Failure of Liposomal-amphotericin B Treatment for New World Cutaneous Leishmaniasis due to Leishmania braziliensis

Atsushi Kosaka; Naoya Sakamoto; Mayu Hikone; Kazuo Imai; Masayuki Ota; Takuya Washino; Takuya Maeda; Sentarou Iwabuchi

doi:10.2169/internalmedicine.4096-19

CASE REPORTS

Failure of Liposomal-amphotericin B Treatment for New World Cutaneous Leishmaniasis due to Leishmania braziliensis

Atsushi Kosaka, Naoya Sakamoto, Mayu Hikone, Kazuo Imai, Masayuki Ota, Takuya Washino, Takuya Maeda, Sentarou Iwabuchi

Author information

Atsushi Kosaka
Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, Japan
Naoya Sakamoto
Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, Japan
Mayu Hikone
Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, Japan
Kazuo Imai
Department of Infectious Diseases and Infection Control, Saitama Medical University, Japan
Center for Clinical Infectious Diseases and Research, Saitama Medical University, Japan
Masayuki Ota
Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, Japan
Takuya Washino
Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, Japan
Takuya Maeda
Department of Microbiology, Saitama Medical University, Japan
Sentarou Iwabuchi
Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, Japan

Keywords: cutaneous leishmaniasis, Leishmania braziliensis, liposomal-amphotericin B

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 9 Pages 1227-1230

DOI https://doi.org/10.2169/internalmedicine.4096-19

Details

Abstract

Liposomal-amphotericin B (L-AmB) is used for cutaneous leishmaniasis (CL); however, its treatment failure has not yet been described in detail. A 58-year-old man returned from the Republic of Venezuela with a cutaneous ulcer on his left lower leg. The causative pathogen was Leishmania braziliensis. We started L-AmB 3 mg/kg/day for 6 days; however, the ulcer did not resolve. The patient was successfully retreated with a higher dose L-AmB 4 mg/kg/day 9 times (total, 36 mg/kg). If L-AmB fails to treat CL and other therapeutics cannot be used, increasing the L-AmB dose is a viable option.

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