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1.
J Craniofac Surg ; 28(5): e446-e447, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28538073

ABSTRACT

The authors present a clinical report of deforming mucocutaneous leishmaniasis of the nose in a native American woman, left untreated for 25 years. The nose was reconstructed using the local tissue displaced as flaps, and using cartilage grafts taken from the nasal septum and the ear shell. To the best of the authors' knowledge, the literature offers just 1 report on a similar patient.


Subject(s)
Leishmaniasis, Mucocutaneous/complications , Leishmaniasis, Mucocutaneous/pathology , Nose Deformities, Acquired/parasitology , Nose Deformities, Acquired/surgery , Rhinoplasty/methods , Aged, 80 and over , Female , Humans , Nose Deformities, Acquired/pathology
3.
BMC Infect Dis ; 15: 38, 2015 Feb 03.
Article in English | MEDLINE | ID: mdl-25645330

ABSTRACT

BACKGROUND: After the onset of HAART, some HIV-infected individuals under treatment present a exacerbated inflammation in response to a latent or a previously treated opportunistic pathogen termed immune reconstitution inflammatory syndrome (IRIS). Few reports of tegumentary leishmaniasis have been described in association with IRIS. Moreover, the immunopathogenesis of IRIS in association with Leishmania is unclear. CASE PRESENTATION: The present study reports on a 29-year-old HIV-infected individual who developed mucocutaneous leishmaniasis associated with immune reconstitution inflammatory syndrome (IRIS) five months following highly active antiretroviral therapy (HAART). Severe lesions resulted in the partial destruction of the nasal septum, with improvement observed 15 days after treatment with Amphotericin B and corticosteroids. The immune response of this patient was evaluated before and after the lesions healed. IRIS was diagnosed in association with high levels of TNF-α and IL-6. Decreased production of IFN-γ and a low IFN-γ/IL-10 ratio were also observed in response to Leishmania antigens. After receiving anti-leishmanial treatment, the individual's specific Th1 immune response was restored. CONCLUSION: The results suggest that the production of inflammatory cytokines by unstimulated T-lymphocytes could contribute to occurrence of leishmaniasis associated with IRIS.


Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Immune Reconstitution Inflammatory Syndrome/diagnosis , Leishmaniasis, Mucocutaneous/diagnosis , AIDS-Related Opportunistic Infections/complications , Adult , Antigens, Protozoan/blood , Antiretroviral Therapy, Highly Active , Diagnosis, Differential , Humans , Immune Reconstitution Inflammatory Syndrome/complications , Leishmania/immunology , Leishmaniasis, Mucocutaneous/complications , Male
4.
Ann Otol Rhinol Laryngol ; 133(9): 820-822, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38840497

ABSTRACT

OBJECTIVE: This case report presents a unique manifestation of Mucocutaneous Leishmaniasis (MCL) in a 56-year-old woman with chronic nasal symptoms. Initially diagnosed with chronic sinusitis and septal perforation, the patient's history of a childhood sandfly bite and subsequent episodes of Leishmaniasis, revealed after nasal surgery, provided crucial information for accurate diagnosis. METHODS: A retrospective review was conducted on this patient's electronic medical record. RESULTS: The patient's life-long struggle with nasal obstruction, congestion, and a septal perforation initially masked the underlying MCL. Sinus surgery and persistent symptoms further complicated the diagnostic process. Only after postoperative complications, including grainy skin texture extending into the nasal passages, did the patient recall the sandfly bite, prompting reevaluation and diagnosis of MCL. The case highlights the challenges of diagnosing MCL due to its varied presentation and potential mimicry of other chronic nasal conditions. It emphasizes the importance of thorough patient history-taking, especially when symptoms are atypical or persistent. Additionally, the report underscores the potential for unexpected postoperative complications in MCL patients and the need for vigilance in recognizing and assessing them. CONCLUSION: This case contributes to the understanding of MCL's diverse clinical presentation and the importance of early diagnosis and multidisciplinary management for prompt intervention and improved outcomes.


