Singer C, Armstrong D, Jones T C, Spiro R H
Am J Med. 1975 Sep;59(3):444-7. doi: 10.1016/0002-9343(75)90405-2.
A case of mococutaneous leishmaniasis in a patient referred to Memorial Sloan-Kettering Cancer Center, New York, with a presumptive diagnosis of lethal mid-line granuloma is described. The patient had lived in Bolivia and had been treated with antimony during and after which his mucosal lesions progressed. These lesions completely healed with 971 mg of amphotericin B. Mucocutaneous leishmaniasis is endemic in many areas of Central and South America and may occur in patients in the United States who have lived in or traveled to these areas. Organisms may be difficult to identify, and multiple biopsies and cultures may be necessary. The use of amphotericin B for the treatment of leishmaniasis is reviewed. It is an effective alternative to antimony therapy, and in some cases resistant to antimony, it may be the drug of choice.
本文描述了一名转诊至纽约纪念斯隆-凯特琳癌症中心的患者,其最初被诊断为致死性中线肉芽肿,最终确诊为皮肤黏膜利什曼病。该患者曾居住在玻利维亚,曾接受锑剂治疗,治疗期间及之后其黏膜病变仍有进展。使用971毫克两性霉素B后,这些病变完全愈合。皮肤黏膜利什曼病在中美洲和南美洲的许多地区为地方病,在美国曾居住或前往这些地区的患者中也可能发生。病原体可能难以识别,可能需要多次活检和培养。本文对两性霉素B在利什曼病治疗中的应用进行了综述。它是锑剂治疗的有效替代药物,在某些对锑剂耐药的病例中,可能是首选药物。