A family cluster of cutaneous Leishmania major infection unresponsive to intralesional meglumine antimonial: Case reports.

We describe a family cluster of L. major that became infected by traveling to an endemic focus of CL, which did not respond to intralesional meglumine antimonial treatment whilst two were hospitalized due to the progressive disease that responded to 4 weeks of oral ketoconazole. Parasite genotyping of the internal transcribed spacer 1 gene revealed the same infecting parasite strain in all family members and was the same strain in GenBank that caused mucosal L. major in a tourist who visited several North African countries. We hypothesise a reduced host immune response in the two hospitalized patients.