A CASE REPORT OF NON-HEAL CUTANEOUS LEISHMANIASIS

The cases of cutaneous Leishmaniasis is increasing all over the world including Iran it increased from 1989 and reached its highest level in 1992. In Iran cutaneous Leishmaniasis is seen endemically in different parts of Isfahan, Khozesten and Kerman. Khozestan province was one of the important regions in Iran - Iraq war. On the other hand, this region is one the focus areas of rural cutaneous leishmaniasis in Iran. Climatic conditions for the vectors, war condition and lack of hygienic facilities predisposed such diseases among militants. Based on the mentioned problems, the best way of controlling the disease is immunization. For this reason, to immunize the people attending war, immunization against cutaneous Leishmaniasis was planned.The case of this study is a man from Miyandoab who received immunization against cutaneous Leishmaniasis 16 years ago, before attending the war. Three months after immunization, some lesions were seen around the injection point. The lesions were treated locally by Glucantime, the lesions relapsed and treated so many times. The patient was referred to parasitology department be a dermatologist, referring to history of the patient, sampling was done around the lesion and some smears were prepared. After Giemsa staining, N.N.N. culture was done. By using stained glasses and by applying a microscope with × 100 magnifying power only a few leishman bodies were seen. On the other hand, after 4 days, wet mount was prepared and they were examined to see promastigote. After 15 days, the same process was repeated and the promastigote was increased. For several times the patient was treated by Glucantime locally by a dermatologist the lesions were healed.Considering several problems that aroused in patients with cutaneous leishmaniasis and referring to reports by other parasitologists in different congresses, it can be suggested that it is better to check the patient considering his /her immunological status before vaccination. It is hoped to prepare a vaccine against leishmaniasis by the attempts of other colleagues in other immunology and parasitology departments.