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Aamir Jalal Al Mosawi
Advisor in Pediatrics and Pediatric Psychiatry, Children Teaching Hospital of Baghdad Medical City, Head, Iraq Headquarter of Copernicus Scientists International Panel, Baghdad, Iraq
*Corresponding author: Al-Mosawi AJ, Advisor in Pediatrics and Pediatric Psychiatry Children Teaching Hospital of Baghdad Medical City, Head, Iraq Headquarter of Copernicus Scientists International Panel Baghdad, Iraq, Email: almosawiaj@yahoo.com
Citation: Al-Mosawi AJ (2020) Post kala-azar Dermal Leishmaniasis: Sodium Stibogluconate Cardiac Toxicity. Sci World J Microbiol Infect Dis, 1(1);1-3.
Copyright: © 2020, Al-Mosawi AJ, This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
ABSTRACT
Background: Post kala-azar dermal leishmaniasis, a dermatosis that may appear in patients apparently cured of visceral leishmaniasis (Kala-azar) caused by Leishmania donovani. Treatment options for the pediatric form are few and have serious limitations. In many geographic areas, the standard treatment of the condition is with daily potentially toxic sodium stibogluconate injections given for a prolonged duration of 30-60 days.
Patients and methods: The case of a twelve-year old boy with biopsy proven post kala azar dermal leishmaniasis whom was referred for consultation by dermatologist because of the development of cardiac symptoms while receiving sodium stibogluconate treatment course, was studied. The relevant medical literature was reviewed.ÂÂ
Results: After an apparent cure of visceral leishmaniasis achieved with four weeks treatment with sodium stibogluconate daily intramuscular injections, the boy developed post kala azar dermal leishmaniasis. After 20 days of additional treatment with sodium stibogluconate, the boy developed palpitation and tightness in the chest. The electroencephalography showed abnormalities consistent with cardiac toxicity mainly in the form of irregular rhythm. Review of the relevant literature revealed no particularly effective and safe alternative. However, the use of intermittent courses of sodium stibogluconate may help in reducing cardiac toxicity.Monitoring of pulse rate during antimonial therapy is important to detect early cardiac toxicity.
Conclusion: The need for a safer treatment of patients with post kala-azar dermal leishmaniasis continued. The use of intermittent courses of sodium stibogluconate and monitoring of pulse rate during antimonial to detect early cardiotoxicity may help in reducing cardiac toxicity.
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