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Gaceta Médica Boliviana

Print version ISSN 1012-2966On-line version ISSN 2227-3662


ROJAS CABRERA, Ernesto; LIMACHI CHOQUE, Jhonny Wilson  and  GUZMAN-RIVERO, Miguel. Combined Treatment in Cutaneous Leishmaniasis with Therapeutic Failure. Gac Med Bol [online]. 2021, vol.44, n.2, pp.260-264. ISSN 1012-2966.

The tegumentary leishmaniasis in Bolivia is mainly caused by L. braziliensis. The clinical manifestations are ulcerative lesions which can generate satellite lesions close to the initial one. The first choice drugs for treatment are pentavalent antimonials; although with variable effectiveness. Lack of response to these drugs leads to the use of other alternatives, considered as second-choice drugs. However, in all cases there is the possibility of therapeutic failure. The present case shows the remission of the lesions using a combined treatment of pentamidine, miltefosine and paromomycin, in a patient with a history of lack of response to monotherapy with Glucantime® The remission of the disease achieved at the end of combined therapy is probably the result of the simultaneous lytic action of the three drugs used and the restoration of the patient’s immune response. Up to 21 months of post-treatment control, all the lesions remained healed and the absence of new ones.

Keywords : Leishmaniasis; therapeutic failure; combined treatment.

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