antimony-sodium-gluconate and Headache

The efficacy and toxicity of sodium stibogluconate (SSG) at a dosage of 20 mg/(kg.d) for either 20 days (for cutaneous disease) or 28 days (for visceral, mucosal, or viscerotropic disease) in the treatment of leishmaniasis is reported. Ninety-six U.S. Department of Defense health care beneficiaries with parasitologically confirmed leishmaniasis were prospectively followed for 1 year. One patient was infected with human immunodeficiency virus; otherwise, comorbidity was absent. Clinical cure occurred in 91% of 83 cases of cutaneous disease and 93% of 13 cases of visceral/viscerotropic disease. Adverse effects were common and necessitated interruption of treatment in 28% of cases, but they were generally reversible. These included arthralgias and myalgias (58%), pancreatitis (97%), transaminitis (67%), headache (22%), hematologic suppression (44%), and rash (9%). No subsequent mucosal leishmaniasis was identified, and there were no deaths attributable to SSG or leishmaniasis.

Topics: Adolescent; Adult; Antimony Sodium Gluconate; Antiprotozoal Agents; Headache; Humans; Injections, Intravenous; Leishmaniasis; Male; Middle Aged; Military Personnel; Pancreatitis; Treatment Outcome

Cutaneous South American leishmaniasis is caused by several species of leishmaniasis. Lack of appropriate treatment may lead to mucocutaneous leishmaniasis, mainly with L. b. braziliensis and L. b. panamensis.. To describe the clinical findings of Israeli travelers infected with cutaneous South American leishmaniasis and to draw attention to this problem.. Ten patients were interviewed, examined and treated.. Twenty-two lesions of cutaneous leishmaniasis were found, all in exposed areas. Patients were seen by an average three physicians (range 1-6) before the final diagnosis was confirmed by direct smear, after an average period of 125 days (range 88-270 days). Treatment with Pentostam was started after an average period of 134 days (range 94-275 days). All lesions healed completely, but with scarring.. Travelers to endemic areas, as well as physicians, should be instructed about the potential risks and the clinical manifestations of cutaneous and mucocutaneous South American leishmaniasis. Such awareness will prevent undue delay in diagnosis and treatment.

Topics: Adult; Animals; Antimony Sodium Gluconate; Antiprotozoal Agents; Female; Headache; Humans; Israel; Leg Ulcer; Leishmania mexicana; Leishmaniasis, Cutaneous; Liver; Liver Function Tests; Male; Meglumine; Meglumine Antimoniate; Muscle Weakness; Muscular Diseases; Organometallic Compounds; Pain; Retrospective Studies; Skin; South America; Travel; Weight Loss