[Four cutaneous leishmaniosis case resistant to meglumine antimoniate treatment].

OBJECTIVE

The aim of the study was to treatment of cutaneous leishmaniasis caused by meglumine antimoniate resistant Leishmania major with Lucilia sericata larvae.

METHODS

Samples obtained from patients'lesions were stained with Giemsa and examined under the microscope. The samples were also incubated to Novy-Nicolle-McNeal (NNN) and Roswell Park Memorial Institute (RPMI) 1640 media. ITS1 region real time PCR was performed for identfying the Leishmania species. The patients were treated using Glucantime® or liposomal amphotericin B or L. sericata larvae according to their response to the treatmet regimes.

RESULTS

In the initial examination, amastigote forms of Leishmania were seen in the samples of all 4 patients under microscopic examination. Two of the patients with cutaneous leishmaniasis, which were caused by Glucantime resistant L. major were treated with liposomal amphotericin B, and two of them were treated with L. sericata larvae. Leishmania promastigotes were not grown in both cultures.

CONCLUSION

Cutaneous leishmaniasis, which wascaused by Glucantime resistant L. major has been successfully treated with L. sericata larvae in a very short time, 10 days. PCR results from samples taken 2 months after the treatment were examined and the results were negative.