[Transfer factor in diffuse cutaneous leishmaniasis. Experience with one case]. / Fato r de transferència na leishmaniose cutis difusa. Experiència de um caso.

Transfer factor was administered in one case of Diffuse Cutaneous Leishmaniasis ("DCL") with minimal therapeutical results after two courses of ten doses each. The patient was 34-year-old white man, born in the State of Pará --Amazon-- region, goldwasher, his disease started 9 years ago and consisted of disseminated papular and nodular lesions, some of them secondarily ulcerated and more closely clustered over the knees elbows and dorsa of the hands. Physical examination was normal except for the skin lesions and a perforation of the nasal septum. Some intradermal tests (Paracoccidiodin, Lepromin and PPD) were positive while the Montenegro (leishmanin) reaction was negative. Increased levels of IgG and IgM were found; IgA was normal even after the treatment. Transfer Factor was obtained from leishmanin positive and PPD strong reactors and the method of preparation is described. By the end of the first ten-doses course, lesions were reduced to dark atrophic residual macules but the histological sections displayed a surprising amount of parasites, predicting unavoidable relapse. For the second series, as the patient refused to be given Amphotericin B he was treated with hot baths and levamisole was administered in a 150 mg daily dosage and 45 days cycles. The leishmanin intradermal test did not became positive after the treatment and this fact is discussed.