Request for information on treatment of leishmaniasis

[Jack Jack]

Hi Lee,

Since I a don't have any medical training please don't take my comments as 
actual advice.

I was diagnosed with and and treated for Leishmania panamensis, previously 
known as Leishmania brazilensis panamensis, in 1997. I acquired the parasite 
hiking along the border between Panama or Costa Rica. L. panamensis is known 
to cause inflammation of the lymphatic nodes and nodes biopsied from my were 
tested by PCR and determined to be Leishmania, although the exact species 
was not determined diagnostically.

I was treated with oral Ketoconazole 600 mg daily for one month and then 
oral Ketoconazole 400 mg daily for a total course of 13 weeks. Three 
cutaneous leisions healed completely. Ketoconazole has been shown to be as 
effective as pentavalent antimony, the classic agent used to treat cutaneous 
leishmaniasis. (See Saenz et al, Efficacy of ketoconazole against Leishmania 
brazilensis panamensis cutaneous leishmaniasis, American Journal of 
Medicine, 1990; 89:147-55.)

The use of ketoconazole against other two other species of Leishmania 
causing cutaneous leishmaniasis is documented in another paper by Navin et 
al, Placebo-Controlled Clinical Trial of Sodium Stibogluconate (Pentostam) 
versus Ketoconazole for Treating Cutaneous Leishmaniasis in Guatemala, 
Journal of Infectious Diseases, 1992;165:528-34.

I cannot comment on how either pentavalent antimony or ketoconazole might 
affect pregnancy.

Feel free to reply to this address if you have more questions.

Good luck,






Date: Wed, 8 Mar 2000 11:26:51 -0300 (EST)
From: Lee Schnur <schnurl at cc.huji.ac.il>
Reply to: leish-l at bdt.org.br
To: Multiple recipients of list <leish-l at bdt.org.br>
Subject: Re: Request for information on treatment of leishmaniasis

Can anyone suggest treatment for cutaneous leishmaniasis, probably acquired
in Central or South America, that is causing swelling along lymphatic
vessels (query, pian bois caused by L. guyanensis?). The patient is 8
months pregnant. Can anyone advise on the dangers of  leishmaniasis and its
treatment during pregnancy. Speedy replies would be greatly apprecieated.
Lee Schnur
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