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DISSEMINATED LEISHMANIASIS, A SEVERE FORM OF LEISHMANIA BRAZILIENSIS INFECTION
Leishmania braziliensis
Leishmaniose cutânea
Leishmaniose disseminada
Disseminação de parasitas
Parasitas
Terapia para leishmaniose
Leishmania braziliensis
Cutaneous leishmaniasis
Disseminated leishmaniasis
Parasite dissemination
Parasites
Therapy for leishmaniasis
Author
Affilliation
Abstract
Disseminated leishmaniasis (DL) is an emergent severe disease manifesting with multiple lesions. To determine the relationship between immune response and clinical and therapeutic outcomes, we studied 101 DL and 101 cutaneous leishmaniasis (CL) cases and determined cytokines and chemokines in supernatants of mononuclear cells stimulated with leishmania antigen. Patients were treated with meglumine antimoniate (20 mg/kg) for 20 days (CL) or 30 days (DL); 19 DL patients were instead treated with amphotericin B, miltefosine, or miltefosine and meglumine antimoniate. High levels of chemokine ligand 9 were associated with more severe DL. The cure rate for meglumine antimoniate was low for both DL (44%) and CL (60%), but healing time was longer in DL (p = 0.003). The lowest cure rate (22%) was found in DL patients with >100 lesions. However, meglumine antimoniate/miltefosine treatment cured all DL patients who received it; therefore, that combination should be considered as first choice therapy.
Keywords in Portuguese
BrasilLeishmania braziliensis
Leishmaniose cutânea
Leishmaniose disseminada
Disseminação de parasitas
Parasitas
Terapia para leishmaniose
Keywords
BrazilLeishmania braziliensis
Cutaneous leishmaniasis
Disseminated leishmaniasis
Parasite dissemination
Parasites
Therapy for leishmaniasis
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