Subject(s)
Leishmaniasis, Mucocutaneous , Humans , Female , Middle Aged , Leishmaniasis, Mucocutaneous/diagnosis , Leishmaniasis, Mucocutaneous/complications , Nasal Obstruction/etiology , Nasal Obstruction/diagnosis , Nasal Obstruction/surgery , Nasal Septal Perforation/etiology , Nasal Septal Perforation/diagnosis , Sinusitis/diagnosis , Sinusitis/complications , Insect Bites and Stings/complications , Insect Bites and Stings/diagnosis , Tomography, X-Ray Computed , Chronic Disease , Diagnosis, Differential
5.
J Coll Physicians Surg Pak ; 20(1): 65-7, 2010 Jan.
Article in English | MEDLINE | ID: mdl-20141699

ABSTRACT

Surgical reconstruction of large facial defects is not possible at times due to extensive loss of tissue that cannot be corrected by surgery alone. In these cases, prosthetic restoration of lost facial tissue can be done using maxillofacial prosthetics. Introduction of new material which gives life-like appearance to such prosthetic restorations e.g. silicone and poly ether rubbers and use of implants to retain these prostheses have given a new dimension to rehabilitation of such patients. This report presents a case of prosthetic rehabilitation of the nasal component of the face secondary to nasal leishmaniasis, using precision attachment retained maxillofacial prosthesis.


Subject(s)
Leishmaniasis, Mucocutaneous/complications , Maxillofacial Prosthesis , Adult , Humans , Male , Prosthesis Design
6.
Rev Soc Bras Med Trop ; 53: e20200040, 2020.
Article in English | MEDLINE | ID: mdl-32578710

ABSTRACT

Mucocutaneous leishmaniasis (MCL) is a chronic infection that can affect the skin and mucous membranes. We report a case of oral, nasopharyngeal, and penile lesions in a 35-year-old cocaine user. The patient presented with ulcerated lesions in 2014. Histopathologic analysis revealed amastigotes, and serological test results were positive for leishmaniasis. Systemic therapy with meglumine antimoniate was administered; however, the patient failed to present for follow-up. In 2018, he returned with nasal collapse, and another histopathologic test confirmed MCL. This case illustrates the importance of careful differential diagnosis of skin and mucous ulcers to identify the particular pathology.


Subject(s)
Antiprotozoal Agents/administration & dosage , Cocaine-Related Disorders/complications , Leishmaniasis, Mucocutaneous/diagnosis , Meglumine Antimoniate/administration & dosage , Adult , Humans , Leishmaniasis, Mucocutaneous/complications , Leishmaniasis, Mucocutaneous/drug therapy , Male
7.
J Cutan Pathol ; 36(1): 53-60, 2009 Jan.
Article in English | MEDLINE | ID: mdl-18494815

ABSTRACT

Trauma can trigger the onset of some lesions of cutaneous leishmaniasis (CL). In this study, we present the case of a 65-year-old man who developed persistent, ulcerative, nodular lymphangiitis at the site of elbow abrasions from a fall during a trip to northeastern Brazil. Skin and lymph node biopsy showed tuberculoid granulomatous inflammation and Grocott-methamine silver-positive yeast forms consistent with Sporothrix and Staphylococcus lugdunensis was identified from tissue culture. Antibacterial and antifungal treatment produced short-term healing. Crusted papules recurred at the sites of injury 3 months later and persisted despite therapy. After 15 months, two punch biopsies showed scarring and granulomatous inflammation; cultures and histochemical stains were negative for microorganisms. Because of refractory disease, multiple polymerase chain reaction (PCR) assays for infectious agents on DNA extracted from the biopsy specimens were performed, and Leishmania guyanensis was detected in all specimens. The patient refused pentavalent antimonial therapy and elected for excision of the CL lesions. After 2 years of follow up, he is without disease. CL should be considered in the differential diagnosis in patients who present with ulcerative, nodular lymphangiitis; have a history of travel to endemic regions; and describe a traumatic insult to the affected region. PCR methods for infectious agents increase the sensitivity and specificity of detecting causative agents in these patients who are negative by routine methods. In some, leishmaniasis may be an occult infection whose presence is heralded by trauma. Coinfection, by altering the immune response, may have facilitated the clinical acquisition of CL.


