Pathogens (Basel, Switzerland) · 2023
The Extraordinary Case of a Woman with a 30-Year-Long Diffuse Leishmaniasis Cured with One Single Ampoule of Intranasal Pentavalent Antimoniate.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Gonçalves Sheila V C B, Costa Dorcas L, Cantinho-Junior João da J, Vieira-Junior José N, Ishikawa Edna A Y, Costa Rubens N, Costa-Filho Antônio C G, Araújo Ronald da C, Uliana Silvia R B, Yasunaka Jenicer K U Y, Coelho Adriano C, Costa Jackson M L, Costa Carlos H N
Аннотация
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.