Fluconazole in the Treatment of Cutaneous Leishmaniasis in a Kidney Transplant Patient a Case Report

Leishmaniasis is a well recognized opportunistic infection, which caused by an intracellular protozoan parasite belonging to genus Leishmania. Although, in healthy subjects the mortality and morbidity from this infection is not significant, however in immunosuppressed patients it can cause an overwhelming visceral disease.We report a case of cutaneous leishmaniasis in a 54 years old diabetic man after kidney transplantation. He had successful unrelated kidney transplantation 14 months before presentation of skin lesions. In physical examination, the patient had multiple itchy and erythematous nodules and ulcers in diameter of 1×2 cm with central ulceration over his arms and hands compatible with a diagnosis of cutaneous leishmaniasis. The patient was given intramuscular Glucantime 20 mg/kg but he didn’t tolerate it. In finally he was treated with fluconazole and after two weeks the ulcers healed. Cutaneous leishmaniasis should be considered as a differential diagnosis of each nodule or chronic skin lesion in kidney transplant patients. Although, antimonials are the first line drug, fluconazole can also used in the treatment of cutaneous leishmaniasis.