A Case of Cutaneous Leishmaniasis Cured by a Combined Treatment of Topical Miltefosine and Injectable Amphotericin B

MARÍA LAURA GUZMAN; MARÍA FLORENCIA PERALTA; MARCELO QUIPILDOR; FRANCESCA PAPERA; ELVIA MEJÍA6; JUAN JOSÉ LAUTHIER; MANUELA BONO; PAOLA ANDREA BARROSO; MARÍA EUGENIA OLIVERA1; DOLORES CATALINA CARRER

Precision Nanomedicine

Andover House, Inc.

Año: 2023 vol. 6 p. 1181 - 1193

male rural worker with cutaneous leishmaniasis (CL) was initially treated with repeated cycles of MeglumineAntimoniate (Glucantime®) and two cycles of Amphotericin B deoxycholate during a three-yearperiod. However, the patient remained with two active lesions. An experimental topical treatment withliposomal Miltefosine was tested. The efficacy was determined from the MD’s inspection of the patient andanalysis of the lesions’ photographic images, lesions samples culture, and anti-Leishmania antibodies quantification.The parasites from the patient were isolated. The parasites were typified as Leishmaniabraziliensis, and their susceptibility to Miltefosine, Meglumine Antimoniate, and Amphotericin B wasmeasured. The wound healing was initially good with the topical treatment, but the clinical cure wasachieved only with a combination of the topical liposomal Miltefosine and intravenous Amphotericin B.Of note, the treatment efficacy was strongly correlated with the degree of stress suffered by the patient. Toour knowledge, this is the first report on using a topical Miltefosine formulation on a CL patient.