The Extraordinary Case of a Woman with a 30-Year-Long Diffuse Leishmaniasis Cured with One Single Ampoule of Intranasal Pentavalent Antimoniate.

Autor: Gonçalves SVCB; Clínica Dermatológica, Hospital Getúlio Vargas, Teresina 64001-200, PI, Brazil., Costa DL; Centro de Agravos Tropicais Emergentes e Negligenciados, Universidade Federal do Piauí, Teresina 64000-450, PI, Brazil., Cantinho-Junior JDJ; Hospital de Urgência de Teresina, Teresina 64017-775, PI, Brazil., Vieira-Junior JN; Instituto de Doenças Tropicais Natan Portella, Teresina 64002-510, PI, Brazil., Ishikawa EAY; Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66075-110, PA, Brazil., Costa RN; Centro de Terapia Renal, Teresina 64003-075, PI, Brazil., Costa-Filho ACG; Hospital Santa Maria, Teresina 64076-410, PI, Brazil., Araújo RDC; Departamento de Medicina Especializada, Universidade Federal do Piauí, Teresina 64049-550, PI, Brazil., Uliana SRB; Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo 05508-090, SP, Brazil., Yasunaka JKUY; Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo 05508-090, SP, Brazil., Coelho AC; Departamento de Biologia Animal, Instituto de Biologia, Universidade Estadual de Campinas, Campinas 13083-862, SP, Brazil., Costa JML; Centro de Pesquisas Gonçalo Moniz, Fundação Osvaldo Cruz, Salvador 40296-710, BA, Brazil., Costa CHN; Centro de Agravos Tropicais Emergentes e Negligenciados, Universidade Federal do Piauí, Teresina 64000-450, PI, Brazil.; Instituto de Doenças Tropicais Natan Portella, Teresina 64002-510, PI, Brazil.
Jazyk: angličtina
Zdroj: Pathogens (Basel, Switzerland) [Pathogens] 2023 Jun 29; Vol. 12 (7). Date of Electronic Publication: 2023 Jun 29.
DOI: 10.3390/pathogens12070890
Abstrakt: Infection with Leishmania amazonensis and L. mexicana may lead to diffuse cutaneous leishmaniasis. The cure is exceptional, especially for the strange case of this lady. Case report: The patient acquired the disease in childhood and remained with lesions for over 30 years, albeit several treatments. She worsened after a pregnancy, developing disseminated lesions. Miltefosine with amphotericin B and pentamidine resulted in remission. Lesions reappeared after one year, accompanied by intra-nasal infiltration of the disease. The nasal spraying of a single ampoule of pentavalent antimoniate resulted in the sustained disappearance of the nasal symptoms and all the cutaneous lesions. After over eight years, she remains disease-free, albeit under renal replacement therapy. The high nasal mucosal antimonial concentration may explain the long-lasting cure via new MHC class I epitope-specific CD8+ cell clones against L. amazonensis present in the nasal mucosa.
Databáze: MEDLINE
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