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Severe Inflammatory and Disseminated Cutaneous Leishmaniasis in a Pregnant Woman: A Case Report from Portoviejo, Ecuador.
Gómez L, Eduardo; Velez N, Lenin; Coello Peralta, Roberto Darwin; Villegas V, Nancy; Pinela M, Elsy; Torres R, Edison.
Affiliation
  • Gómez L E; Department of Parasitology and Tropical Medicine, Faculty of Medical Sciences, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
  • Velez N L; Leishmaniasis Project, Faculty of Medical Sciences, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
  • Coello Peralta RD; Ministry of Public Health, Guayaquil, Ecuador.
  • Villegas V N; Department of Parasitology and Tropical Medicine, Faculty of Medical Sciences, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
  • Pinela M E; Leishmaniasis Project, Faculty of Medical Sciences, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
  • Torres R E; Ministry of Public Health, Guayaquil, Ecuador.
Am J Case Rep ; 25: e944422, 2024 Jul 05.
Article in En | MEDLINE | ID: mdl-38968161
ABSTRACT
BACKGROUND Leishmaniasis is a zoonosis with worldwide prevalence that causes dermal lesions and can be serious in humans. This report presents a case of cutaneous leishmaniasis (CL) that was apparently associated with a zoonotic transmission in a peri-urban area of the city of Portoviejo, Ecuador, close to mountainous and forested sites. CASE REPORT For 37 years, we have studied transmission of leishmaniasis in Ecuador, and have seen a wide variety of clinical presentations of the disease caused by different strains of the parasite Leishmania in patients, including pregnant women, without marked difference among them. CL without complications causes painless lesions of different clinical aspect. The present study reports a case of a 25-year-old woman presenting with severely inflamed, disseminated, and painful lesions of CL. The patient was not given antimonial treatment; however, local cryotherapy was given, together with topical anti-inflammatory and antibiotic ointment. All the lesions were observed to heal, and no amastigotes were found in smear stains after clinical healing. Since there was no reactivation after 1.5 years of follow-up, conventional antileishmanial treatment with meglumine antimoniate was not given to the patient. CONCLUSIONS This report shows the importance of a properly done epidemiological and clinical presumtive diagnosis, followed by parasitological confirmation, and the benefit of using an alternative treatment for vulnerable patients, such as this pregnant woman, for whom the therapy with pentavalent antimonials is not indicated. All observed lesions healed and no amastigotes were found in the smears after clinical healing.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Leishmaniasis, Cutaneous / Pregnancy Complications, Parasitic Limits: Adult / Female / Humans / Pregnancy Country/Region as subject: America do sul / Ecuador Language: En Journal: Am J Case Rep Year: 2024 Document type: Article Affiliation country: Ecuador Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Leishmaniasis, Cutaneous / Pregnancy Complications, Parasitic Limits: Adult / Female / Humans / Pregnancy Country/Region as subject: America do sul / Ecuador Language: En Journal: Am J Case Rep Year: 2024 Document type: Article Affiliation country: Ecuador Country of publication: United States