Volume 22, Number 11—November 2016
Letter
Leishmania major Cutaneous Leishmaniasis in 3 Travelers Returning from Israel to the Netherlands
Justin S. Kuilder, Pieter J. Wismans, Ewout M. Baerveldt, Jaap J. van Hellemond, Mariana de Mendonça Melo, and Perry J.J. van Genderen
Table
Characteristics of 3 travel companions to Israel and a cohort of patients with imported cutaneous leishmaniasis previously diagnosed at the Institute for Tropical Diseases, Harbour Hospital, Rotterdam, the Netherlands, 2007–2016
| Characteristics | Case-patient 1 | Case-patient 2 | Case-patient 3 | Cohort, n = 27* |
|---|---|---|---|---|
| Age, y (SD) |
55.2 |
52.6 |
52.3 |
45.4 (15.2) |
| Sex |
M |
F |
F |
M: 19 (70.4); F: 8 (29.6) |
| New World/Old World |
Old World |
Old World |
Old World |
New World: 18 (66.7); Old World: 9 (33.3) |
| Country of acquisition |
Israel |
Israel |
Israel |
Argentina: 1 (3.7); Brazil; 2 (7.4); Costa Rica: 2 (7.4); Ecuador: 3 (11.1); Ethiopia: 1 (3.7); French-Guyana: 1 (3.7); Israel: 1 (3.7); Mexico: 1 (3.7); Morocco: 4 (14.8); Peru: 1 (3.7); Spain: 2 (7.4); Suriname: 6 (22.2); Trinidad and Tobago: 1 (3.7); Turkey: 1 (3.7) |
| Reason for visit |
Tourism |
Tourism |
Tourism |
Tourism: 18 (66.7); work-related visit: 2 (7.4); family visit: 6 (22.2); unknown: 1 (3.4) |
| Clinical manifestation |
Ulceration/plaque-like lesion |
Ulceration |
Plaque-like lesion |
Erythematous papule: 1 (3.7); nodule/plaquelike lesion: 9 (33.3); ulceration: 17 (63.0) |
| Mean no. skin lesions |
12 |
6 |
1 |
1.6 (median 1.0, range 1.0–5.0) |
| Localization |
≥1 localization |
≥1 localization |
Lower leg |
Face: 4 (14.8); upper arm: 3 (11.1); lower arm: 10 (37.0); upper leg: 0; lower leg: 6 (22.2); trunk or neck: 1 (3.7); ≥1 localization: 3 (11.1) |
| Diagnostic method |
Histology/PCR |
Histology/PCR |
Histology/PCR |
Histology: 0; PCR: 19 (70.3); histology/PCR: 8 (29.7) |
| Leishmania spp. |
L. major |
L. major |
L. major |
L. major: 2 (7.4); L. tropica: 1 (3.7); L. infantum: 4 (14.8); L. donovani: 1 (3.7); L. mexicana: 1 (3.7); L .braziliensis: 7 (25.9); L. guyanensis: 4 (14.8); L. panamensis: 1 (3.7); L. lainsoni: 1 (3.7); Unknown: 5 (18.5) |
| Treatment | Miltefosine | Miltefosine | Wait and see | Cryotherapy: 2 (7.4); topical paromomycin/methylbenzethoniumchloride: 1 (3.7); theurapeutic excision: 1 (3.7); fluconazole: 1 (3.7); pentamidineisethionate: 2 (7.4); systemic stibogluconate: 3 (11.1); miltefosine: 17 (63.0) |
*Values are no. (%) except as indicated.
Page created: October 19, 2016
Page updated: October 19, 2016
Page reviewed: October 19, 2016
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