Cutaneous Leishmaniasis- how to cure this?
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A 6-year-old Greek boy, was referred to hospital because of a small ulcerative lesion next to the left angle of his lips. The lesion persisted for a period of 11 months prior to referral despite several courses of oral antibiotics or local antibiotic ointments. The child never complained of fever, chills, sweating or weight loss during this time. His previous history was unremarkable. On examination he had a shallow ulcer right next to the left angle of his lips with a diameter of approximately 1cm. There were no enlarged lymph nodes and no hepatosplenomegaly. A more detailed examination of his ear, nose and throat did not reveal any mucosal involvement of the lesion. The lesion was surgically removed and the resected tissue was sent for histopathology, culture and polymerase chain reaction (PCR) testing for Leishmania parasites. The culture was negative for bacteria or parasites but PCR, using molecular screening methods: EF-PCR and k26-PCR, a molecular assay specific for the L. donovani complex that discriminates L. donovani/L. infantum zymodemes, revealed the presence of L. donovani in the tissue of the lesion of the patient.
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@shubhankar The treatment approach depends in part on host and parasite factors. Some approaches/regimens are effective only against certain Leishmania species/strains and only in particular geographic regions. Even data from well-conducted clinical trials are not necessarily generalizable to other settings. Of particular note, data from the many clinical trials of therapy for visceral leishmaniasis in parts of India are not necessarily directly applicable to visceral leishmaniasis caused by L. donovani in other areas, to visceral leishmaniasis caused by other species, or to treatment of cutaneous and mucosal leishmaniasis. Special groups (such as young children, elderly persons, pregnant/lactating women, and persons who are immunocompromised or who have other comorbidities) may need different medications or dosage regimens.