Treatment of mucosal leishmaniasis (L-infantum) with miltefosine in a patient with Good syndrome

We report on a 76-year old patient with recurrent mucosal leishmaniasis. Multiple treatment regimens were administered. After the second relapse, immunologic workup and review of the patient's history revealed the presence of Good syndrome, characterized by immunodeficiency in patients with thymoma. The third relapse was treated with oral miltefosine with complete resolution of the lesions. Miltefosine is an option for treating Old World leishmaniasis (Leishmania infantum) and immunodeficiency should be considered in patients with recurrent leishmaniasis. (C) 2013 Elsevier B.V. All rights reserved.