Leischmania, anergic patient
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Occasional patients are anergic to leischmania, and the ulcers and mucosal lesion rapidly multiply. These patients have a clinical appearance somewhat similar to those with anergic leprosy (lepromatous leprosy). Treatment has not been very successful, although some progress has been reported with intra-lesional injection of gamma interferon, which can induce oxidative killing within macrophages. This little boy has lived in the hospital since age 7, with only minimal improvement in his lesions. He is now 24 years old.