Advertisement

Mucosal leishmaniasis in Brazilian patients: two case reports with similar clinical presentation and different approaches

Published:March 09, 2016DOI:https://doi.org/10.1016/j.oooo.2016.02.017
      Mucosal leishmaniasis is a chronic infection that affects the upper respiratory tract and/or the oral mucosa caused by Leishmania protozoan parasites. We present two cases of oral leishmaniasis and discuss the different diagnostic strategies and treatment. In both cases, the patients were male, 60 and 94 years of age, and presented with lesions on the soft palate. In the first patient, the final diagnosis was made on the basis of histopathologic examination. In the second case, polymerase chain reaction and Montenegro skin test were necessary to confirm the diagnosis. The first patient was treated with meglumine antimoniate (Glucantime), and the lesions healed after 2 months. In the second case, the patient received treatment with liposomal amphotericin B but later died as a result of generalized infection. Mucosal leishmaniasis is a highly disfiguring disease. Early diagnosis is important to prevent a lethal outcome.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Abbas K.
        • Musatafa M.A.
        • Abass S.
        • et al.
        Mucosal leishmaniasis in a Sudanese patient.
        Am J Trop Med Hyg. 2009; 80: 935-938
        • Reveiz L.
        • Chapman E.
        • Torres R.
        • et al.
        Interventions for American cutaneous and mucocutaneous leishmaniasis: a systematic review update.
        PLoS One. 2013; 8: E61843
        • Okumura Y.
        • Yamauchi A.
        • Nagano I.
        • et al.
        A case of mucocutaneous leishmaniasis diagnosed by serology.
        J Dermatol. 2014; 41: 739-742
        • Strazzulla A.
        • Cocuzza S.
        • Pinzone M.R.
        • et al.
        Mucosal leishmaniasis: an underestimated presentation of a neglected disease.
        Biomed Res Int. 2013; 2013: 805108
        • Boggild A.K.
        • Valencia B.M.
        • Veland N.
        • et al.
        Non-invasive cytology brush PCR diagnostic testing in mucosal leishmaniasis: superior performance to conventional biopsy with histopathology.
        PLoS One. 2011; 6: E26395
        • Abbas K.
        • el Toum I.A.
        • el Hassan A.M.
        Oral leishmaniasis associated with kala-azar. A case report.
        Oral Surg Oral Med Oral Pathol. 1992; 73: 583-584
        • Melo M.N.
        • Mayrink W.
        • da Costa C.A.
        • et al.
        Standardization of the Montenegro antigen.
        Rev Inst Med Trop Sao Paulo. 1977; 19: 161-164
        • Degrave W.
        • Fernandes O.
        • Campbell D.
        • Bozza M.
        • Lopes U.
        Use of molecular probes and PCR for detection and typing of Leishmania: a mini review.
        Mem Inst Oswaldo Cruz. 1994; 89: 463-469
        • Di Lella F.
        • Vincenti V.
        • Zennaro D.
        • et al.
        Mucocutaneous leishmaniasis: report of a case with massive involvement of nasal, pharyngeal and laryngeal mucosa.
        Int J Oral Maxillofac Surg. 2006; 35: 870-872
        • Virgilio G.R.
        • Hale B.R.
        A case of mucocutaneous leishmaniasis.
        Otolaryngol Head Neck Surg. 2005; 132: 800-801
        • Guerra J.A.
        • Coelho L.I.
        • Pereira F.R.
        • et al.
        American tegumentary leishmaniasis and HIV-AIDS association in a tertiary care center in the Brazilian Amazon.
        Am J Trop Med Hyg. 2011; 85: 524-527
        • David C.V.
        • Craft N.
        Cutaneous and mucocutaneous leishmaniasis.
        Dermatol Ther. 2009; 22: 491-502
        • Faucher B.
        • Pomares C.
        • Fourcade S.
        • et al.
        Mucosal Leishmania infantum leishmaniasis: specific pattern in a multicentre survey and historical cases.
        J Infect. 2011; 63: 76-82
        • de Oliveira C.I.
        • Brodskyn C.I.
        The immunobiology of Leishmania braziliensis infection.
        Front Immunol. 2012; 3: 145
        • Oryan A.
        • Shirian S.
        • Tabandeh M.R.
        • Hatam G.R.
        • Kalantari M.
        • Daneshbod Y.
        Molecular, cytological, and immunocytochemical study and kDNA sequencing of laryngeal Leishmania infantum infection.
        Parasitol Res. 2013; 112: 1799-1804
        • Goto H.
        • Lindoso J.A.
        Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis.
        Expert Rev Anti Infect Ther. 2010; 8: 419-433
        • García A.L.
        • Parrado R.
        • Rojas E.
        • Delgado R.
        • Dujardin J.C.
        • Reithinger R.
        Leishmaniases in Bolivia: comprehensive review and current status.
        Am J Trop Med Hyg. 2009; 80: 704-711
        • Lessa H.A.
        • Lessa M.M.
        • Guimarães L.H.
        • et al.
        A proposed new clinical staging system for patients with mucosal leishmaniasis.
        Trans R Soc Trop Med Hyg. 2012; 106: 376-381
        • Blum J.
        • Desjeux P.
        • Schwartz E.
        • Beck B.
        • Hatz C.
        Treatment of cutaneous leishmaniasis among travellers.
        J Antimicrob Chemother. 2004; 53: 158-166
        • Tiuman T.S.
        • Santos A.O.
        • Ueda-Nakamura T.
        • Filho B.P.
        • Nakamura C.V.
        Recent advances in leishmaniasis treatment.
        Int J Infect Dis. 2011; 15: E525-E532
        • Dedet J.P.
        • Melogno R.
        • Cardenas F.
        • et al.
        Rural campaign to diagnose and treat mucocutaneous leishmaniasis in Bolivia.
        Bull World Health Organ. 1995; 73: 339-345
        • Sampaio S.A.P.
        • Castro R.M.
        • Dillon N.L.
        • Martins J.E.C.
        Treatment of cutaneous leishmaniasis with amphotericin B. A report of 70 cases.
        Int J Dermatol. 1991; 10: 179-181
        • Lopez-Berestein G.
        • Bodey G.P.
        • Fainstein V.
        • et al.
        Treatment of systemic fungal infections with liposomal amphotericin B.
        Arch Int Med. 1989; 149: 2533-2536