Department of Medicine;
Can J Infect Dis Med Microbiol. 2010 Summer;21(2):e79-83. doi: 10.1155/2010/768645.
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.
皮肤利什曼病是一种流行于中美洲、南美洲、墨西哥和加勒比地区的疾病，影响着数百万人。随着前往这些地区的旅行变得越来越普遍，皮肤利什曼病在发达国家变得越来越重要。然而，在北美，皮肤利什曼病的识别和获得适当的治疗仍然是一个挑战。本文报告了一名加拿大男子在前往哥斯达黎加旅行后感染皮肤利什曼病的病例。通过对皮肤活检进行聚合酶链反应分析，确认了种特异性诊断，结果显示为巴拿马利什曼原虫阳性。在伊曲康唑治疗失败后，尽管在管理这种治疗方法方面存在重大障碍，并且关于其疗效和耐受性的数据很少，但该患者仍成功地用葡萄糖酸锑钠进行了治疗。本文还回顾了皮肤利什曼病的发病机制、诊断和全身治疗，以及其在发达国家的出现。
