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Leishmania tropica in children: a retrospective study.

Journal of the American Academy of Dermatology (2014-04-30)
Michal Solomon, Eli Schwartz, Felix Pavlotsky, Nicole Sakka, Aviv Barzilai, Shoshana Greenberger
ABSTRACT

Limited data are available regarding topical and systemic therapies for Leishmania tropica in children. 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. 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. 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. This was a retrospective study. 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.

MATERIALS
Product Number
Brand
Product Description

Amphotericin B for microbiological assay, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
Paromomycin sulfate salt, ≥98% (TLC)
Sigma-Aldrich
Paromomycin sulfate salt, suitable for plant cell culture, BioReagent
Sigma-Aldrich
Paromomycin sulfate salt, powder, BioReagent, suitable for cell culture, potency: ≥675 μg per mg
Sigma-Aldrich
Amphotericin B solubilized, powder, γ-irradiated, BioXtra, suitable for cell culture
Amphotericin B for peak identification, European Pharmacopoeia (EP) Reference Standard
Amphotericin B, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
Amphotericin B solution, 250 μg/mL in deionized water, 0.1 μm filtered, BioReagent, suitable for cell culture
Sigma-Aldrich
Amphotericin B from Streptomyces sp., BioReagent, suitable for cell culture, ~80% (HPLC)
Sigma-Aldrich
Amphotericin B from Streptomyces sp., ~80% (HPLC), powder