Spontaneous Regression Of Cutaneous Lesions Caused By Leishmania Panamensis In A Traveller Returning From Costa Rica
Di Paola, P., Ngo Ngai, C., Froidefond, M., Doudier, B., Dudouet, P., Lagier, J. C., L'Ollivier, C., & Mortier, C. (2024). Spontaneous regression of cutaneous lesions caused by Leishmania panamensis in a traveller returning from Costa Rica. Travel medicine and infectious disease, 61, 102749. https://doi.org/10.1016/j.tmaid.2024.102749
View Original Source →Case Details
Disease Location
Skin
Personal Characteristics
66-year-old man
Clinical Characteristics
Presented for skin lesions that had appeared one month after he had travelled to costa rica. A physical examination reported one ulceration on his left arm associated with an axillary adenopathy and lymphatic spread, three ulcerations on his chest, and one ulceration on his right ankle, associated with lymphangitis. Anatomopathological analysis revealed granular epithelia. A direct examination of the skin smear and the biopsy analysis, including detection of leishmanial amastigote forms, was negative. Later, real-time pcr tests, targeting the kinetoplastic minicircle gene of leishmania, were performed on both the skin smear and the non-conservative skin liquid where the biopsy was, and returned negative. After partial remission, a new skin swab and a second punch biopsy. Real-time pcr tests were positive on both samplings. Subsequent sequencing targeting both the its1 and its2 region of the rrna gene found 98.8 % identity with l panamensis
Remission Characteristics
The follow-up physical examination showed a spontaneous reduction in the diameter of all the lesions as well as skin improvement
Treatment & Mechanisms
Proposed Remission Mechanisms
Leishmania panamensis has a high capacity to generate well-organised granuloma with multinucleated giant cells, which can limit the spread of the infection, consequently controlling cutaneous leishmania (cl)
Clinical Treatment
Biopsy x2
Non-Clinical Treatment
Dressing