Mucocutaneous leishmaniasis treated with miltefosine
DOI:
https://doi.org/10.51481/amc.v58i2.924Keywords:
Mucocutaneous leishmaniasis, Meglumine antimoniate (glucantime), Miltefosine (Impavido), sodium stibogluconate (Pentostam), PCR (polymerase chain reaction)Abstract
Miltefosine (Impavido®) is an anticancer medicine that has been found highly effective against mucocutaneous and visceral leishmaniasis worldwide, making it a very attractive option for patients with underlying diseases and treatments that contraindicate the use of glucamine antimoniate (Glucantime®) or sodium stibogluconate (Pentostam®). Here we present the case of a 78 years old male, with a history of type 2 diabetes mellitus, high blood preasure, anticoagulated with warfarin for chronic atrial fibrillation, who started with a solitary cutaneous ulcer of purplish edges on the right ear helix of chronic evolution associated with multiple ulcerations on the nasal mucosa. Skin biopsy was reported as nonspecific, but as clinical suspicion of leishmaniasis was high, a polymerase chain reaction of nasal mucosa tissue was performed for Leishmania with positive results for Leishmania panamensis. Due to comorbidities and the treatment of our patient we decided to use miltefosine (Impavido®) for 2 months with very good results.
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