[Leish-l] [Tropmed-l] LV patiente 92y old

Mon Apr 23 11:04:54 BRT 2012

---------- Forwarded message ----------
From: Marco Tulio Antonio Garciazapata <mctulianglobal at gmail.com>
Date: 2012/4/17
Subject: Re: [Tropmed-l] LV patiente 92y old
To: Kleber Luz <klebergluz at gmail.com>
Cc: tropmed-L at lineu.icb.usp.br

Kleber,

Through cyber and by courtesy of *Jenny F Laskarzewsky*, Pharm. D,
BCPS (Clinical
Pharmacist at San Ramon Regional Medical Center / San Francisco Bay Region,
United States) have just received another information that may be of
interest an unrandomized trial "Treatment of Bolivian mucosal leishmaniasis
with miltefosine" (*Soto J, et al Clinical Infectious Diseases.
2007;44(3);350)* concluded that the cure rate for *miltefosine* (*2.5
mg/kg/day (Max=150 mg/day) for 28 days*) was equivalent to parenteral
Amphotericin B, with its toxicity profile is far superior to that of
amphotericin B.

*Prof. Marco Tulio A Garcia-Zapata, MD, PhD*

Medical Tropicalist / Head Professor / Principal Researcher

Tropical Medicine & Dermatology Department (DMTD)

Center for Studies and Research in (Re)Emerging Diseases (NUPEREME)

Reference Sentry for International and Travel Medicine (USCREMIVI)

Caixa Postal 12911 - Setor Leste Vila Nova

Goiania - GO, 74643-970, Brazil

Phone(=62)3269-8219, Fax (+62)3521-1839

E-mail: nupereme at gmail.com
medicinadeviagem.hc.hdt at gmail.com
mctulianglobal at gmail.com

***************
2012/4/15 Marco Tulio Antonio Garciazapata <mctulianglobal at gmail.com>

> Kleber,
>
> Your case can be a "Record" in the literature. We have to offer some kind
> of solution and quickly. Due we do not have much experience in the
> treatment of leishmaniasis in the elderly population. Worried, I found
> that there are few studies that deal with the issue.
>
>  It is well known effectiveness in the treatment of leishmaniasis, in
> general, with the group of antimonial drugs and / or derivatives of
> amphotericin B, but without doubt, are very toxic and not recommended in
> these patients.
>
>  In the treatment of invasive fungal infections in the elderly (Aging and infectious
> diseases, 15 August, CID 2001:33), *lipid formulations of** amphotericin B
> * (liposome/"Ambisome", lipid complex/"Abelcet" and colloidal dispersion B/"Amphotec"
> or "Amphocil"), would be the drugs recommended, but at high cost, are not
> the choice. Expected in the coming years, the goianan pharmaceutical
> industry available at the national market such formulations result of
> promising studies in nanotechnology made by Faculty of Pharmacy / Federal
> University of Goias, Brazil.
>
>  In this case the recommendation is to use *alternative drug*, in spite of
> being less toxic and less effective, can be invaluable in such patients. *
> "Primum non nocere"!!!* Draws attention to the subject with very little
> experience using *MILTEFOSINE*, the 1st anti-leishmania drugs more
> effective oral (Expert Review of Anti-infective Therapy, April 2006, Vol 4,
> No. 2, Pages 177-185). But I found a review in this sense (Am. J. Trop.
> Hyg., 78 (5), 2008, p. 745-749) and mainly a report of three cases in the"Triangulo
> Mineiro" - MG, Brazil, of unforgettable Prof. Aluizio Prata (RIP) who
> along with Mario Leon (Rev. Inst. Trop. S. Paulo, May-June, 200, 46 (3)
> :175-177) successfully used, *AZITHROMYCIN* (500 mg/dia/10 days oral) in patients
> aged 76-80 years of age.
>
>
> Hopefully this information can help you.
>
> Best regards,
>
> *Prof. Marco Tulio A Garcia-Zapata, MD, PhD*
> *Medical Tropicalist / Head Professor / Principal Researcher*
> Tropical Medicine & Dermatology Department (DMTD)
> Center for Studies and Research in (Re)Emerging Diseases (NUPEREME)
> Reference Sentry Unit for International and Travel Medicine (USCREMIVI)
> Teaching Hospital / Tropical Pathology & Public Health Institute (IPTSP)
>
Federal University of Goias, Brazil (UFG)

>
> Caixa Postal 12911 - Setor Leste Vila Nova
> Goiania - GO, 74643-970, Brazil
> Phone(=62)3269-8219, Fax (+62)3521-1839
> E-mail: nupereme at gmail.com
> medicinadeviagem.hc.hdt at gmail.com
>  mctulianglobal at gmail.com
>
>
>
>
>
> 2012/4/9 Kleber Luz <klebergluz at gmail.com>
>
>> Hello every body! Today i had done a diagnose of VL in a patient 92 y
>> old, test fast test was positive and the bone marrow aspireted was positive
>> with a lot of leishmanias. Does anyone had a patient like this. He was HIV
>> negative.
>>
>> --
>> Prof.Adjunto III -  Kleber Giovanni Luz - DEPARTAMENTO DE
>> INFECTOLOGIA/UFRN/HOSPITAL GISELDA TRIGUEIRO
>> Rua Cônego Monte, 110 - QUINTAS
>> CEP 59037-170
>> NATAL-RN
>> *FONE (FAX): (84) - 3215-1603
>> FONE: (84) - 3232-7948
>> CEL: (84) - 9193 - 6208*
>>
>>
>>
>> _______________________________________________
>> TropMed-L mailing list
>> TropMed-L at lineu.icb.usp.br
>> http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/tropmed-l
>>
>>
>

-- 
*Prof. Marco Tulio A Garcia-Zapata, MD, PhD*
*Medical Tropicalist / Head Professor / Principal Researcher*
Tropical Medicine & Dermatology Department (DMTD)
Center for Studies and Research in (Re)Emerging Diseases (NUPEREME)
Reference Sentry Unit for International and Travel Medicine (USCREMIVI)
Tropical Pathology & Public Health Institute (IPTSP)
Federal University of Goias (UFG)
Goiania - GO, BRAZIL

Caixa Postal 12911 - Setor Leste Vila Nova
Goiania - GO, 74643-970, Brazil
Phone: (+2)3269-8219, Fax (+62)3521-1839
E-mail: nupereme at gmail.com
medicinadeviagem.hc.hdt at gmail.com
mctulianglobal at gmail.com
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