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Sunday, September 23, 2012

Leishmaniasis - Poison Ivy isn't the worst of it for this geocacher!

The pimple that wouldn't go away
Friendly sand fly
Thankful for these folks
Nurse Rosita giving me the daily injection...don't make me look
Where I spend part of my mornings
Probably the worst thing geocaching got me into was a patch of poison ivy. I remember when I went after a cache in Greensboro, NC called I Am Mrs Ego (GC1JQAG) during the summer. My wife said, "don't go in there" but I didn't listen. Well, I found something worse! Recently I published a blog about the Utuquinia River in Peru. I had a great time surveying for possible locations for a geocache series that might be combined with eco-tourism. Along with my partners on this trip I explored rivers, hiked jungle trails, camped and generally had a great time. We covered up in bug repellent but the bugs found their way through it all. One particular silent and painless biting bug that got to me during the course of this trip is known locally as the Mantablanca (the white blanket). It's official name is Lutzomyia. In plain English it is a sand fly, frequenting sandbanks along the rivers and streams in the jungle and in the mountains. The trip took place in the first week of May 2012. In early July I started noticing what looked like a pimple above my right eye near the hairline. It simply wouldn't go away. I went to see a doctor and was referred to a dermatologist. After several weeks of antibiotic treatment the doctor did a biopsy. Within the week the results indicated that I have Leishmaniasis, also locally known as Uta. Apparently an infected female sand fly enjoyed a blood meal and deposited the protozoa in the bite area. After several months the protozoa formed the leishmaniasis parasite under the skin and began to form a boil. I was fortunate to have access to good medical care in the capital city and received a quick diagnosis. I'm away from my geocaching activities in the jungle to get this treated. Cutaneous leishmaniasis, if untreated, will usually lead to disfiguring ulcers in the location of the bite. It can also progress to a more serious type that attacks the internal organs. My dermatologist introduced me to the head of the leishmaniasis department at the Institute for Tropical Medicine at the Cayetano Heredia Hospital in Lima. They began the treatments. They consist of a daily injection of sodium estriboglucante directly into a vein in my arm or hand. The side effects make you feel worse than the disease. Nonetheless I stayed in the capital city to take the three weeks of treatment. I was their "gringo" case study and they took pride in showing me off to the doctors that came through from numerous countries to study tropical diseases. I'm an anomaly too. They've never seen leishmaniasis on the scalp. I currently have three lesions healing up slowly and nicely thanks to the good doctors at the hospital. Thanks to the Peruvian government there are no charges for the treatment. Yes, it's all free. Will I go back out to the jungle. You bet! There's more work to do, caches to hide and tourism to organize before I retire! If coming to the jungles of South America, particularly in Peru and Brazil be sure to wear long sleeves in the jungle and spray all your exposed skin with a deet-based insect repellent for protection. I learned that there is a strain of leischmaniasis that is readily available in the mountains too. If you are anywhere around sand take these precautions. I've met lots of folks who come from all over the mountains and jungle of Peru, Venezuela and Ecuador for treatment here. Many are poor and live far out into the jungle where medical facilities aren't readily available. They contract the disease and don't seek treatment until their skin ulcers are quite large. Not a pretty sight. Thank you for praying for me. I have to have regular check ups over the next year to make sure that the parasites are gone and don't start their mischief again. Thanks to Gustavo for the sand fly photo.
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