LeishMan Recommendations for Treatment of Cutaneous and Mucosal Leishmaniasis in Travelers, 2014

01 Mar 2014
Johannes Blum, MD, Pierre Buffet, MD, Leo Visser, MD, Gundel Harms, MD, Mark S. Bailey, MD, Eric Caumes, MD, Jan Clerinx, MD, Pieter P.A.M. van Thiel, MD, Gloria Morizot, MD, Christoph Hatz, MD, Thomas P.C. Dorlo, Diana N.J. Lockwood, MD

Background

Treatment of cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML) in travelers is still controversial. Over the last decade, national and international consortia have published recommendations for treating CL in travelers. These guidelines harmonize many issues, but there are some discrepancies.

Methods

Leishmania parasites causing CL can now be genotyped by polymerase chain reaction techniques for detecting Leishmania DNA. Therefore, treatment recommendations can now be species based rather than based on geographical exposure. To review the evidence on which the recommendations were based, “LeishMan” (Leishmaniasis Management), a group of experts from 13 institutions in eight European countries, performed a PubMed (MEDLINE) literature search and considered unpublished evidence and the experts' own personal experiences. The Oxford evidence grading system was used to evaluate the information.

Results and Conclusion

In this article, the authors provide practical treatment recommendations for imported CL and ML in Europe, drawn up from the review by the European experts.