{
  "abstract": "Cutaneous leishmaniasis is a neglected vector-borne disease caused by Leishmania spp., with viable parasites potentially persisting after clinical cure. Immunosuppressive therapies may favor reactivation of latent infection. The case of a 62-year-old Brazilian woman with a 25-year history of rheumatoid arthritis who developed a painful ulcerative lesion on her right leg 1 month after initiating tocilizumab therapy is reported. Molecular testing confirmed Leishmania (Viannia) braziliensis, consistent with reactivated cutaneous leishmaniasis. Tocilizumab was discontinued, and liposomal amphotericin B was initiated but interrupted because of nephrotoxicity and hepatotoxicity. Despite incomplete treatment, the lesion gradually healed after withdrawal of immunosuppression without requiring additional antiparasitic therapy. Secondary prophylaxis with liposomal amphotericin B was subsequently initiated under close clinical and laboratory monitoring, and no recurrence has been observed during follow-up. This case highlights the importance of screening clinical history for prior leishmaniasis, maintaining vigilance for reactivation in patients from endemic areas, and promptly adjusting immunosuppressive therapy to optimize clinical outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Laboratório de Parasitologia, São Paulo, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil",
    "Laboratório de Doenças Infecciosas e Emergentes, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil",
    "Faculdade de Medicina, Departamento de Infectologia e Medicina Tropical, São Paulo, Universidade de São Paulo, São Paulo, Brazil",
    "Laboratório de Soroepidemiologia, São Paulo, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Regina Maia de Souza"
    },
    {
      "affs": [
        1
      ],
      "name": "Felipe Francisco Tuon"
    },
    {
      "affs": [
        2
      ],
      "name": "Antônio Carlos Nicodemo"
    },
    {
      "affs": [
        2
      ],
      "name": "Christini Takemi Emori"
    },
    {
      "affs": [
        3
      ],
      "name": "Beatriz Julieta Celeste"
    },
    {
      "affs": [
        3
      ],
      "name": "Maria Carmen Arroyo Sanchez"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Valdir Sabbaga Amato"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a0555wv1cjy04.bib",
  "cited_by": 1,
  "doi": "10.4269/ajtmh.26-0345",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13590949/",
  "id": "a0555wv1cjy04",
  "issns": [
    "0002-9637",
    "1476-1645"
  ],
  "landing_url": "https://doi.org/10.4269/ajtmh.26-0345",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2739|Research on Leishmaniasis Studies"
    ]
  ],
  "openalex": "W7213269704",
  "pdf_url": null,
  "pmcid": "PMC13590949",
  "pmid": "42743917",
  "published": "2026-09-15",
  "publisher": "The American Society of Tropical Medicine and Hygiene",
  "ris": "https://research.draconitic.com/paper/a0555wv1cjy04.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:20:34Z",
      "native_id": "PMC13590949",
      "source": "pmc",
      "url": "https://doi.org/10.4269/ajtmh.26-0345"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Research on Leishmaniasis Studies",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Reactivation of Cutaneous Leishmaniasis in a Rheumatoid Arthritis Patient Undergoing Tocilizumab Treatment",
  "title_text": "Reactivation of Cutaneous Leishmaniasis in a Rheumatoid Arthritis Patient Undergoing Tocilizumab Treatment",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:20:34Z",
  "url": "https://research.draconitic.com/paper/a0555wv1cjy04",
  "venue": "The American Journal of Tropical Medicine and Hygiene",
  "versions": []
}