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Case 4-2005: Sodium Stibogluconate for Cutaneous Leishmaniasis
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     To the Editor: In Case 4-2005 (Feb. 10 issue),1 a discussant states that sodium stibogluconate (Pentostam, GlaxoSmithKline, United Kingdom) is available in the United States only from the Centers for Disease Control and Prevention (CDC). The U.S. military is another potential supplier of sodium stibogluconate. This drug has been used under an investigational-new-drug protocol at Walter Reed Army Medical Center (Washington, D.C.) since 1978 and is now also available at Brooke Army Medical Center (San Antonio, Tex.). Cutaneous leishmaniasis has been diagnosed in more than 800 soldiers and civilian contractors returning from Iraq or Afghanistan.2,3 Sodium stibogluconate may be a potential treatment option for these patients and is available to military health care beneficiaries and to those who acquire the infection while performing military duties.3 Providers with questions concerning the treatment or evaluation of leishmaniasis related to military service should contact the Infectious Diseases Service at either Walter Reed Army Medical Center (202-782-1663) or at Brooke Army Medical Center (210-916-5554). Contractors supporting military operations should contact the CDC.

    (The views expressed are those of the authors and should not be construed as representing the positions of Walter Reed Army Medical Center, the Department of the Army, or the Department of Defense.)

    Joshua D. Hartzell, M.D.

    Walter Reed Army Medical Center

    Washington, DC 20307

    joshua.hartzell@na.amedd.army.mil

    Naomi Aronson, M.D.

    Uniformed Services University of the Health Sciences

    Bethesda, MD 20814

    References

    Case Records of the Massachusetts General Hospital (Case 4-2005). N Engl J Med 2005;352:609-615.

    Update: Cutaneous leishmaniasis in U. S. military personnel -- Southwest/Central Asia, 2002-2004. MMWR Morb Mortal Wkly Rep 2004;53:264-265.

    Weina PJ, Neafie RC, Wortmann G, Polhemus M, Aronson NE. Old world leishmaniasis: an emerging infection among deployed US military and civilian workers. Clin Infect Dis 2004;39:1674-1680.