Leishmaniasis treatment differs depending on the type of infection present and the severity of it. Treatment can be as simple as allowing the infection to run its course or as complex as the removal of a patient’s spleen. Medications used to treat leishmaniasis also vary widely in strength, risk to the patient, and severity of side effects. Doctors may choose to attempt treatment with a mild medication before moving to a stronger medication.
The first step in successfully treating leishmaniasis is identifying what type of infection the patient has. The best leishmaniasis treatment will depend on the type of infection, whether it is cutaneous, mucocutaneous, or visceral. Both cutaneous and mucocutaneous forms of the infection can clear up on their own, though use of certain medications can greatly reduce the amount of time a person has to fight the disease. Visceral infection with leishmaniasis requires medical treatment because without it, the parasite can cause to serious illness or death.
There are a number of different medications used in leishmaniasis treatment. The most common treatments are with drugs in a class known as pentavalent antimonials, which are only administered as injections. Sodium stibogluconate and meglumine antimoniate are toxic to the leishmaniasis organism and also the patient undergoing treatment. The toxicity of the medication requires that the patient be observed during treatment to make sure that he or she does not suffer an adverse reaction. These drugs are used to treat all forms of the leishmaniasis infection.
Fluconazole may also be used in leishmaniasis treatment if pentavalent antimonial treatments are unsuccessful or not possible. This medication is usually used as an antifungal treatment but doctors may prescribe it to treat leishmaniasis as well. Pentamidine is another drug that can be prescribed for leishmaniasis treatment, but the side effects of this drug are generally more severe than those caused by fluconazole.
Amphotericin B, which is administered intravenously, is used to treat serious cases of leishmaniasis. This medication, which is usually used to treat fungal infections, can cause serious side effects and so is generally only administered if the patient’s life is in danger. It is administered in a hospital setting and given by a healthcare professional, which makes it possible for the patient to be monitored for serious side effects.
Extremely severe cases of visceral leishmaniasis may require the removal of the patient's spleen. If the parasite does not respond to normal treatment, it may be necessary to perform this operation in order to save the patient's life. Severe cases of cutaneous leishmaniasis may require plastic surgery in order to repair damage from scarring.