Kuna Anna, Olszański Romuald, Szostakowska Beata, Kulawiak Natalia, Kant Ravi, Grzybek Maciej
Department of Tropical and Parasitic Diseases, Faculty of Health Science, Medical University of Gdansk, 81-519 Gdansk, Poland.
Specialized Dermatology Outpatient Clinic, 81-366 Gdynia, Poland.
Trop Med Infect Dis. 2024 Sep 30;9(10):227. doi: 10.3390/tropicalmed9100227.
Cutaneous leishmaniasis is one of the most commonly diagnosed dermatological condition in travel medicine after diarrhoeal diseases and febrile status. The disease is transmitted by and sandflies. It appears in various clinical forms, the most common of which is a painless ulcer with raised edges, usually present on exposed parts of the body on the side where the insect bite occurred. Annually, over a million new cutaneous leishmaniasis (CL) cases are reported globally. We present two cases of affliction, the first occurring in Patient 1, who attempted treatment through the Kambo cleanse in South America, which is considered a toxic, even life-threatening, procedure. It involves the subcutaneous application of a substance dangerous to humans derived from the surface mucus of a frog. Patient 2 applied caustic ointments, a fruitarian diet, and hyperbaric oxygen therapy in a private setting. After initial therapeutic failures caused by the patients' unconventional treatment ideas, the causal treatment effect was satisfactory, demonstrating the efficacy of these treatments in resolving the infection when applied appropriately. Despite the typical CL presentation in both patients, their self-treatment course was unusual. It is worth noting that alternative, sometimes harmful, self-treatment initiatives by patients may be surprising and ineffective. Promoting knowledge about tropical diseases among travellers and medical staff is crucial to improving treatment outcomes.
皮肤利什曼病是旅行医学中除腹泻病和发热状态外最常诊断的皮肤病之一。该病由白蛉传播。它有多种临床形式,最常见的是边缘隆起的无痛溃疡,通常出现在昆虫叮咬部位一侧的身体暴露部位。全球每年报告超过100万例新的皮肤利什曼病(CL)病例。我们介绍两例病例,第一例发生在患者1身上,他在南美洲尝试通过坎波清洁法进行治疗,这被认为是一种有毒甚至危及生命的程序。它涉及皮下应用从青蛙表面黏液中提取的对人类有害的物质。患者2在私人环境中使用苛性软膏、水果饮食和高压氧疗法。在患者非传统治疗观念导致最初治疗失败后,病因治疗效果令人满意,表明这些治疗在适当应用时对解决感染有效。尽管两名患者都有典型的CL表现,但他们的自我治疗过程却不寻常。值得注意的是,患者的替代治疗举措,有时是有害的,可能令人惊讶且无效。在旅行者和医务人员中推广热带病知识对于改善治疗结果至关重要。