Subject(s)
Leishmaniasis, Mucocutaneous/pathology , Skin/injuries , Skin/microbiology , Aged , Animals , Anti-Bacterial Agents , Brazil , DNA, Protozoan/analysis , Elbow/microbiology , Elbow/pathology , Humans , Leishmania guyanensis , Leishmaniasis, Mucocutaneous/complications , Leishmaniasis, Mucocutaneous/surgery , Male , Polymerase Chain Reaction , Sporothrix , Sporotrichosis/complications , Sporotrichosis/drug therapy , Sporotrichosis/pathology , Staphylococcal Infections/complications , Staphylococcal Infections/drug therapy , Staphylococcal Infections/pathology , Elbow Injuries
8.
J Eur Acad Dermatol Venereol ; 23(9): 1026-34, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19453817

ABSTRACT

BACKGROUND: Mucosal leishmaniasis is caused mainly by Leishmania braziliensis and it occurs months or years after cutaneous lesions. This progressive disease destroys cartilages and osseous structures from face, pharynx and larynx. OBJECTIVE AND METHODS: The aim of this study was to analyse the significance of clinical and epidemiological findings, diagnosis and treatment with the outcome and recurrence of mucosal leishmaniasis through binary logistic regression model from 140 patients with mucosal leishmaniasis from a Brazilian centre. RESULTS: The median age of patients was 57.5 and systemic arterial hypertension was the most prevalent secondary disease found in patients with mucosal leishmaniasis (43%). Diabetes, chronic nephropathy and viral hepatitis, allergy and coagulopathy were found in less than 10% of patients. Human immunodeficiency virus (HIV) infection was found in 7 of 140 patients (5%). Rhinorrhea (47%) and epistaxis (75%) were the most common symptoms. N-methyl-glucamine showed a cure rate of 91% and recurrence of 22%. Pentamidine showed a similar rate of cure (91%) and recurrence (25%). Fifteen patients received itraconazole with a cure rate of 73% and recurrence of 18%. Amphotericin B was the drug used in 30 patients with 82% of response with a recurrence rate of 7%. The binary logistic regression analysis demonstrated that systemic arterial hypertension and HIV infection were associated with failure of the treatment (P < 0.05). CONCLUSION: The current first-line mucosal leishmaniasis therapy shows an adequate cure but later recurrence. HIV infection and systemic arterial hypertension should be investigated before start the treatment of mucosal leishmaniasis. Conflicts of interest The authors are not part of any associations or commercial relationships that might represent conflicts of interest in the writing of this study (e.g. pharmaceutical stock ownership, consultancy, advisory board membership, relevant patents, or research funding).


Subject(s)
Antiprotozoal Agents/therapeutic use , Case Management/statistics & numerical data , Leishmania braziliensis/pathogenicity , Leishmaniasis, Mucocutaneous/drug therapy , Leishmaniasis, Mucocutaneous/epidemiology , Skin/parasitology , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Brazil , Cohort Studies , Female , Humans , Hypertension/etiology , Itraconazole/therapeutic use , Leishmaniasis, Mucocutaneous/complications , Logistic Models , Male , Meglumine/therapeutic use , Middle Aged , Pentamidine/therapeutic use , Retrospective Studies , Risk Factors , Secondary Prevention , Treatment Failure , Young Adult
10.
Acta Otorrinolaringol Esp ; 60(4): 298-300, 2009.
Article in Spanish | MEDLINE | ID: mdl-19814979

ABSTRACT

We report a case of mucocutaneous Leishmaniasis, an uncommon illness in our area. Leishmaniasis covers a group of diseases caused by protozoa of the genus Leishmania with several pathogenic species transmitted by Phlebotomus mosquitoes. Leishmania braziliensis is endemic in parts of South America and is responsible for the mucocutaneous Leishmaniasis reported here. The initial lesion is cutaneous and appears as an ulcer on arms or legs, leaving a scar. In some untreated cases, a late phase may affect the ENT area with hard to treat chronic destructive and mutilating lesions.


Subject(s)
Leishmaniasis, Mucocutaneous/complications , Otorhinolaryngologic Diseases/etiology , Adult , Humans , Male
11.
Infez Med ; 27(4): 452-455, 2019 12 01.
Article in English | MEDLINE | ID: mdl-31846999

ABSTRACT

The management of mucosal leishmaniasis in immunocompromised patients is not standardized and limited data are available on the use of miltefosine for treatment and secondary prophylaxis. We describe a case of mucosal leishmaniasis in an HIV-coinfected patient treated with miltefosine due to a severe allergic reaction to liposomal amphotericin B.


