South American cutaneous leishmaniasis: report of ten cases in Israeli travelers

Abstract

Background Cutaneous South American leishmaniasis is caused by several species of leishmaniasis. Lack of appropriate treatment may lead to mucocutaneous leishmaniasis, mainly with L. b. braziliensis and L. b. panamensis.Objective To describe the clinical findings of Israeli travelers infected with cutaneous South American leishmaniasis and to draw attention to this problem.Subjects Ten patients were interviewed, examined and treated.Results Twenty-two lesions of cutaneous leishmaniasis were found, all in exposed areas. Patients were seen by an average three physicians (range 1–6) before the final diagnosis was confirmed by direct smear, after an average period of 125 days (range 88–270 days). Treatment with Pentostam was started after an average period of 134 days (range 94–275 days). All lesions healed completely, but with scarring.Conclusion Travelers to endemic areas, as well as physicians, should be instructed about the potential risks and the clinical manifestations of cutaneous and mucocutaneous South American leishmaniasis. Such awareness will prevent undue delay in diagnosis and treatment.