RESUMO
BACKGROUND: Leishmaniasis is a widespread disease in tropical and subtropical countries, except for Australia and Oceania. In Poland, tourists, migrants and travellers from leishmaniasis-endemic countries may carry Leishmania. CASE PRESENTATION: We present a case of undiagnosed cutaneous leishmaniasis in a patient who received many weeks of inadequate antibiotic treatment. Ulceration in the right submandibular region was thought to be a purulent complication after laser surgery. Six weeks before the ulcer developed, the patient had visited the jungle (Guatemala). Cutaneous leishmaniasis was finally diagnosed after nine months based on a proper history and a polymerase chain reaction (PCR) assay. Treatment with antimony derivatives was administered. After three months, the ulcer healed but left a scar. CONCLUSION: A lack of knowledge about tropical diseases among doctors and an incomplete medical history were the reasons for many weeks of erroneous treatment of cutaneous leishmaniasis with antibiotics. This is the first reported case of cutaneous leishmaniasis misdiagnosed as a complication after an aesthetic medical procedure.
RESUMO
Malaria is a parasitic disease caused in humans by five species of Plasmodium: P. falciparum, P. vivax, P. malariae, P. ovale, and P. knowlesi and transmitted through a female mosquito bite. In 2020, there were 241 million cases of malaria worldwide including 627,000 deaths. Traveling to malaria endemic areas is a significant risk factor, therefore, it is very important to use non-specific and pharmacological prophylaxis. Malaria symptoms usually appear 10-14 days after infection and the disease may be suspected, based on patient examination and medical history, in patients with fever who have stayed in malaria endemic areas. The initial symptoms of the disease are not pathognomonic and it is important to remember that not all malaria patients develop a fever. A prerequisite for successful treatment of this potentially life-threatening disease is well-targeted, timely diagnosis and immediate implementation of antiparasitic therapy. Despite significant progress in the fight against malaria across the world, the disease still poses a diagnostic and therapeutic challenge, especially when it develops as a result of an imported infection and when diagnosis is complicated by the presence of other diseases. A professional group that requires special attention are maritime workers. In this study we present clinical cases of malaria which show how important it is in the clinical practice of various specialists to include malaria in the differential diagnosis of patients with fever returning from tropical regions.