Article Text

Two cases of cutaneous leishmaniasis in Dutch military personnel treated with oral miltefosine
  1. Eric Martin van der Snoek1,
  2. SM Couwenberg1,
  3. C Stijnis2,
  4. LM Kortbeek3 and
  5. EM Schadd4
  1. 1Department of Dermatology, Central Military Hospital, Utrecht, The Netherlands
  2. 2Center for Tropical and Travel Medicine, Academic Medical Center, Amsterdam, The Netherlands
  3. 3Laboratory for Infectious Diseases and Perinatal Screening, RIVM, Bilthoven, The Netherlands
  4. 4Department of Internal Medicine, Central Military Hospital, Utrecht, The Netherlands
  1. Correspondence to Dr Eric Martin van der Snoek, Department of Dermatology, Military Hospital, P.O. Box 90.000, Utrecht 3509 AA, The Netherlands; e.vandersnoek{at}


Introduction In the Netherlands, cutaneous leishmaniasis is most commonly seen in military personnel deployed on a mission or training abroad. The treatment of two Dutch soldiers who acquired cutaneous leishmaniasis with oral miltefosine was evaluated. Adverse effects were monitored and the improvement of skin lesions was assessed.

Case reports A military nurse with a painless Chiclero's ulcer due to Leishmania (Viannia) braziliensis acquired in Belize and a military physical training instructor with itchy swelling and small ulcer of the back of his left elbow due to L. donovani/infantum complex acquired in Ibiza were treated with oral miltefosine 50 mg three times a day for 28 days.

Discussion Both patients responded well to oral miltefosine. Adverse effects were mild. Increase of creatinine levels was seen while liver transaminase levels were unremarkable.

Conclusions Miltefosine proved to be a convenient, effective and well-tolerated treatment option in the treatment of cutaneous leishmaniasis in Dutch military personnel.


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  • Collaborators The authors are grateful to PPAM van Thiel for reviewing the manuscript.

  • Contributors The authors of this manuscript (EMvdS, SMC, CS, LMK and EMS) have participated sufficiently in this work to take public responsibility for appropriate portions of the content. EMvdS takes responsibility for the integrity of the work as a whole, from inception to published article. Authorship credit was based on (1) substantial contributions to conception and design, or acquisition of data or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content and (3) final approval of the version to be published. All these conditions were met by all authors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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