Case Report: Cutaneous Leishmaniasis: A Case Series with Intralesional Treatment in Northeast Brazil

• Published in: The American journal of tropical medicine and hygiene Vol. 111; no. 3; pp. 457 - 461
• Main Authors: Pereira de Carvalho Meneses, Yana Gabriela, Rapela Medeiros, Ângela Cristina, Felinto de Brito, Maria Edileuza, de Medeiros, Zulma Maria
• Format: Journal Article
• Language: English
• Published: United States Institute of Tropical Medicine 04.09.2024
• Subjects: Adult; Antiprotozoal Agents - administration & dosage; Antiprotozoal Agents - therapeutic use; Brazil - epidemiology; Female; Humans; Injections, Intralesional; Leishmania braziliensis; Leishmaniasis, Cutaneous - drug therapy; Male; Meglumine Antimoniate - administration & dosage; Meglumine Antimoniate - therapeutic use; Middle Aged; Parasitic diseases; Prospective Studies; Young Adult; Brazil
• ISSN: 0002-9637; 1476-1645; 1476-1645
• DOI: 10.4269/ajtmh.23-0566

In 2022, the Pan American Health Organization recommended the intralesional application (IL) of pentavalent antimonials in adult patients with localized cutaneous leishmaniasis (CL) caused by Leishmania ( Viannia ) braziliensis . Other guidelines differ from that recommendation, considering that infections caused by a Leishmania species that can be associated with increased risk for mucosal leishmaniasis, in particular L. ( V. ) braziliensis , should not be eligible for intralesional treatment. This was a prospective interventional study carried out with eight patients diagnosed with CL residing in northeast Brazil during the period from 2019 to 2022. To our knowledge, this is the first prospective study on the subject conducted in the northeast region, which has the second-highest number of cases in the country. In our sample, clinical cure was achieved with the use of intralesional treatment in all cases, and there were no serious adverse events or mucosal involvement during the 1-year follow-up period. We emphasize the importance of using the right criteria for choosing this therapeutic modality and highlight the advantages of intralesional treatment due to the lower risk of adverse events and cost reduction to health services.