The following article is about my longtime friend's nephew. He was traveling in South America this past fall and winter, and failed to use his insect repellent. Not a big deal, right?

WRONG!

W. Oregon man fights flesh-eating parasite

Sue

After reading this, I can't help but wonder whether he might have been better off seeking medical help in South America, where the doctors would be more familiar with how to treat this parasitic infection. Even though we have good medicine here, when it comes to unusual local diseases and conditions, local knowledge is quite valuable. I've seen a less dramatic example of this.

Da Bing

He did, and the doctor said it was likely Leishmaniasis, but she didn't really pursue it (maybe because it's not that easy to cure, even if she was aware of the treatment), and he thought she was wrong due to the lapse of time, so he let it go.

And once the diagnosis was finally made, there were still delays because the doctors said they had to know which strain it was before they would give him the only drug known to treat it, and they had to get approval from somewhere because it's still not approved by the FDA.

In general, however, I think you're right about getting local diseases/conditions treated where they know the most about them.

Sue

I remember that part. The patient refused treatment because he thought the doctor was wrong. Why didn't he take the doctor seriously? I get the feeling he didn't want medical treatment outside of the US. We shouldn't play quarterback after the fact, but he probably wouldn't have suffered that much if he got on it fast.

DB

Considering what he's had to go through to get the only med that is known to work, what would he have been treated with in S.A.?

Just because they know what it is doesn't necessarily mean they have the means to treat it.

But I do understand what you're saying about his not wanted to be treated outside the U.S. A friend's father came back here (from Switzerland!) to have surgery on his knee. They 'forgot' to give him antibiotics for a week, and he nearly lost his leg. Sometimes faith is misplaced.

Sue

Let me share one example that I've encountered. I've seen American doctors panic at the sight of a certain condition common in some parts of the world. They generally have no experience with it, and tend to go right to the big bat. Unnecessarily big, and with last serious side effects, I was told by foreign doctors who knew how to treat this problem.

What was curious for me was that the parasite host had to take an experimental drug. Was it experimental because it was new, or was it because the FDA watches over drugs a lot more cautiously than its counterpart in other countries? In other words, was it difficult for him to get access to the drug because of government regulations, or because of the scarcity of this drug? Perhaps in areas where that parasite occurred regularly, doctors could get access to to that drug easily due to the relative lack of regulations and to the need for this drug.

We're just speculating & shooting the breeze. Neither one of us knows more than what the article tells us, but I think the lessons are: (1) don't forget the insect repellent, and (2) if you emerge from the jungle with anything remotely weird, get it treated right away. Don't stop until it's gone, and certainly don't wait for months.

Da Bing

Apparently, it was your second suggestion. This is from the book Leishmania by Jay Farrell, that I found online.

"Organic pentavalent antimony in the form of sodium antimony gluconate has been used since the 1940s. Two such preparations, sodium stibogluconate and meglumine antimoniate have been used over three decades as first line VL chemotherapy. Current penavalent antimony preparations include sodium stibogulconate, available as Pentostam (Wellcome Foundation Ltd., London) and meglumine antimoniate, available as Glucantime (...France, Brazil) that is used mostly in South America." (It goes on to say there are a couple of mfgrs. in India and at least one in China.)

So, it does exist in SA and is available there. Well, I'm sure he knows more about now than he ever dreamed.

Sue

Thanks for doing the research! This is very interesting. Anything bad enough to have a whole book devoted to it, with a title that ends in -mania, is definitely not something you'd want to get.

Now, I've got these year-old bug bites that don't want to go away. The doctors don't have an explanation for this. I hope you guys won't end up reading about me.

Da Bing