Abstract：
BACKGROUND: Cutaneous leishmaniasis (CL) is a vector-borne parasitic infection endemic to many sub-tropical regions worldwide. In the Americas, Leishmania braziliensis is responsible for most reported CL cases. Variable symptom presentation and susceptibility to secondary infection make diagnosing CL a difficult proposition for physicians who may not encounter cases frequently.
METHODS: We present the case of a 50-year-old man with multiple progressive lesions, diagnosed initially as a bacterial infection, who presented to a North American emergency department after several unsuccessful trials of antibiotic therapy. Eventually, polymerase chain reaction testing of a wound biopsy sample confirmed the presence of L. braziliensis. After a complicated course, the patient\'s infection resolved after tailored antiparasitic therapy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the need to include travel history in the evaluation of atypical dermatologic infections.
METHODS: We present the case of a 50-year-old man with multiple progressive lesions, diagnosed initially as a bacterial infection, who presented to a North American emergency department after several unsuccessful trials of antibiotic therapy. Eventually, polymerase chain reaction testing of a wound biopsy sample confirmed the presence of L. braziliensis. After a complicated course, the patient\'s infection resolved after tailored antiparasitic therapy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the need to include travel history in the evaluation of atypical dermatologic infections.
摘要：
背景：皮肤利什曼病（CL）是全球许多亚热带地区特有的媒介传播寄生虫感染。在美洲,巴西利什曼原虫是大多数报告的CL病例。可变的症状表现和对继发感染的易感性使诊断CL对于可能不经常遇到病例的医生来说是一个困难的命题。
方法：我们介绍了一个50岁的男性多发性进展性病变的病例，最初被诊断为细菌感染，在几次抗生素治疗试验失败后，他向北美急诊科就诊。最终,伤口活检样本的聚合酶链反应测试证实了巴西乳杆菌的存在。经过复杂的课程，经过量身定制的抗寄生虫治疗，患者的感染得以解决。为什么应该让紧急医生意识到这一点？：这个案例强调了在评估非典型皮肤病感染时需要包括旅行史。
方法：我们介绍了一个50岁的男性多发性进展性病变的病例，最初被诊断为细菌感染，在几次抗生素治疗试验失败后，他向北美急诊科就诊。最终,伤口活检样本的聚合酶链反应测试证实了巴西乳杆菌的存在。经过复杂的课程，经过量身定制的抗寄生虫治疗，患者的感染得以解决。为什么应该让紧急医生意识到这一点？：这个案例强调了在评估非典型皮肤病感染时需要包括旅行史。
