Everything old is new again: a case series of pediatric cutaneous leishmaniasis in Portland, Maine.

Autor:	Jubulis J; Division of Pediatric Infectious Diseases, Department of Pediatrics, Maine Medical Center, Portland, ME, USA., Goddard A; Division of Pediatric Infectious Diseases, Department of Pediatrics, Maine Medical Center, Portland, ME, USA., Seiverling E; Department of Dermatology, Tufts University, Boston, MA, USA., Kimball M; Department of Family Medicine, Maine Medical Center, Portland, ME, USA., McCarthy C; Division of Pediatric Infectious Diseases, Department of Pediatrics, Maine Medical Center, Portland, ME, USA.
Jazyk:	angličtina
Zdroj:	Journal of tropical pediatrics [J Trop Pediatr] 2022 Dec 05; Vol. 69 (1).
DOI:	10.1093/tropej/fmad003
Abstrakt:	Leishmaniasis has varying clinical manifestations and treatment regimens, dependent on species and host. Old world leishmaniasis, found primarily in Africa and Asia, may be associated with visceral disease, while new world disease, primarily in Latin America, may be associated with mucocutaneous disease. We present a case series of pediatric African patients with New World cutaneous leishmaniasis. Data extraction was performed via chart review, of children with cutaneous leishmaniasis presenting to the pediatric infectious diseases clinic in Portland, ME. Biopsy specimens were sent to the federal center for disease control (CDC) for identification via polymerase chain reaction (PCR) and culture. Five cases of cutaneous leishmaniasis were diagnosed in pediatric patients (ages 1-17 years) in Maine during the study period. Leishmaniasis was not initially suspected; thus, time to diagnosis was 1-4 months, Two patients were diagnosed with Leishmania panamensis, one with Leishmania brasiliensis, one with Leishmania sp. and one with mixed infection (L. panamensis and Leishmania mexicana). One patient was managed with surgical excision only, one was observed off therapy, and three were treated with ketoconazole. This case series highlights the importance of a high index of suspicion in migrant patients. Detailed travel history and epidemiologic knowledge is essential to diagnosis, as patients may present with forms of illness not congruent with their country of origin. (© The Author(s) [2023]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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