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New world cutaneous leishmaniasis in travellers
Eli Schwartz1, Cristoph Hatz, Johannes Blum
1The Center for Geographic Medicine and Tropical Diseases, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Israel. elischwa@post.tau.ac.il
The Lancet. Infectious Diseases
|May 27, 2006
Summary
Cutaneous leishmaniasis is rising in travelers returning from Latin America, particularly from Bolivia. Diagnosis via PCR and new treatments like liposomal amphotericin B show promise for this emerging infectious disease.
Area of Science:
- Tropical medicine
- Infectious diseases
- Dermatology
Background:
- Travel to Latin America is increasing, leading to a rise in imported infectious diseases.
- Cutaneous leishmaniasis (CL) cases among travelers have significantly increased in Europe.
- A notable proportion of CL cases are acquired in the Amazon basin, particularly Bolivia.
Purpose of the Study:
- To review the epidemiology and clinical presentation of CL in travelers.
- To discuss current diagnostic methods and treatment strategies for CL.
- To highlight challenges and future directions in managing CL.
Main Methods:
- Literature review of CL cases in travelers.
- Discussion of diagnostic techniques, focusing on Polymerase Chain Reaction (PCR).
- Analysis of current treatment options, including pentavalent antimonials and liposomal amphotericin B.
Main Results:
- CL incidence has doubled in the Netherlands and tripled in the UK.
- Leishmania (Viannia) braziliensis is a common cause, potentially leading to mucocutaneous leishmaniasis.
- PCR offers high sensitivity and species-specific diagnosis for targeted treatment.
- Pentavalent antimonials have limitations including adverse events and relapse rates up to 25%.
Conclusions:
- PCR is the preferred diagnostic method for CL.
- While pentavalent antimonials remain a primary treatment, their limitations necessitate alternatives.
- Liposomal amphotericin B demonstrates potential as a more effective and tolerable treatment for New World leishmaniasis.
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