Leishmania tropica in children: A retrospective study

作者：Solomon Michal^*; Schwartz Eli; Pavlotsky Felix; Sakka Nicole; Barzilai Aviv; Greenberger Shoshana

来源：Journal of the American Academy of Dermatology, 2014, 71(2): 271-277.

DOI：10.1016/j.jaad.2013.12.047

• children
• cryotherapy
• intralesional
• Leishmania tropica
• liposomal amphotericin B
• paromomycin ointment
• sodium stibogluconate

Background: Limited data are available regarding topical and systemic therapies for Leishmania tropica in children.
Objective: We sought to characterize the clinical presentation and evaluate the efficacy and safety of topical and systemic treatments in pediatric patients infected with L tropica.
Methods: A retrospective study was performed on 47 children with L tropica cutaneous leishmaniasis. Treatments included topical or systemic therapy with liposomal amphotericin B or pentavalent antimony.
Results: Seventy patients with L tropica cutaneous leishmaniasis were treated at our center between 2008 and 2012, of which 47 (67%) were children. The average age of the pediatric population was 8.8 years, and the face was the most common site of involvement (76%). The average number of lesions was 2.6. 24 children (51%) required systemic therapy. The patients were treated with 3 to 5 mg/kg/d of intravenous liposomal amphotericin B, and a response was observed in 83% of the patients within 3 months.
Limitations: This was a retrospective study.
Conclusion: The disease burden of L tropica in children is high, and because of facial involvement and a low response to topical therapies, systemic therapy is often required. In our experience, liposomal amphotericin B treatment in children is safe and effective and is required for a considerably shorter duration than treatment with pentavalent antimony.

• 出版日期2014-8