20
Special Populations
77. In general, clinically manifest cases of VL and ML should be treated
even in these special populations of persons because the benefits
of treatment typically outweigh the risks. However, patient-specific
factors, including the presence of comorbid conditions, should be
considered in the selection of the antileishmanial therapy, dosage
regimen, and monitoring approach (Table 4) (S-L).
78. Decisions regarding whether and how to treat cases of CL in persons
with special characteristics or comorbid conditions should take into
account the potential risks and benefits of various approaches, such
as initially observing without antileishmanial therapy, deferring
treatment (eg, until after pregnancy/delivery), and using local (vs.
systemic) therapy as the sole approach or as a temporizing measure,
if otherwise appropriate and feasible (S-VL).
Treatment
