Cutaneous leishmaniasis: A diagnosis of suspicion

摘要

Dear Sir, A 20-year-old male presented with a 3-week history of two ulcerative lesions on the dorsum aspect of his left little and right index distal phalanges. They were restricting movement and increasingly swollen despite two courses of antibiotics (Fig 1). He was otherwise well with no systemic upset. Three months previously he had returned from army duty in Belize, where he had been aware of multiple, seemingly insignificant, bites despite standard issue army precautions of mosquito nets and repellent cream. He was treated initially for pyogenic infection with intravenous Benzylpenicillin and Frucloxacillin. Wound swab culture was negative.