Subject(s)
Leishmaniasis, Mucocutaneous/drug therapy , Phosphorylcholine/analogs & derivatives , Coinfection , HIV Infections/complications , Humans , Leishmaniasis, Mucocutaneous/complications , Male , Middle Aged , Phosphorylcholine/therapeutic use , Time Factors
12.
Biomedica ; 39(Supl. 2): 58-65, 2019 08 01.
Article in English, Spanish | MEDLINE | ID: mdl-31529834

ABSTRACT

INTRODUCTION: Mucosal leishmaniasis has a progressive course and can cause deformity and even mutilation in the affected areas. It is endemic in the American continent and it is mainly caused by Leishmania (Viannia) braziliensis. OBJECTIVE: To describe a series of mucosal leishmaniasis cases and the infectious Leishmania species. MATERIALS AND METHODS: We included 50 patients with a clinical diagnosis of mucosal leishmaniasis and parasitological confirmation, and we described their clinical and laboratory results. We performed species typing by PCR-RFLP using the miniexon sequence and hsp70 genes; confirmation was done by sequencing. RESULTS: The median time of disease evolution was 2.9 years (range: 1 month to 16 years). The relevant clinical findings included mucosal infiltration (94%), cutaneous leishmaniasis scar (74%), total loss of the nasal septum (24%), nasal deformity (22%), and mucosal ulceration (38%). The symptoms reported included nasal obstruction (90%), epistaxis (72%), rhinorrhea (72%), dysphonia (28%), dysphagia (18%), and nasal pruritus (34%). The histopathological study revealed a pattern compatible with leishmaniasis in 86% of the biopsies, and amastigotes were identified in 14% of them. The Montenegro skin test was positive in 86% of patients, immunofluorescence in 84%, and culture in 8%. Leishmania (V.) braziliensis was identified in 88% of the samples, L. (V) panamensis in 8%, and L. (V.) guyanensis and L. (L.) amazonensis in 2% respectively. CONCLUSION: In this study, we found a severe nasal disease with destruction and deformity of the nasal septum in 25% of the cases, probably associated with late diagnosis. Leishmania (V.) braziliensis was the predominant species. We described a case of mucosal leishmaniasis in Colombia caused by L. (L.) amazonensis for the first time.


Introducción. La leishmaniasis mucosa tiene un curso progresivo y puede causar deformidad e incluso mutilación de las zonas afectadas. Es endémica en el continente americano y es causada principalmente por Leishmania (Viannia) brasiliensis. Objetivo. Describir una serie de casos de leishmaniasis mucosa y las especies de Leishmania infecciosas. Materiales y métodos. Se estudiaron 50 pacientes con diagnóstico clínico de leishmaniasis mucosa y confirmación parasitológica. Se describieron sus características clínicas y los resultados de laboratorio. La tipificación de especies se hizo mediante reacción en cadena de la polimerasa de los polimorfismos de la longitud de los fragmentos de restricción (Restriction Fragment Length Polymorphism Polymerase Chain Reaction, PCR-RFLP) en la secuencia del miniexon y el gen hsp70 y se confirmó por secuenciación. Resultados. La evolución de la enfermedad fue de un mes a dieciséis años (mediana de 2,8 años). Los hallazgos clínicos fueron los siguientes: infiltración mucosa (94 %), cicatriz de leishmaniasis cutánea (74 %), pérdida total del tabique nasal (24 %), deformidad nasal (22 %) y ulceración (38 %). Los síntomas reportados fueron: obstrucción nasal (90 %), epistaxis (72 %), rinorrea (72 %), disfonía (28 %), disfagia (18 %) y prurito nasal (34 %). La histopatología mostró un patrón compatible con leishmaniasis en 86 % de las biopsias y se identificaron amastigotes en 14 % de ellas. La prueba de Montenegro fue positiva en 86 % de los pacientes, la inmunofluorescencia en 84 %, y el cultivo en 8 %. Leishmania (V.) brasiliensis se identificó en 88 % de las muestras, L. (V) panamensis en 8 %, y L. (V.) guyanensis y L. (L.) amazonensis en 2 %, respectivamente. Conclusión. Se encontró enfermedad nasal grave con destrucción y deformidad del tabique nasal en una cuarta parte de los casos, probablemente debido a un diagnóstico tardío. Leishmania (V.) brasiliensis fue la especie predominante. Se describe por primera vez un caso de leishmaniasis mucosa causado por L. (L.) amazonensis en Colombia.


