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Leishmaniasis

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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

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