Cutaneous leishmaniasis is a parasitic infection transmitted by infected sandfly bites, causing skin lesions that progress from small papules to large nodules and ulcerations; if untreated, it can spread to mucous membranes (mucocutaneous leishmaniasis), causing severe disfigurement and potentially life-threatening complications like airway obstruction or sepsis, with treatment involving specialized medications like pentavalent antimonials or amphotericin B, and prevention through insect repellent in endemic regions.
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Parasites Are Eating His Face! Doctor Reacts to Monsters Inside MeAdded:
After a six-month odyssey across South America, newly engaged Adam Spencer has returned home with a massive wound across his face.
This show always starts out with somebody who travels to South America or Asia or Africa and they develop a terrible infection and then it becomes a monster inside of them. And you know what? I'm going to South America in a few months.
>> I felt like my body was breaking down.
his wound had grown to about 2 in.
>> So what is the differential diagnosis for this massive wound? Meaning that what are the different things that this could possibly be? Well, the first thing is it could be due to trauma. Although they don't mention that he had any trauma on his vacation. It could be due to cancer. Some people who have soft tissue cancer can have chronic large wounds like this, but at this point it would be quite advanced and somebody this young unlikely to be that. And the third thing is it could be a terrible infection. And this show is called Monsters Inside Me, so it's got to be a bad infection.
>> Fact that Adam had this rather dramatic lesion on his cheek and he had spent time in South America made me think that this could be cutaneous leechmanasis.
>> Cutaneous leashmanasis is a parasitic infection that is caused by a protozoa.
It's called leash mania. Now, this is transmitted through the bites of infected female sandflies. And in general, you can get this in subtropical and tropical regions, but you can also, believe it or not, get it in the United States. Guess which state has cutaneous leech manasis? It is not Florida. It's Texas. The body sends immune cells to attack the parasite. But the parasites fight back, penetrating the immune cells and then reproducing inside them. Okay, now this is actually quite scary because the immune cells are there to destroy the parasite, but the parasite actually hijacks the immune cells and grows inside of them, which is frightening.
>> As the parasites multiply, they devastate the surrounding tissue, causing hideous sores on the skin.
>> Cutaneous leech manasis usually starts off as small papules and then they grow into large nodules. And if it's not treated appropriately, these nodules can coalesce into kind of this like volcanic ulcerations that can become quite large.
As you see on this guy's cheek, >> the doctor looked in my throat and he thought that I might have mucoutaneous leechmanasis.
>> So this is even worse than cutaneous leechmanasis. Mucooutaneous leechmanasis is when cutaneous leechmanasis has been going on for so long that it goes from your skin to your mucous membranes. It's basically inside your mouth, inside your nose, and they can even grow inside your throat. And unlike cutaneous leechmanis, where these lesions are actually not all that painful, when you get mucoutaneous leechmanis, the lesions inside your mouth and your throat can be very painful. In addition, these can be very disfiguring and I feel bad for this guy because it just keeps getting worse for the poor guy.
>> Mucoutaneous lemanasis can be very disfiguring and when it's not treated could be deadly. I became really afraid that it was already strong enough that I could die.
>> So, how can you die from mucoututaneous leashmanasis? Well, obviously it can look quite disfiguring, but on top of that, if you get it in your airway, it can technically cause airway obstruction by all the swelling that it can create.
If you've had it for long enough, it can make swallowing near impossible and theoretically, you could die from malnutrition. And if you still don't treat it, then it can actually go into other organs and you can get septic and die from that. So, my rejuvenation nation friends, please do not get this.
And if you do get it, please get it treated right away.
>> It kind of sucks because I have to pick the oozing around it and then it might ooze it during the night and I just I haven't been sleeping well.
>> So, the good news is is that these cutaneous lesions like that huge wound on the side of his face probably doesn't hurt much. But the bad news is is that this can be scarring and so this can definitely be disfiguring. Even though it looks bad right now, even after it's treated, it can leave scarring behind.
>> Was my face ever going to look the same again.
There was there's nothing I could do. I was essentially helpless waiting for the treatment to begin.
>> The main treatment for cutaneous leechmanasis are pentavalent antimonials and these are specialized drugs that can target that cutaneous leechmanasis and basically destroy it. The problem with these drugs though is that they do have quite a bit of side effects and toxicity. You can get both heart and liver toxicity from these medications.
Now, because these medications have such severe potential side effects, his doctor was probably waiting for biopsy results to come back before he started treating them. You know, unlike let's say if you've got some type of a throat infection or a bronchitis, sometimes doctors will treat you with an antibiotic even though they don't have any, let's say, lab results back because they know that most likely they'll be able to treat it with a broadspectctrum antibiotic. But because the cutaneous leechmanis, those medications can be toxic for your body. You don't just want to start somebody on it if you don't have a definite diagnosis.
>> A week later, Shaylin discovers something new.
Two new lesions popped up on his back, so we knew that it had gone systemic.
>> Oh jeez. That means that it's gotten into his bloodstream and it has spread to other parts of his body. Not good news.
>> A week later, the CDC confirms the diagnosis. So they permit Adam to take a powerful drug called amphoteras B.
>> Amphoterism B is an antifungal medication that can be used to treat cutaneous leechmanasis. like the pentavalent antimonials I mentioned earlier. They do have potential side effects though like liver toxicity but not as risky as the pentavalent antimonials. The negative with amphotarism B though is it has to be injected as an IV so you can't take it in a pill form.
>> Adam notices an improvement.
>> My throat had completely healed which was just so relieving.
>> Well that is great news. Now, the typical course of amphoteras B for this type of infection is about 1 to two weeks.
>> I have 5 days left of the 21-day treatment, and now I feel like it's it's reverting finally.
>> So, it sounds like it was so severe that they upped his course to 3 weeks.
Whatever it takes to destroy this parasite definitely is needed. And how do you then treat the scarring afterwards? So the first thing is scar gels like silicone based scar gels can kind of help during the initial youthful kind of scarring process. After that there are a number of treatments that we can do either in a plastic surgeon or a dermatologist's office. This includes laser treatments that can help reduce the redness and hopefully help prevent let's say thickening of the scarring.
You can also consider micro needling treatments or RF micro needling that can help after the scar has gotten a little bit more mature. Unfortunately scars are permanent. So, if he does have scarring from this infection, there's no way to completely get rid of it. There is no eraser for scars.
>> We had to put the wedding plans on hold because I had a flesheating parasite on my face, but I'm going to have a huge scar. You can see that that wound is granulating. It's cleaning up. There's not this kind of ugly angry redness that it used to have before, but he definitely has a lot of scar treatments ahead of him. I hope he does get access to a good dermatologist or a plastic surgeon. So, how do you avoid yourself?
my rejuvenation nation from getting this type of horrible parasitic infection.
Let's find out.
>> Travelers to Asia, the Middle East, Southern Europe, and South America should use deepbased insect repellent to avoid being bitten by sandfly.
>> You also want to avoid being bitten by mosquitoes in these subtropical and tropical countries, especially mosquitoes that may bite you in the private area. Take a peek at this video right up here from Monsters Inside Me where a guy got bit by a mosquito down there and he ended up growing a massive worm in his privates. Yes, you got to see this one right up here. And remember, adopt don't shop, save a life today.
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