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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 21, Issue 2, Pages e79-e83
http://dx.doi.org/10.1155/2010/768645
The 2009 CJIDMM Trainee Review Article Award

Systemic Therapy of New World Cutaneous Leishmaniasis: A Case Report and Review Article

Amir Abadir,1 Ameen Patel,1 and Shariq Haider1,2

1Department of Medicine, McMaster University, Hamilton, Ontario, Canada
2Division of Infectious Diseases, McMaster University, Hamilton, Ontario, Canada

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cutaneous leishmaniasis is a disease endemic to Central and South America, Mexico and the Caribbean, and affects millions of people. As travel to these regions becomes more common, cutaneous leishmaniasis is becoming a disease of increasing importance in the developed world. However, disease recognition and access to appropriate therapy for cutaneous leishmaniasis remains a challenge in North America. The present article reports a case of cutaneous leishmaniasis in a Canadian man following a trip to Costa Rica. Species-specific diagnosis was confirmed by polymerase chain reaction analysis of a skin biopsy, which was positive for Leishmania panamensis. After failing a course of itraconazole, the patient was successfully treated with sodium stibogluconate, despite significant barriers to administering this therapy, and the paucity of data regarding its efficacy and tolerability. The pathophysiology, diagnosis and systemic treatment of cutaneous leishmaniasis, as well as its emerging presence in the developed world, are reviewed.