Soto Jaime, Gutiérrez Patricia, Soto Paula, Escobar Julio, Paz David, Rivero Daniela, Villalba Aracely, Berman Jonathan
Fundación Nacional de Dermatología, Santa Cruz, Bolivia.
Hospital Dermatológico de Jorochito, Santa Cruz, Bolivia.
Am J Trop Med Hyg. 2025 Feb 25;112(5):963-965. doi: 10.4269/ajtmh.24-0725. Print 2025 May 7.
Aerosolized pentamidine is Food and Drug Administration approved to treat Pneumocystis pneumonia via a route that does not lead to systemic absorption or toxicity. Because Leishmania is also susceptible to pentamidine and mucosal leishmaniasis is also an infection of the respiratory tract, we performed a pilot study of aerosolized pentamidine (300 mg for 10 days over approximately 4 weeks) for mucosal leishmaniasis caused by Bolivian Leishmania braziliensis with a 2-year follow-up. Of 15 patients, 6 of 7 patients with initially mild disease were cured, 3 of 4 patients with initially moderate disease relapsed at the 18- to 24-month follow-up visits, and 3 of 4 patients with initially severe disease failed early after treatment. This study suggests that inhaled pentamidine may be useful as a well-tolerated treatment of mild mucosal leishmaniasis and that to rule out relapse, mucosal leishmaniasis follow-up should extend to 2 years.
雾化喷他脒已获美国食品药品监督管理局批准，可通过不会导致全身吸收或毒性的途径来治疗肺孢子菌肺炎。由于利什曼原虫也对喷他脒敏感，且黏膜利什曼病也是一种呼吸道感染，我们开展了一项针对雾化喷他脒（300毫克，在约4周内给药10天）治疗由玻利维亚巴西利什曼原虫引起的黏膜利什曼病的试点研究，并进行了为期2年的随访。15名患者中，7名初始病情为轻度的患者有6名治愈，4名初始病情为中度的患者中有3名在18至24个月的随访时复发，4名初始病情为重度的患者中有3名在治疗后早期治疗失败。这项研究表明，吸入喷他脒可能作为轻度黏膜利什曼病的一种耐受性良好的治疗方法，并且为了排除复发，黏膜利什曼病的随访应延长至2年。
