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Treatment for leishmaniasis may vary according to the type of disease. In the case of cutaneous leishmaniasis, as many times there are no symptoms or the presence of a small lump at the site of the insect bite, no specific treatment is necessary. However, if the lump increases in size or develops into a sore, the doctor may recommend the use of amphotericin B to speed up treatment.
On the other hand, in the case of visceral leishmaniasis, as it is a more serious infection that can bring complications to the person, treatment is always necessary, and the doctor indicates the use of Amphotericin B or antimony drugs pentavalents, which are stronger against infection, but which also cause more side effects.
In addition to medications to eliminate the protozoan, treatment should involve controlling common complications of this disease, such as anemia, diarrhea, malnutrition, bleeding and infections due to a drop in immunity, as these are situations that debilitate and can put the patient at risk. to the person's life. Learn more about leishmaniasis.
Most used remedies
Remedies should be indicated by the general practitioner or infectious disease specialist according to the type of leishmaniasis that the person has. In the case of cutaneous leishmaniasis, in most cases no medication is necessary, but the use of amphotericin B may be indicated.
However, in cases where the wounds increase and/or reach the mucous membranes, the remedies indicated for cutaneous leishmaniasis may be the same as those normally indicated for visceral leishmaniasis, also called kala-azar. Thus, the doctor may indicate the use of Pentavalent Antimonial Compounds, such as Meglumine Antimoniate and Sodium Stibogluconate, which are the main treatment option, applied in intramuscular or venous doses, for 20 to 30 days.S
In a few cases, these drugs can cause side effects, such as arrhythmias, body aches and lack of appetite, and are contraindicated in people with kidney or liver failure, in pregnant women in the first two trimesters of pregnancy and in cases that show signs of alterations on the electrocardiogram, known as increased QT interval.
Other alternative options in cases of lack or contraindications to these drugs are Pentamidines and immunomodulators, such as interferon gamma and GM-CSF, in addition to Miltefosine, which is an oral drug that can also be used in the treatment of leishmaniasis.
Care during treatment
Before starting the treatment, some precautions should be observed, including the evaluation and stabilization of the clinical conditions caused by the disease, such as dressings or transfusions to control bleeding, iron and vitamin replacement or, if necessary, transfusion of blood, to help recovery from anemia, a diet with protein and calories to improve malnutrition and use of antibiotics to treat infections.
Treatment can be done at home, as long as the person is able to receive the necessary care there and is able to travel to the hospital to receive medication and for medical reassessments. In addition, hospitalization should be recommended whenever there is:
- Severe anemia, with hemoglobin less than 5 g/dL;
- Severe or prolonged diarrhea;
- Severe malnutrition;
- Presence of bleeding;
- Generalized swelling;
- Presence of other associated diseases, such as arterial hypertension, heart disease, kidney disease or liver disease;
- Children under 6 months or seniors over 65 years of age;
- When the disease returns after treatment is finished or there is no response to treatment.
Furthermore, after completion of treatment, the person must be followed up in consultations by the doctor after 3, 6 and 12 months and, if he remains stable at the last evaluation, the patient is considered cured.
Signs of improvement and worsening
Signs of improvement may appear after the 1st week after starting treatment and are characterized by a decrease in fever, reduction of swollen belly, weight gain and recovery of disposition.
On the other hand, when treatment is not started quickly or is not carried out according to medical advice, it is possible that signs and symptoms of worsening may arise, including an increase or reappearance of fever, weight loss, constant weakness, viral and bacterial infections throughout the body and bleeding.