Infectious Diseases

Answer 2 Pentavalent antimony. This patient has mucocutaneous leishmaniasis, a condition commonly seen in troops returning from the Middle East as well as patients from South America. The case patient’s symptoms demonstrate the classic presentation of this disease. A punch biopsy identifies leishmania amastigotes in tissue and confirms the diagnosis. Small single lesions may resolve with watchful waiting, but multiple lesions and lesions on the face are usually treated with pentavalent antimonials. Amphotericin B may be an alternative agent that can be used in patients who cannot tolerate antimonials. None of the other antibiotic agents listed are effective against Leishmania. SUGGESTED READING Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 6th ed. New York: Elsevier/Churchill Livingstone; 2005. Click here to return to the questions

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