USE OF LIPOSOMAL ANFOTERICIN B IN DISEMINATED CUTANEOUS LEISHMANIASIS CAUSED BY Leishmania braziliensis IN A PEDIATRIC PATIENT WITH DOWN SYNDROME

Sandoval-Juárez A.; Rojas-Palomino N.; Roca L.K.; Pilares-Barco G.; Cuadros-Castro J.; Araujo-Castillo R. · Revista Peruana de Medicina Experimental y Salud Publica (2023) · DOI: 10.17843/rpmesp.2023.401.11481

Resumen

We present a case of disseminated cutaneous leishmaniasis with extensive manifestation in a pediatric patient with Down syndrome. The case was confirmed by parasitological and immunological tests. The species was identified as Leishmania (Viannia) braziliensis by polymerase chain reaction-restriction frag-ment length polymorphisms (PCR-RFLP). The immune deficit that occurs as part of Down syndrome may have been the reason for the aggressive and prolonged clinical manifestations as well as the poor response to stibogluconate and deoxycholate amphotericin. The patient was treated with liposomal am-photericin B and at the end of therapy, showed clinical improvement of the lesions. This report highlights the challenges of the diagnosis and treatment of cutaneous leishmaniasis in immunosuppressed pediatric patients, especially under difficult social, economic and geographic conditions. Leishmaniasis should be considered as a differential diagnosis when treating atypical chronic dermatologic ulcers; the use of lipo-somal amphotericin in immunocompromised patients should also be considered in these cases.