Diagnosis and treatment of american tegumentary leishmaniasis in a patient in rural Ceará: case report

Abstract

Introduction: American Tegumentary Leishmaniasis (ATL) is an infectious disease, non-contagious, of chronic development, endemic in some regions of Brazil, which in recent years, has shown a significant increase in the number of cases, being the State of Ceará as one of the major areas affected by this infection. Objective: to discuss a clinical case of ATL, encompassing diagnosis and treatment in an adult patient living in the rural area of the State of Ceará. Method: Case report and data analysis, diagnosis, and management based on the literature regarding ATL, using the integrative review method. Results: The diagnosis was made through an incisional biopsy of the lesion and, after obtaining a positive result for ATL, the patient was referred to the state reference unit for the treatment of infectious pathologies, Hospital São José (HSJ). The patient started the treatment with drugs administered orally, however, these medications were not efficient, requiring hospitalization. At the end of the treatment period, the patient evolved with an improvement in the clinical picture, with re-epithelialization of the lesions, regression of the ulcers, and was later referred for outpatient care. Discussion: Despite the growing studies on drugs with fewer adverse effects and a greater possibility of adherence to ATL treatment, the conventional therapeutic regimen had to be used, given the non-efficacy of the alternative therapy. Conclusion: The development of drugs that can be used more effectively, with fewer adverse effects, and with the potential to provide treatment adherence is urgent, whereas existing treatments must become more effective through the decentralization of the health service for endemic regions so that patients affected by neglected diseases, such as ATL, can be treated in their surroundings.