ATL - (LTA)

It is an infectious disease that tends to progress to chronic, non-contagious, caused by different species of protozoa of the genus Leishmania and transmitted by blood sucking insects generally designated sandflies. It is a zoonosis, as it has bitten wild animals as reservoirs by sandflies.
Man is accidentally infected when the parasite invades the ecosystem in extractive activities or the implementation of agricultural projects in recently deforested areas. It is endemic in the Amazon region, with significant impact. It is characterized by polymorphism lesion, affecting the skin, commonly manifesting as an ulcerated lesion, single or multiple, measuring between 3 and 12 cm in diameter, with raised edges, "in a picture frame", granular base and bloody, often associated to secondary bacterial infection.
Depending on the species of Leishmania and the host immunogenetic factors may occur mucosal lesions and cartilage, which usually begins in the nasal mucosa, appearing runny nose and nasal bleeding, evolving into septum perforation and destruction of the nasal cavity, mucosa, cartilage and cases more severe compromises the floor of the mouth, tongue, larynx, trachea and bronchi, with severe mutilations, affecting vital functions leading to death.
The diagnosis is clinical, based on the characteristics of the skin lesions and laboratory tests through the following: scraped from the ulcer edge, isolation of the parasite in culture, isolation of the parasite in laboratory animals ("hamster"), intradermal Montenegro, and indirect immunofluorescence pathological examination of the lesion.
In the treatment of mucocutaneous leishmaniasis the drugs of first choice remain the pentavalent antimonials, namely pentavalent antimonials meglumine, ie, meglumine antimoniate and sodium stibogluconate.
In case of failure of these substances may be used other drugs such as Amphotericin B and pentamidine. All are injectable administration, with several applications, making patient compliance. Genetic factors may considerably slow healing of injuries. The eco-epidemiological conditions of the Amazon do not allow the institution of prophylactic measures. There is no vaccine available for clinical use.