antimony-sodium-gluconate and Lip-Diseases

The worldwide prevalence of leishmaniasis is increasing because of ecologic changes and increased medical profession awareness. Furthermore, solitary cases have been recently reported in Western countries. The authors describe the epidemiology, mode of transmission, and diagnosis of leishmaniasis and present 4 oral cases treated with systemic, localized, or combined therapy. The authors suggest that clinicians should maintain a high index of suspicion for atypical, resistant, oral and perioral lesions in individuals with a history of traveling in certain geographic regions. After diagnosis, treatment should be determined jointly by experts from the fields of oral and maxillofacial surgery, oral medicine, and dermatology based on leishmaniasis species and clinical presentation.

Topics: Adolescent; Adult; Aged; Amphotericin B; Animals; Antimony Sodium Gluconate; Antiprotozoal Agents; Diagnosis, Differential; Endemic Diseases; Female; Humans; Leishmania braziliensis; Leishmania infantum; Leishmania major; Leishmaniasis; Leishmaniasis, Cutaneous; Lip Diseases; Male; Mouth Diseases; Young Adult

Topics: Adult; Antimony Sodium Gluconate; Antiprotozoal Agents; Humans; Iraq; Leishmaniasis, Cutaneous; Lip Diseases; Male; Military Personnel; United States

Topics: Afghanistan; Antimony Sodium Gluconate; Antiprotozoal Agents; Child; Facial Dermatoses; Female; Humans; Leishmaniasis, Cutaneous; Lip Diseases; London

A 24-year old German man was complaining of painful ulcers with infiltration of the lips without alteration of the oral mucosa and swelling of the regional lymph nodes. Three months earlier he had visited Israel, Italy, Romania and Bulgaria. He was treated with penicillin, doxycyclin, ciprofloxacin, itraconazole and prednisolone after detection of Candida spec. and staphylococci in another town without any effect. The smear and biopsy were sent to the Robert Koch Institute Berlin. Giemsa stain by phase contrast light microscopy with oil immersion showed extracellular amastigote leishmaniae with clearly stained kinetoplasts. Leishmania major could be detected by PCR investigation. The IgE was elevated, other investigations of the blood and from the lips were inconspicuous. The ulcers healed promptly under the treatment with Pentostam (antimony derivative) 0,1 ml/kg body weight i.m. for 12 days and 15% Paromomycin ointment.

Topics: Adult; Amebicides; Animals; Antimony Sodium Gluconate; Candidiasis; Diagnosis, Differential; Diagnostic Errors; Humans; Immunoglobulin E; Leishmania major; Leishmaniasis, Cutaneous; Lip Diseases; Male; Mouth Mucosa; Ointments; Paromomycin; Polymerase Chain Reaction