes type 2 and after surgery received an immunosuppressive regimen including mycophenolate mofetil, tacrolimus, and prednisolone to prevent rejection of the transplant [9]. Reactivation of American cutaneous leishmaniasis after treatment with corticosteroids for coincident rheumatologic disease has been reported as well [10].…”

Section: Discussionmentioning

confidence: 99%

Reactivation of Cutaneous Leishmaniasis after Renal Transplantation: A Case Report

Mortazavi

Salehi

Kamyab

2014

Case Reports in Dermatological Medicine

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A 45-year-old man with reactivation of previously existing and subsiding cutaneous leishmaniasis on his wrist and lower leg (shin) after renal transplantation was admitted to our dermatology service on March 2008. He presented to us with two huge tumoral and cauliflower-like lesions. Skin smear and histopathology of skin showed leishman bodies and confirmed the diagnosis. After renal transplantation, he received cyclosporine plus prednisolone to induce immunosuppression and reduce the probability of transplant rejection. After immunosuppressive therapy, reactivation of cutaneous leishmaniasis with the above presentation took place. The patient responded to 800 mg/day intravenous sodium stibogluconate for 3 weeks plus local cryotherapy. Systemic plus local therapy along with reducing the doses of immunosuppressive drugs led to improvement of lesions. Reactivation of leishmaniasis after immunosuppression has been rarely reported.

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Section: Discussionmentioning

confidence: 99%

Reactivation of Cutaneous Leishmaniasis after Renal Transplantation: A Case Report

Mortazavi

Salehi

Kamyab

2014

Case Reports in Dermatological Medicine

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“…A screen-and-treat strategy should be complemented by early ART initiation, as now recommended by WHO [79]. The decline in incidence of VL–HIV co-infection in Europe following the introduction of ART is a powerful testimony of the effectiveness of that strategy.…”

Section: Discussionmentioning

confidence: 99%

A Screen-and-Treat Strategy Targeting Visceral Leishmaniasis in HIV-Infected Individuals in Endemic East African Countries: The Way Forward?

Griensven

Diro²,

López‐Vélez³

et al. 2014

PLoS Negl Trop Dis

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In the wake of the HIV epidemic, visceral leishmaniasis (VL), a disseminated protozoan infection caused by the Leishmania donovani complex, has been re-emerging, particularly in North Ethiopia where up to 40% of patients with VL are co-infected with HIV. Management of VL in HIV co-infection is complicated by increased drug toxicity, and high treatment failure and relapse rates with all currently available drugs, despite initiation of antiretroviral treatment. Tackling L. donovani infection before disease onset would thus be a logical approach. A screen-and-treat approach targeting latent or the early stage of infection has successfully been implemented in other HIV-associated opportunistic infections. While conceptually attractive in the context of VL–HIV, the basic understanding and evidence underpinning such an approach is currently lacking. Prospective cohort studies will have to be conducted to quantify the risk of VL in different risk groups and across CD4 cell count levels. This will allow developing clinical prognostic tools, integrating clinical, HIV and Leishmania infection markers. Interventional studies will be needed to evaluate prophylactic or pre-emptive treatment strategies for those at risk, ideally relying on an oral (combination) regimen. Issues like tolerability, emergence of resistance and drug interactions will require due attention. The need for maintenance therapy will have to be assessed. Based on the risk–benefit data, VL risk cut-offs will have to be identified to target treatment to those most likely to benefit. Such a strategy should be complemented with early initiation of antiretroviral treatment and other strategies to prevent HIV and Leishmania infection.

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“…Bone marrow or solid organ transplantation [89][90][91][92][93][94][95] and therapy with immunosuppressive or biologic drugs [96][97][98] also have been associated with the appearance of ATL. In immunosuppressed patients, CL is characterized by atypical cutaneous lesions and persistent negativity of diagnostic tests 91 .…”

Section: Resultsmentioning

confidence: 99%

“…The excretion of amphotericin B, pentamidine isethionate and miltefosine in breast milk is [93][94][95][96][97][98]103,[107][108][109][110][111][112][113][114] (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…In transplant recipients, CL and ML are rare and usually there is a time interval between transplantation and disease manifestation 106 . Reviews of organ transplant recipients with leishmaniasis show that the majority of patients have undergone renal transplantation, and most cases are identifi ed as visceral-type disease 93,[107][108][109] .…”

Section: Human Immunodefi Ciency Virus/acquired Immunodefi Ciencymentioning

confidence: 99%

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Treatment of American tegumentary leishmaniasis in special populations: a summary of evidence

Silva

Galvão

Gomes

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Revista da Sociedade Brasileira de Medicina Tropical 46(6):669-677, Nov-Dec, 2013http://dx.doi. org/10.1590/0037-8682-0104-2013 Address to: Dr a Juliana Saboia Fontenele e Silva. Lab. ABSTRACT We aimed to assess and synthesize the information available in the literature regarding the treatment of American tegumentary leishmaniasis in special populations. We searched MEDLINE (via PubMed), EMBASE, LILACS, SciELO, Scopus, Cochrane Library and mRCT databases to identify clinical trials and observational studies that assessed the pharmacological treatment of the following groups of patients: pregnant women, nursing mothers, children, the elderly, individuals with chronic diseases and individuals with suppressed immune systems. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. The available evidence suggests that the treatments of choice for each population or disease entity are as follows: nursing mothers and children (meglumine antimoniate or pentamidine), patients with renal disease (amphotericin B or miltefosine), patients with heart disease (amphotericin B, miltefosine or pentamidine), immunosuppressed patients (liposomal amphotericin), the elderly (meglumine antimoniate), pregnant women (amphotericin B) and patients with liver disease (no evidence available). The quality of evidence is low or very low for all groups. Accurate controlled studies are required to fi ll in the gaps in evidence for treatment in special populations. Post-marketing surveillance programs could also collect relevant information to guide treatment decision-making.

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Dissemination of localized cutaneous leishmaniasis in an organ transplant recipient: case report and literature review

Cited by 16 publications

References 27 publications

Reactivation of Cutaneous Leishmaniasis after Renal Transplantation: A Case Report

Reactivation of Cutaneous Leishmaniasis after Renal Transplantation: A Case Report

A Screen-and-Treat Strategy Targeting Visceral Leishmaniasis in HIV-Infected Individuals in Endemic East African Countries: The Way Forward?

Treatment of American tegumentary leishmaniasis in special populations: a summary of evidence

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