Subject(s)
Leishmania braziliensis/isolation & purification , Leishmania guyanensis/isolation & purification , Leishmaniasis, Mucocutaneous/parasitology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Colombia/epidemiology , DNA, Protozoan/genetics , Female , Genes, Protozoan , HSP70 Heat-Shock Proteins/genetics , Humans , Leishmania braziliensis/classification , Leishmania braziliensis/genetics , Leishmania guyanensis/classification , Leishmania guyanensis/genetics , Leishmaniasis, Mucocutaneous/complications , Leishmaniasis, Mucocutaneous/epidemiology , Leishmaniasis, Mucocutaneous/pathology , Male , Middle Aged , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Protozoan Proteins/genetics , Sequence Analysis, DNA , Skin/parasitology , Species Specificity , Young Adult
13.
An Bras Dermatol ; 93(1): 123-125, 2018.
Article in English | MEDLINE | ID: mdl-29641713

ABSTRACT

Brazil is a country with a high prevalence of infectious diseases such as leprosy and leishmaniasis. However, coinfection of these diseases is still poorly understood. We report a case of a patient who presented with lepromatous leprosy and cutaneous-mucosal leishmaniasis at the same period. After clinical, laboratory, and histopathological diagnosis, the treatment was introduced and the patient showed important clinical improvement. He was followed in our outpatient clinic. Both pathologies play an important role in the immune system. Depending on the immune response profile of the host, diseases may present themselves in different ways. In this case, the patient showed a divergent immune response for each disease. We hypothesized that this response is specific for each pathogen.


Subject(s)
Coinfection/complications , Leishmaniasis, Mucocutaneous/complications , Leprosy, Lepromatous/complications , Coinfection/immunology , Coinfection/pathology , Humans , Immunity, Cellular/immunology , Leishmaniasis, Mucocutaneous/immunology , Leishmaniasis, Mucocutaneous/pathology , Leprosy, Lepromatous/immunology , Leprosy, Lepromatous/pathology , Male , Middle Aged
14.
Am J Trop Med Hyg ; 99(2): 327-330, 2018 08.
Article in English | MEDLINE | ID: mdl-29869609

ABSTRACT

Mucosal leishmaniasis (ML) is associated with progressive tissue destruction and granuloma formation, often after a considerable period of latency from an initial cutaneous infection. We report a case of recurrent epistaxis of 3 years duration and nasopharyngeal obstruction in a woman with treated cutaneous leishmaniasis nearly 30 years before and with no further exposure to Leishmania. Computed tomography revealed nasal septal perforation and histopathology demonstrated chronic inflammation. Microscopy was negative for amastigotes, but molecular testing of nasal mucosa biopsy detected Leishmania (Viannia) braziliensis. The patient underwent 28 days of treatment with IV sodium stibogluconate and her symptoms improved significantly. Sixteen months after treatment, she continues to have episodic epistaxis and detectable parasite load in her nasal lesion. Although ML is known to take years to decades to develop, there are few reported cases in the literature of such a long latency period. This report highlights the importance of considering ML in the differential diagnosis of chronic epistaxis in countries where leishmaniasis is endemic or in immigrants from these countries, even when presentation occurs decades after leaving an endemic region.


Subject(s)
Leishmaniasis, Mucocutaneous/complications , Leishmaniasis, Mucocutaneous/diagnosis , Nasal Mucosa/parasitology , Nasal Septal Perforation/parasitology , Adult , Antimony Sodium Gluconate/therapeutic use , Antiprotozoal Agents/therapeutic use , Diagnosis, Differential , Epistaxis/parasitology , Female , Humans , Inflammation , Leishmania braziliensis/genetics , Leishmania braziliensis/isolation & purification , Leishmaniasis, Mucocutaneous/drug therapy , Nasal Septal Perforation/diagnostic imaging , Nasal Septum/diagnostic imaging , Nasal Septum/pathology , Parasite Load , Peru , Time Factors , Tomography, X-Ray Computed
15.
Postgrad Med J ; 83(976): 649-57, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17396274

ABSTRACT

Epidemiology, disease patterns, immunology, diagnosis, treatment and control measures of leishmaniasis are described. Various issues relating to leishmaniasis are highlighted: the relative lack of importance given to this disease compared with other infections, climate change and its possible impact on extension of endemicity of this infection, and new diagnostic tests which are improving diagnosis, especially in resource poor areas. Other important aspects discussed include the potential for newer oral therapy to change the way this disease is managed; Leishmania-HIV coinfection and groups at risk; and development of an effective vaccine.


