Leishmaniasis has varying clinical manifestations and treatment regimens, dependent on species and host. Old world leishmaniasis, found primarily in Africa and Asia, may be associated with visceral disease, while new world disease, primarily in Latin America, may be associated with mucocutaneous disease. We present a case series of pediatric African patients with New World cutaneous leishmaniasis. Data extraction was performed via chart review, of children with cutaneous leishmaniasis presenting to the pediatric infectious diseases clinic in Portland, ME. Biopsy specimens were sent to the federal center for disease control (CDC) for identification via polymerase chain reaction (PCR) and culture. Five cases of cutaneous leishmaniasis were diagnosed in pediatric patients (ages 1-17 years) in Maine during the study period. Leishmaniasis was not initially suspected; thus, time to diagnosis was 1-4 months, Two patients were diagnosed with Leishmania panamensis, one with Leishmania brasiliensis, one with Leishmania sp. and one with mixed infection (L. panamensis and Leishmania mexicana). One patient was managed with surgical excision only, one was observed off therapy, and three were treated with ketoconazole. This case series highlights the importance of a high index of suspicion in migrant patients. Detailed travel history and epidemiologic knowledge is essential to diagnosis, as patients may present with forms of illness not congruent with their country of origin.

中文翻译：

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旧事重现：缅因州波特兰的小儿皮肤利什曼病病例系列。

利什曼病具有不同的临床表现和治疗方案，这取决于物种和宿主。主要在非洲和亚洲发现的旧世界利什曼病可能与内脏疾病有关，而主要在拉丁美洲的新世界利什曼病可能与皮肤粘膜疾病有关。我们介绍了一组患有新大陆皮肤利什曼病的非洲儿科患者的病例系列。数据提取是通过图表审查进行的，这些儿童患有皮肤利什曼病，在缅因州波特兰的儿科传染病诊所就诊。活检标本被送到联邦疾病控制中心 (CDC)，通过聚合酶链反应 (PCR) 和培养进行鉴定。在研究期间，缅因州的儿科患者（1-17 岁）诊断出 5 例皮肤利什曼病。最初并未怀疑利什曼病；因此，诊断时间为 1-4 个月，两名患者被诊断为巴拿马利什曼原虫，一名患有巴西利什曼原虫，一名患有利什曼原虫。一种是混合感染（L. panamensis 和 Leishmania mexicana）。一名患者仅接受手术切除，一名患者停止治疗，三名患者接受酮康唑治疗。该病例系列强调了高度怀疑移民患者的重要性。详细的旅行史和流行病学知识对于诊断至关重要，因为患者可能会出现与其原籍国不一致的疾病形式。panamensis 和 Leishmania mexicana）。一名患者仅接受手术切除，一名患者停止治疗，三名患者接受酮康唑治疗。该病例系列强调了高度怀疑移民患者的重要性。详细的旅行史和流行病学知识对于诊断至关重要，因为患者可能会出现与其原籍国不一致的疾病形式。panamensis 和 Leishmania mexicana）。一名患者仅接受手术切除，一名患者停止治疗，三名患者接受酮康唑治疗。该病例系列强调了高度怀疑移民患者的重要性。详细的旅行史和流行病学知识对于诊断至关重要，因为患者可能会出现与其原籍国不一致的疾病形式。