[Pseudotumoral sublingual leishmaniasis caused by Leishmaniainfantum]. / Leishmaniose sublinguale pseudotumorale à Leishmaniainfantum.

INTRODUCTION: Mucosal leishmaniasis is endemic in certain parts of Latin America and are usually absent in Morocco. Herein we report a case of Leishmaniainfantum in a Moroccan patient. PATIENTS AND METHODS: A 61-year-old male patient working as a tourist bus driver presented with a sublingual endobuccal tumor. He reported a history of treated cutaneous leishmaniasis of the lower lip in 2009 and had presented the sublingual oral tumor since December 2011. The histopathological findings as well as the species-specific PCR analysis confirmed the diagnosis of sublingual mucosal leishmaniasis due to L. infantum. HIV serology was negative. Our patient was then treated with intra-muscular meglumine antimoniate for 25 days, resulting in complete disappearance of the oral lesion. CONCLUSION: Our case thus has several peculiarities: the strictly mucosal character of the lesion, occurring in an immunocompetent subject, the unusual pseudotumoral form, and the causative agent, L. infantum, not known for its mucosal tropism in our country.

Tungiasis presenting as a soft tissue oral lesion.

BACKGROUND: The sand flea Tunga penetrans usually infects the feet and affects primary school-age children and elderly persons in rural Uganda. Tungiasis occurs nationwide but disease outbreaks have been reported in the Busoga sub-Region of eastern Uganda, associated with poor sanitation and proximity between humans and domestic animals. Ectopic tungiasis, usually seen with extensive infection and at weight-bearing body surfaces often follows exposure in highly infested environments. For patients who present abroad treatment may be surgical excision or amputation. CASE PRESENTATION: An adult female Musoga by tribe, resident in a Kampala City suburb presented at Mulago National Referral and Teaching Hospital's Oral Surgery and Jaw Injuries Unit with a discoloured swollen tongue, facial cellulitis and submandibular lymphadenopathy. A swelling palpable in the body of her tongue was excised and sent for histology. Tungiasis of the tongue was diagnosed after microscopic examination of formalin-fixed paraffin-embedded Haematoxylin and Eosin-stained tissue sections. CONCLUSION: Lingual tungiasis is a rare diagnosis that was made on histological examination. Atypical presentation outside an endemic area predisposed the patient to partial glossectomy instead of the less invasive flea enucleation. Ectopic disease in a city-resident highlights the plight not only of visitors to infested areas but also of the communities and their domestic animals.

Platyhelminthes in tongue--a rare case and review.

Humans are the only known definitive host of the tapeworm Taenia solium and become a carrier by eating undercooked pork contaminated with "Cysticercus cellulosae" (cysticerci). Pigs act as an intermediate host and acquire cysticercosis by ingestion of eggs or proglottids from human feces, which develop into cysticerci within tissue, mostly without causing clinical symptoms in the host. Cysticercosis occurs in humans in a context of "fecal peril" by ingestion of egg-contaminated soil, water, vegetation, or auto-infestation. It has been reported in the published data that the separation of swine from humans, healthy cooking, and hygienic practices would lead to the eradication of the disease. However, cysticercosis is still a major public health problem in endemic regions, with more than 50 million infected people and is now a re-emerging disease in industrialized countries owing to human migration. It is the second most common cause of seizures in tropical countries. We report a case of oral cysticercosis in a 28-year-old woman who presented with a painless swelling in the ventral portion of the tongue. An excisional biopsy was performed, and histopathologic examination revealed a cystic cavity containing the tapeworm.

Tongue Nodule as Primary Manifestation of American Cutaneous Leishmaniasis in an Immunocompetent Patient.

Leishmaniasis is a parasitic disease considered an endemic public health problem in developing countries, where it is a reportable disease. Isolated oral manifestation is rare, and its clinical manifestations are variable. In this paper we describe an unusual case of an immunocompetent patient, 57-year-old man with a painless reddish submucosal nodule located on the tongue dorsum. Microscopical analysis showed chronic inflammatory infiltrate with macrophages containing leishmania in cytoplasmic vacuoles. PCR assays confirmed the diagnosis and patient was treated with meglumine antimoniate for 30 days. Absence of the parasite was confirmed by PCR. Thirteen years after treatment, a scar fibrosis persisted on the tongue dorsum. The case reported reveals that leishmaniasis should be considered in the diagnosis of tongue nodules in immunocompetent patients.

[Linguatula serrata-infection in a dog imported from Romania to Germany]. / Linguatula serrata-Befall bei einem Importhund aus Rumänien.

The pentastomid Linguatula serrata, the so-called "tongue worm", is a nasopharyngeal parasite of dogs widely distributed in the Middle East, Africa and Asia. While linguatulosis was formerly also endemic in Central Europe, it now mainly plays a role as an imported parasitosis. Because L. serrata is known to be a zoonotic agent, a potential infection risk for the owner and other contact persons needs to be considered. Here, a 1.5-year-old, mixed-breed sheepdog, which had been imported from Romania, was presented because of serous nasal discharge and a pharyngeal "throat-clearing" noise. Upon sneezing, a parasite specimen was expelled and the tentative diagnosis "lingua-tulosis" was made. After expulsion of the parasite, clinical signs initially resolved. However, a second L. serrata individual was expelled 8 months later, so that a treatment attempt with milbemycin oxime/ praziquantel was initiated. No parasite eggs were detected in fecal samples or nasal mucus smears at this stage. This case report highlights the difficulties associated with the diagnosis and treatment of linguatulosis and discusses them in light of the zoonotic potential of this parasite.

