Cutaneous leishmaniasis in Louisiana - one-year follow-up: A case report

Figure 1 Physical examination. A: Skin ulcer with tracking nodules on admission; B and C: Skin ulcer after antibiotics for cellulitis.

Figure 2 Computer tomography scan of left lower extremity, cross sectional view showing phlegmon and ulcerated skin (orange arrows).

Figure 3 Histopathology was compatible with leishmaniasis amastigotes. A: Reactive squamous epithelium with mixed superficial and deep inflammatory infiltrate (hematoxylin-eosin staining, original magnification × 40); B: Organisms compatible with Leishmania amastigotes (hematoxylin-eosin staining, original magnification × 1000). Location within histiocytes is obscured by marked acute inflammatory infiltrate; C: Parasitized histiocytes with staining of Leishmania amastigotes (PAS, original magnification × 1000); and D: Parasitized histiocytes with staining of Leishmania amastigotes (Giemsa, original magnification × 1000).

Figure 4 Report from centers for disease control and prevention.

Figure 5 Patient followed up with dermatology and infectious diseases clinic at several occasions, and then visited at approximately 11 mo with a healed ulcer. A: Skin ulcer after 13 d of 28 d treatment with miltefosine; B: After 5 mo of treatment; and C: After 11 mo of treatment.