Transient Success Using Prolonged Treatment with Miltefosine for a Patient with Diffuse Cutaneous Leishmaniasis Infected with Leishmania mexicana mexicana

Alejandro Ordaz-Farias Department of Medicine, University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; Dermatology Service, Infectious Diseases Service of the University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; National Vector Borne Disease Program, National Center for Epidemiologic Surveillance and Infection Control, Mexico City, Mexico; Department of Experimental Medicine, Medical Faculty, National Autonomous University of México, Mexico D.F., Mexico

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Fania Z. Muñoz-Garza Department of Medicine, University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; Dermatology Service, Infectious Diseases Service of the University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; National Vector Borne Disease Program, National Center for Epidemiologic Surveillance and Infection Control, Mexico City, Mexico; Department of Experimental Medicine, Medical Faculty, National Autonomous University of México, Mexico D.F., Mexico

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Farah K. Sevilla-Gonzalez Department of Medicine, University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; Dermatology Service, Infectious Diseases Service of the University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; National Vector Borne Disease Program, National Center for Epidemiologic Surveillance and Infection Control, Mexico City, Mexico; Department of Experimental Medicine, Medical Faculty, National Autonomous University of México, Mexico D.F., Mexico

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Ana Arana-Guajardo Department of Medicine, University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; Dermatology Service, Infectious Diseases Service of the University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; National Vector Borne Disease Program, National Center for Epidemiologic Surveillance and Infection Control, Mexico City, Mexico; Department of Experimental Medicine, Medical Faculty, National Autonomous University of México, Mexico D.F., Mexico

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Jorge Ocampo-Candiani Department of Medicine, University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; Dermatology Service, Infectious Diseases Service of the University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; National Vector Borne Disease Program, National Center for Epidemiologic Surveillance and Infection Control, Mexico City, Mexico; Department of Experimental Medicine, Medical Faculty, National Autonomous University of México, Mexico D.F., Mexico

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Nancy Treviño-Garza Department of Medicine, University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; Dermatology Service, Infectious Diseases Service of the University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; National Vector Borne Disease Program, National Center for Epidemiologic Surveillance and Infection Control, Mexico City, Mexico; Department of Experimental Medicine, Medical Faculty, National Autonomous University of México, Mexico D.F., Mexico

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Ingeborg Becker Department of Medicine, University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; Dermatology Service, Infectious Diseases Service of the University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; National Vector Borne Disease Program, National Center for Epidemiologic Surveillance and Infection Control, Mexico City, Mexico; Department of Experimental Medicine, Medical Faculty, National Autonomous University of México, Mexico D.F., Mexico

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Adrian Camacho-Ortiz Department of Medicine, University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; Dermatology Service, Infectious Diseases Service of the University Hospital “Dr. José Eleuterio González,” Monterrey, Nuevo Leon, México; National Vector Borne Disease Program, National Center for Epidemiologic Surveillance and Infection Control, Mexico City, Mexico; Department of Experimental Medicine, Medical Faculty, National Autonomous University of México, Mexico D.F., Mexico

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Leishmania sp. is an intracellular parasite that causes a variable degree of clinical manifestations, especially in the skin. We present the case of a 38-year-old male with a chronic history of mucocutaneous disease present since childhood that generated deformity, loss of cartilage in the ears and nose, and scarring that limited his range of motion. The parasite was identified as L. mexicana mexicana. The patient was treated with a 3-month course of oral miltefosine with overwhelming results.

Author Notes

* Address correspondence to Adrian Camacho-Ortiz, Gonzalitos y Madero Sn, Mitras Centro, Monterrey, Nuevo Leon, Mexico 64610. E-mail: acamacho_md@yahoo.com

Authors' addresses: Alejandro Ordaz-Farias, Ana Arana-Guajardo, and Adrian Camacho-Ortiz, Hospital Universitario–Internal Medicine, Monterrey, Nuevo Leon, Mexico, E-mails: ordaz7@hotmail.com, ana.aranag@gmail.com, and acamacho_md@yahoo.com. Fania Z. Muñoz-Garza, Farah K. Sevilla-Gonzalez, and Jorge Ocampo-Candiani, Hospital Universitario–Dermatology, Monterrey, Nuevo Leon, Mexico, E-mails: faniazamantta@hotmail.com, farahkaty82@hotmail.com, and jocampo2000@yahoo.com.mx. Nancy Treviño-Garza, Secretary of Health, National Center for Epidemiologic Surveillance and Infection Control, Mexico, Mexico, E-mail: nantrevino@hotmail.com. Ingeborg Becker, National Autonomous University of Mexico, Experimental Medicine, Mexico DF, Mexico, E-mail: becker@servidor.unam.mx.

  • 1.

    Maroli M, Khoury C, 2004. Prevention and control of leishmaniasis vectors: current approaches. Parassitologia 46: 211215.

  • 2.

    World Health Organization. Control of Leishmaniases. Report of a Meeting of the WHO Expert Committee on the Control of Leishmaniases. Available at: http://whqlibdoc.who.int/trs/WHO_TRS_949_eng.pdf. Accessed August 2, 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Mondal S, Bhattacharya P, Ali N, 2010. Current diagnosis and treatment of visceral leishmaniasis. Expert Rev Anti Infect Ther 8: 919944.

  • 4.

