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European Journal of Dermatology

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Clinical complexity of Leishmania (Viannia) braziliensis infections amongst travelers Volume 23, issue 2, March-April 2013

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Authors
Hautklinik Mikrobiologisches Institut – Universitätsklinikum Erlangen Wasserturmstraße 3/5, 91054 Erlangen Germany, Klinik und Poliklinik für Hauterkrankungen, Mikrobiologisches Institut – Universitätsklinikum Erlangen Wasserturmstraße 3/5, 91054 Erlangen Germany, Institut für Immunologie, Universitätsklinikum Münster, Germany, Institut für Tropenmedizin und Internationale Gesundheit, Charité-Universitätsmedizin Berlin, Berlin, Germany

The protozoan parasite Leishmania (Viannia) braziliensis is one of the main causes of cutaneous and mucocutaneous leishmaniasis in South America. Here, we describe three cases of L. (V.) braziliensis infection which were acquired during travelling in Bolivia, Peru or Paraguay and illustrate the phenotypic heterogeneity and therapeutic complexity of the disease. Two patients presented with unusual clinical manifestations, i.e. with prominent regional lymphadenopathy (“bubonic leishmaniasis”) and with simultaneously emerged skin and mucosal lesions, respectively. Both patients insufficiently responded to oral treatment with miltefosine; resolution of the lesions was only achieved after a course of intravenous liposomal amphotericin B.