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<DIV><FONT size=2 face=Arial>Dear Dr. Flavio,</FONT></DIV>
<DIV><FONT size=2 face=Arial></FONT> </DIV>
<DIV><FONT size=2 face=Arial>In the state of Espírito Santo, Southeast Brazil,
we have only L. braziliensis infecting humans and dogs. I have treated some
patients who had skin ulcers few years after successful treatment of
primary infection. The shortest time between the two events was three
years. In my own experience as a patient, I had cutaneous leishmaniasis
in1984 for the first time, which was successfully treated with Antimony and
in 1995 for the second time. In both episodes parasites were identified as L.
braziliensis through isoenzymes.</FONT></DIV>
<DIV><FONT size=2 face=Arial></FONT> </DIV>
<DIV><FONT size=2 face=Arial>Sincerely Yours,</FONT></DIV>
<DIV><FONT size=2 face=Arial></FONT> </DIV>
<DIV><FONT size=2 face=Arial>Aloísio Falqueto</FONT></DIV>
<DIV><FONT size=2 face=Arial>Coordinator of Reference Service for Leishmaniasis
in the State of Espírito Santo </FONT></DIV>
<DIV><FONT size=2 face=Arial></FONT> </DIV>
<DIV><FONT size=2 face=Arial>
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<P style="MARGIN: 0cm 0cm 10pt" class=MsoNormal>----- Original Message -----
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<DIV
style="FONT: 10pt arial; BACKGROUND: #e4e4e4; font-color: black"><B>From:</B>
<A title=queiroz.telles@uol.com.br
href="mailto:queiroz.telles@uol.com.br">Flavio Queiroz Telles</A> </DIV>
<DIV style="FONT: 10pt arial"><B>To:</B> <A title=jayusp@hotmail.com
href="mailto:jayusp@hotmail.com">jeffrey shaw</A> ; <A
title=leish-l@lineu.icb.usp.br
href="mailto:leish-l@lineu.icb.usp.br">Leish-L</A> </DIV>
<DIV style="FONT: 10pt arial"><B>Sent:</B> Thursday, April 02, 2015 9:16
PM</DIV>
<DIV style="FONT: 10pt arial"><B>Subject:</B> [Leish-l] Auricular
leishmaniasis</DIV>
<DIV><BR></DIV>
<DIV>Dear All</DIV>
<DIV>I have a patient who presented proved cutaneous leishmaniasis 3 years
ago. He was successfully treated with meglumine but after 3 years he presented
a secondary auricular lesion. Biopsy did not show amastigotes but histology
like leishmaniasis (no parasites). Anew meglumine course was effective.
Considering L. braziliensis braziliensis is the only species identified in the
state of Parana, South of Brazil, is this feasible?</DIV>
<DIV><BR></DIV>
<DIV>Regards</DIV>
<DIV><BR></DIV>
<DIV>Flavio Queiroz telles MD, PhD</DIV>
<DIV>Federal University of Parana, Brazil</DIV>
<DIV><BR></DIV>
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