{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T14:02:08Z","timestamp":1764770528082,"version":"3.46.0"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Intralesional injection of pentavalent antimonials is a recommended treatment of cutaneous leishmaniasis (CL). We describe an allergic response to meglumine antimoniate after intralesional treatment of a CL lesion. A 61-year-old male resident of the United Kingdom developed an enlarging, nontender nodule on the right earlobe. Histological analysis and polymerase chain reaction testing confirmed a diagnosis of CL. Intralesional therapy with meglumine antimoniate was initiated, and two infiltrations were completed. After each administration, localized swelling and erythema were noted, and after the second infiltration, an urticarial rash also appeared on the patient\u2019s hands. An immunological hypersensitivity reaction, with mixed Type I and Type IV features, was suspected, and treatment was discontinued. The patient declined further treatment, and the lesion gradually resolved, with full recovery 36 months after the first treatment. Recent travel history suggested Spain as the most likely country of acquisition. This report also reviews the literature on allergy to antimonial drugs. The prevalence of pentavalent antimonial hypersensitivity varies considerably between studies, likely due to differences in reporting of adverse events. Clinicians treating leishmaniasis should be aware of this adverse effect of antimonials, which may require use of alternative therapies.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0210","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T15:39:46Z","timestamp":1761233986000},"page":"1217-1219","source":"Crossref","is-referenced-by-count":1,"title":["Delayed Hypersensitivity to Intralesional Meglumine Antimoniate for Cutaneous Leishmaniasis"],"prefix":"10.4269","volume":"113","author":[{"given":"Owain","family":"Donnelly","sequence":"first","affiliation":[{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom;"},{"name":"Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna M.","family":"Checkley","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom;"},{"name":"Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen L.","family":"Walker","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom;"},{"name":"Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom;"},{"name":"Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"J Travel Med","first-page":"116","article-title":"LeishMan recommendations for treatment of cutaneous and mucosal leishmaniasis in travelers, 2014","volume":"21","author":"Blum","year":"2014"},{"key":"b2","series-title":"Clin Infect Dis","first-page":"e202","article-title":"Diagnosis and treatment of leishmaniasis: Clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH)","volume":"63","author":"Aronson","year":"2016"},{"key":"b3","series-title":"Am J Trop Med Hyg","first-page":"51","article-title":"A diagnostic algorithm for detection of Leishmania spp. in human fresh and fixed tissue samples","volume":"111","author":"Silva-Flannery","year":"2024"},{"key":"b4","series-title":"Emerg Infect Dis","first-page":"1723","article-title":"Leishmaniases in the European Union and neighboring countries","volume":"27","author":"Berriatua","year":"2021"},{"key":"b5","series-title":"Parasitology","first-page":"213","article-title":"Typing of Leishmania isolates from vectors and leporids of the Madrid (Spain) outbreak","volume":"151","author":"Fern\u00e1ndez-Ar\u00e9valo","year":"2024"},{"key":"b6","series-title":"Lancet Infect Dis","first-page":"763","article-title":"Treatment options for visceral leishmaniasis: A systematic review of clinical studies done in India, 1980\u20132004","volume":"5","author":"Olliaro","year":"2005"},{"key":"b7","series-title":"Molecules","first-page":"2317","article-title":"Pentavalent antimonials: New perspectives for old drugs","volume":"14","author":"Fr\u00e9zard","year":"2009"},{"key":"b8","series-title":"PLoS Negl Trop Dis","first-page":"e0006052","article-title":"Drug resistance and treatment failure in leishmaniasis: A 21st century challenge","volume":"11","author":"Ponte-Sucre","year":"2017"},{"year":"2019","series-title":"Toxicological Profile for Antimony and Compounds.","key":"b9"},{"key":"b10","series-title":"J Occup Med","first-page":"392","article-title":"Dermatitis in workers exposed to antimony in a melting process (abstract)","volume":"35","author":"White","year":"1993"},{"key":"b11","series-title":"J Allergy Clin Immunol Pract","first-page":"2124","article-title":"Anaphylaxis after first exposure to gadoterate meglumine: A case report and literature review","volume":"6","author":"Bianchi","year":"2018"},{"key":"b12","series-title":"Shiraz E-Med J","first-page":"155","article-title":"Therapeutic and adverse effects of glucantime used for treatment of cutaneous leishmaniasis","volume":"8","author":"Beheshti","year":"2007"},{"key":"b13","series-title":"Mem Inst Oswaldo Cruz","first-page":"e180200","article-title":"Meglumine antimoniate intralesional infiltration for localised cutaneous leishmaniasis: A single arm, open label, phase II clinical trial","volume":"113","author":"Ramalho","year":"2018"},{"key":"b14","series-title":"Expert Rev Anti Infect Ther","first-page":"381","article-title":"Safety profile of meglumine antimoniate intralesional infiltration for cutaneous leishmaniasis","volume":"18","author":"Fernandes","year":"2020"},{"key":"b15","series-title":"Allergy","first-page":"1609","article-title":"Delayed allergic skin reactions due to intralesional meglumine antimoniate therapy for cutaneous leishmaniasis","volume":"67","author":"C\u00f3rdoba","year":"2012"},{"key":"b16","series-title":"Clin Infect Dis","first-page":"574","article-title":"A randomized, controlled, noninferiority, multicenter trial of systemic vs intralesional treatment with meglumine antimoniate for cutaneous leishmaniasis in Brazil","volume":"77","author":"Lyra","year":"2023"},{"key":"b17","series-title":"PLoS Negl Trop Dis","first-page":"e0009734","article-title":"An old drug and different ways to treat cutaneous leishmaniasis: Intralesional and intramuscular meglumine antimoniate in a reference center, Rio de Janeiro, Brazil","volume":"15","author":"Oliveira-Ribeiro","year":"2021"},{"key":"b18","series-title":"Acta Derm Venereol","first-page":"adv35089","article-title":"Comparison of intralesional sodium stibogluconate versus intralesional meglumine antimoniate for the treatment of Leishmania major cutaneous leishmaniasis","volume":"104","author":"Solomon","year":"2024"},{"key":"b19","series-title":"PLoS Negl Trop Dis","first-page":"e0010578","article-title":"Effectiveness of intralesional sodium stibogluconate for the treatment of localized cutaneous leishmaniasis at Boru Meda General Hospital, Amhara, Ethiopia: Pragmatic trial","volume":"16","author":"Zewdu","year":"2022"},{"key":"b20","series-title":"Trop Med Infect Dis","first-page":"286","article-title":"Intralesional meglumine antimoniate: Safe, feasible and effective therapy for cutaneous leishmaniasis in Bolivia","volume":"7","author":"Rojas Cabrera","year":"2022"},{"key":"b21","series-title":"PLoS Negl Trop Dis","first-page":"e0006141","article-title":"Harmonized clinical trial methodologies for localized cutaneous leishmaniasis and potential 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