Hautklinik Mikrobiologisches Institut-Universitätsklinikum Erlangen Wasserturmstraße 3/5, 91054 Erlangen Germany.
Eur J Dermatol. 2013 Apr 1;23(2):218-23. doi: 10.1684/ejd.2013.1934.
The protozoan parasite Leishmania (Viannia) braziliensis is one of the main causes of cutaneous and mucocutaneous leishmaniasis in South America. Here, we describe three cases of L. (V.) braziliensis infection which were acquired during travelling in Bolivia, Peru or Paraguay and illustrate the phenotypic heterogeneity and therapeutic complexity of the disease. Two patients presented with unusual clinical manifestations, i.e. with prominent regional lymphadenopathy ("bubonic leishmaniasis") and with simultaneously emerged skin and mucosal lesions, respectively. Both patients insufficiently responded to oral treatment with miltefosine; resolution of the lesions was only achieved after a course of intravenous liposomal amphotericin B.
原生动物寄生虫利什曼原虫（Viannia）巴西利什曼原虫是南美的皮肤和粘膜利什曼病的主要原因之一。在这里，我们描述了在玻利维亚、秘鲁或巴拉圭旅行时感染利什曼原虫（V.）巴西利什曼原虫的三例病例，并说明了该疾病的表型异质性和治疗复杂性。两名患者表现出不寻常的临床表现，即明显的局部淋巴结病（“腺鼠疫样利什曼病”）和同时出现的皮肤和粘膜病变。两名患者对米替福新的口服治疗反应不佳；只有在接受静脉注射脂质体两性霉素 B 治疗后，病变才得以消退。
