Coinfection of Leishmania (Viannia) braziliensis and Streptococcus pneumoniae in Multiple Cutaneous Lesions

PAULO R. CORTES, LAURA S. CHIAPELLO, DAVID DIB, MONICA V. HERRERO, CARMEN T. NUNCIRA , CARLOS DE PETRIS, JOSE ECHENIQUE

PLOS Neglected Tropical Deseases

PUBLIC LIBRARY SCIENCE

Lugar: San Francisco, CA; Año: 2016

1935-2727

12-year-old girl was seen by a physician in Frias (Santiago del Estero Province, northern Argentina region) due to a lesion in her left leg that presented a painless papule, which later became ulcerative. The mother referred that the first lesion appeared after an insect bite in the left leg of her daughter, but she did not remember any febrile episode. She reported no othersymptoms or past medical history associated with skin ulcerations, diabetes, recurrent ear infections, or chronic diseases. In a few days, new lesions with similar characteristics appeared on her arms and legs. The first clinical impressions were ulcers caused by group A beta-hemolytic streptococci or staphylococci. No bacteriological cultures or other microbiological studieswere performed to determine the putative cause of those lesions. Nevertheless, she received an empirical antibiotic treatment, such as topical rifampicin (3 applications/day of a 100 mg/ml solution) concomitantly with penicillin G benzathine (