Oral cysticercosis.

Cysticercosis is the result of infection with the larval stage of the tapeworm, Taenia solium. The parasite may settle at any site in the body without causing symptoms, which arise almost exclusively from the involvement of brain or eye, and this may occur several years after infection. Cysticercosis is one of the leading causes of acquired epilepsy in Latin America, parts of Asia, and Africa. More cases are being reported in other countries as a result of immigration from endemic areas. Cysticercosis may cause cystic swellings or nodules in the mouth, and these may be the only evidence of the disease. We present a healthy patient who had multiple intraoral cystic swellings that were diagnosed as cysticercosis in a biopsy specimen. Subsequent investigations showed cysticerci in the brain.

Oral cysticercosis: case report and review of the literature.

Cysticercosis is a condition that occurs when man is infested by the larvae of Taenia solium, acting as an intermediate host instead of definitive. Oral cysticercosis is a rare event, and it represents a difficulty in clinical diagnosis. A case of oral cysticercosis in a 23-year-old white female who presented a painless swelling in the dorsal portion of the tongue is reported. An excisional biopsy was performed and histopathological examination revealed a cystic cavity containing the tapeworm.

Oral helminthic infestations.

Oral infections caused by helminths (worms) are rarely encountered in clinical practice, and consequently, there is a paucity of information in the medical and dental literature about these conditions. In the present article, we review the English literature related to oral helminthic infestations. The main oral infections caused by helminths include four roundworm (trichinosis, trichuriasis, filariasis, and larva migrans) and three tapeworm infections (cysticercosis, sparganosis, and echinococcosis). Cases are mainly encountered in endemic areas and mainly present a benign clinical picture. The diagnosis of oral helminthic infections is mostly established after histopathological examination, which shows parasitic larvae lined by fibrous tissue and inflammatory cells. Surgical excision is the preferred treatment of isolated oral lesions caused by helminths; however, patients should undergo thorough medical evaluation to exclude the possible involvement of other body systems.

Cystic echinococcosis of the tongue leading to diagnosis of multiple localizations.

The tongue is a rare site of localization of cystic echinococcosis. We report a 3-year-old patient with cystic echinococcosis of the tongue demonstrated by histopathology. The cyst of the tongue was surgically removed. The tongue lesion led us to find additional liver and lung cystic lesions that were successfully treated with albendazole therapy.

Leishmaniasis of the tongue treated with liposomal amphotericin B.

A 66-year-old man, immunosuppressed because of a lymphoma and with severe ischaemic heart disease and proteinuria, presented with a swelling on the tongue due to leishmaniasis. His travel history suggested that he had acquired the infection in the Mediterranean area some years earlier. He was treated with liposomal amphotericin B for 21 days and made a good recovery despite a temporary deterioration in renal function. Oral lesions are a rare manifestation of Old World leishmaniasis. Liposomal amphotericin B is a novel treatment that may be well tolerated when there is concern about the toxicity of more established drugs.

Oral cysticercosis.

A 35-year-old Indian male with nodules in the tongue, lower lip and subcutaneous tissues and convulsions of recent onset is presented. Surgical excision of the nodules confirmed the clinical diagnosis of cysticercosis and relieved the lingual discomfort. This is the 26th case of oral cysticercosis being reported.

Visceral leishmaniasis: a lingual presentation in a patient with HIV infection.

The term leishmaniasis covers a series of illnesses caused by the protozoan Leishmania; depending on the patient's immune response, the particular species of the protozoan, and the geography, the condition may manifest itself as cutaneous, mucocutaneous, or visceral disease. Visceral leishmaniasis has often been found as a co-infection associated with the human immunodeficiency virus, particularly in the region of the western Mediterranean. We report the case of an HIV-infected patient with a history of treated laryngeal leishmaniasis who subsequently appeared for treatment with a tumorous lesion on the dorsum of the tongue that was caused by Leishmania infection.

Cysticercosis of the tongue.

Cysticercosis is a condition where man forms the intermediate host for the proglottids of Taenia solium. The common sites of cysticercosis are brain, skeletal muscle and subcutaneous tissues, but they can be found at any site. An unusual case of lingual cysticercosis is being reported.

Multiple nodules on the tongue of a patient with seizures.

Systemic cysticercosis with cerebral involvement is a serious disease that may be encountered with greater frequency in the southwestern United States because of the proximity to areas of endemic disease. Because oral lesions can occur, the dentist and dental specialists, by recognizing and performing biopsies of lesions in patients suspected of having the disease, can provide a valuable service.

Lingual cysticercosis--a case report.

Cysticercosis is unlikely to be the first diagnosis for a swelling over the tongue. In this report we document an unusual case of lingual cysticercosis presenting as an isolated lesion.