Reply to Torres and Suárez

TO THE EDITOR—We appreciate Drs Torres and Suárez’s interest in our article, “High-Dose Oral Fluconazole Therapy Effective for Cutaneous Leishmaniasis Due to Leishmania (Vianna) braziliensis” [1]. They refer to evidence of Leishmania amazonensis isolated from human as well as domestic and wild reservoir hosts from the state of Ceará and suggest it is an important etiologic agent of cutaneous leishmaniasis in the region. Concerning human hosts, their statement is based on 2 publications [2, 3] that showed a single isolate of L. amazonensis from only 1 human case of cutaneous leishmaniasis. Both articles deal with the same parasite grown from a human skin biopsy sample in 1984. Because that event was so rare, the question as to whether it was an imported case remains. In respect to domestic and wild reservoirs of L. amazonensis in the state of Ceará, there is no proof of