    Richard JV, Werbovetz KA, 2010. New antileishmanial candidates and lead compounds. Curr Opin Chem Biol 14: 447455.

  • 5.

    Almeida OL, Santos JB, 2011. Advances in the treatment of cutaneous leishmaniasis in the new world in the last ten years: asystematic literature review. An Bras Dermatol 86: 497506.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Zerpa O, Ulrich M, Blanco B, Polegre M, Avila A, Matos N, Mendoza I, Pratlong F, Ravel C, Convit J, 2007. Diffuse cutaneous leishmaniasis responds to miltefosine but then relapses. Br J Dermatol 156: 13281335.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Turetz ML, Machado PR, Ko AI, Alves F, Bittencourt A, Almeida RP, Mobashery N, Johnson WD Jr, Carvalho EM, 2002. Disseminated leishmaniasis: a new and emerging form of leishmaniasis observed in northeastern Brazil. J Infect Dis 186: 18291834.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Ruiz JH, Becker I, 2007. CD8 cytotoxic T cells in cutaneous leishmaniasis. Parasite Immunol 29: 671678.

  • 9.

    Hernández-Ruiz J, Salaiza-Suazo N, Carrada G, Escoto S, Ruiz Remigio A, Rosenstein Y, Zentella A, Becker I, 2010. CD8 cells of patients with diffuse cutaneous leishmaniasis display funconal exhaustion: the latteris reversed, in vitro, by TLR2 agonists. PLoS Negl Trop Dis 4: e871.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Mayrink W, Botelho AC, Magalhães PA, Batista SM, Lima A de O, Genaro O, Costa CA, Melo MN, Michalick MS, Williams P, Dias M, Caiaffa WT, Nascimento E, Machado-Coelho GL, 2006. Immunotherapy, immunochemotherapy and chemotherapy for American cutaneous leishmaniasis treatment. Rev Soc Bras Med Trop 39: 1421.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Pereira LI, Dorta ML, Pereira AJ, Bastos RP, Oliveira MA, Pinto SA, Galdino H Jr, Mayrink W, Barcelos W, Toledo VP, Lima GM, Ribeiro-Dias F, 2009. Increase of NK cells and proinflammatory monocytes are associated with the clinical improvementof diffuse cutaneous leishmaniasis after immunochemotherapy with BCG/Leishmania antigens. Am J Trop Med Hyg 81: 378383.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Okwor I, Uzonna JE, 2009. Immunotherapy as a strategy for treatment of leishmaniasis: a review of the literature. Immunotherapy. 1: 765776.

  • 13.

    Simpson MH, Mullins JF, Stone OJ, 1968. An Autochthonous Case in Texas and the Mexican States of Tamaulipas and Nuevo Leon. Arch Dermatol 97: 301303.

  • 14.

    Trainor KE, Porter BF, Logan KS, Hoffman RJ, Snowden KF, 2010. Eight cases of feline cutaneous leishmaniasis in Texas. Vet Pathol 47: 10761081.

  • 15.

    McHugh CP, 2010. Cutaneous leishmaniasis in Texas. J Am Acad Dermatol 62: 508510.

  • 16.

    Wright NA, Davis LE, Aftergut KS, Parrish CA, Cockerell CJ, 2008. Cutaneous leishmaniasis in Texas: a northern spread of endemic areas. J Am Acad Dermatol 58: 650652.

  • 17.

    Nilforoushzadeh MA, Jaffary F, Ansari N, Siadat AH, Nilforoushan Z, Firouz A, 2008. A comparative study between the efficacy of systemic meglumineantimoniate therapy with standard or low dose plus omeprazole in the treatment of cutaneous leishmaniasis. J Vector Borne Dis 45: 287291.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Van Griensven J, Balasegaram M, Meheus F, Alvar J, Lynen L, Boelaert M, 2010. Combination therapy for visceral leishmaniasis. Lancet Infect Dis 10: 184194.

  • 19.

    Shakya N, Sane SA, Vishwakarma P, Bajpai P, Gupta S, 2011. Improved treatment of visceral leishmaniasis (kala-azar) by using combination of ketoconazole, miltefosine with an immunomodulator-Picroliv. Acta Trop 119: 188193.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Shamsi Meymandi S, Javadi A, Dabiri S, Shamsi Meymandi M, Nadji M, 2011. Comparative histological and immunohistochemical changes of dry type cutaneous leishmaniasis after administration of meglumineantimoniate, imiquimod or combination therapy. Arch Iran Med 14: 238243.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Kashani MN, 2007. Evaluation of meglumineantimoniate effects on liver, kidney and pancreas function tests in patients with cutaneous leishmaniasis. Eur J Dermatol 17: 513515.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Soto J, Toledo J, Valda L, Balderrama M, Rea I, Parra R, Ardiles J, Soto P, Gomez A, Molleda F, Fuentelsaz C, Anders G, Sindermann H, Engel J, Berman J, 2007. Treatment of Bolivian mucosal leishmaniasis with miltefosine. Clin Infect Dis 44: 350356.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Calvopina M, Gomez E, Sindermann H, Cooper P, Hashiguchi Y, 2006. Relapse of new world diffuse cutaneous leishmaniasis caused by Leishmania (Leishmania) mexicana after miltefosine treatment. Am J Trop Med Hyg 75: 10741077.

    • PubMed
    • Search Google Scholar
    • Export Citation
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