Patient 3 received only two doses because of the low number of lesions. Three 4‐mg/kg intramuscular injections of pentamidine base were administered every 48 hours to patients 1 and 2 during hospitalization. The species was identified as L major by the French leishmaniasis reference center (Montpellier, France). 3 Promastigote forms of Leishmania were also isolated on a mix of heat‐inactivated fetal calf serum and RPMI supplemented with antibiotics (vancomycin and amikacin). Microscopic examination of biopsies obtained from both patients confirmed the diagnosis of leishmaniasis.įor these three patients, parasitological diagnosis was confirmed by polymerase chain reaction (PCR) using the method described by Foulet et al. Patient 3 had three erythematous infiltrations on her feet. Patient 2 had about 10 lesions on his back, right buttock, and left wrist, and also two erysipeloid lesions on the right foot without phlebitis or lymphadenitis. They presented smaller lesions than those seen in patient 1. Patient 2, a 63‐year‐old English man, and patient 3, a 33‐year‐old French woman, who both participated in this archeological mission, were invited to consult at the same hospital. Ulcerated and necrotic lesions covered with scabs on the left elbow (Patient 1, prior to treatment).
MICHELLE DUPIN SKIN
Direct microscopic examination of smears obtained by skin biopsies and stained with May‐Grunwald‐Giemsa showed numerous intra‐ and extra‐cellular amastigote forms of Leishmania. Fifteen painless, ulcerated and necrotic lesions covered with scabs were located on her forearms, arms, and nose (Figure 1). They spent considerable time outdoors and slept in a house without protection against arthropod bites.Īt admission, lesions were present for 3 weeks. Two weeks earlier, she returned from Western Turkmenistan where she participated in archeological excavations in a semi‐arid desert near Bugdayly with three other persons from mid‐September to mid‐October 2012. Case Reports Case 1Īn immunocompetent 39‐year‐old French woman was admitted in Bégin Hospital for papulonodular skin lesions.
We reported a cluster of L major leishmaniasis in four travelers returning from Turkmenistan. 2 Leishmania major is responsible for zoonotic Old World CL. 1 It can be classified according to reservoir (anthroponotic or zoonotic CL) or geographic distribution (New World or Old World CL). Approximately 0.7 to 1.2 million CL cases occur each year. Cutaneous leishmaniasis (CL) is endemic in more than 70 countries worldwide.
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