Subject(s)
Leishmaniasis, Cutaneous , Leishmaniasis, Visceral , Animals , Antiprotozoal Agents/therapeutic use , HIV Infections/complications , Humans , Immunity, Cellular , Leishmaniasis, Cutaneous/complications , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/drug therapy , Leishmaniasis, Cutaneous/immunology , Leishmaniasis, Mucocutaneous/complications , Leishmaniasis, Mucocutaneous/diagnosis , Leishmaniasis, Mucocutaneous/drug therapy , Leishmaniasis, Mucocutaneous/immunology , Leishmaniasis, Visceral/complications , Leishmaniasis, Visceral/diagnosis , Leishmaniasis, Visceral/drug therapy , Leishmaniasis, Visceral/immunology
16.
Am J Trop Med Hyg ; 75(2): 267-9, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16896130

ABSTRACT

Mucosal leishmaniasis (ML) is often clinically silent until reaching a highly advanced state. In this prospective study, 6 of 220 patients with early cutaneous leishmaniasis were diagnosed with mucosal involvement by otorhinolaryngological examination (a rate similar to the reported rate of late ML). Detection of early ML may represent an important strategy in preventing severe mucosal destruction in human leishmaniasis.


Subject(s)
Leishmaniasis, Cutaneous/complications , Leishmaniasis, Mucocutaneous/complications , Leishmaniasis, Mucocutaneous/diagnosis , Adolescent , Adult , Aged , Animals , Antibodies, Protozoan/blood , Brazil , Endoscopy/methods , Female , Humans , Leishmaniasis, Cutaneous/diagnosis , Male , Middle Aged , Nasal Mucosa/parasitology , Nasal Mucosa/pathology , Prospective Studies , Skin Tests/methods
19.
J Laryngol Otol ; 119(7): 567-9, 2005 Jul.
Article in English | MEDLINE | ID: mdl-16175986

ABSTRACT

We report a case of mucocutaneous leishmaniasis caused by Leishmania viannia braziliensis. Despite several courses of both oral and intravenous antibiotics no improvement was seen. This case highlights the importance of taking a thorough history, including details of recent travel, and considering rarer causes when no improvement with antibiotics is seen. Our patient was infected with a particularly virulent strain and destruction of the mucous membranes is not uncommon. Rapid diagnosis and treatment are therefore crucial.


Subject(s)
Cellulitis/parasitology , Facial Dermatoses/parasitology , Leishmaniasis, Mucocutaneous/complications , Adolescent , Animals , Anti-Infective Agents/therapeutic use , Cellulitis/drug therapy , Cellulitis/pathology , Facial Dermatoses/drug therapy , Facial Dermatoses/pathology , Female , Humans , Leishmania braziliensis/isolation & purification , Leishmaniasis, Mucocutaneous/drug therapy , Nasal Cavity/parasitology , Treatment Outcome
20.
Rev. Soc. Bras. Med. Trop ; 53: e20200040, 2020. graf
Article in English | SES-SP, Coleciona SUS (Brazil), LILACS | ID: biblio-1136884

ABSTRACT

Abstract Mucocutaneous leishmaniasis (MCL) is a chronic infection that can affect the skin and mucous membranes. We report a case of oral, nasopharyngeal, and penile lesions in a 35-year-old cocaine user. The patient presented with ulcerated lesions in 2014. Histopathologic analysis revealed amastigotes, and serological test results were positive for leishmaniasis. Systemic therapy with meglumine antimoniate was administered; however, the patient failed to present for follow-up. In 2018, he returned with nasal collapse, and another histopathologic test confirmed MCL. This case illustrates the importance of careful differential diagnosis of skin and mucous ulcers to identify the particular pathology.


Subject(s)
Humans , Male , Adult , Leishmaniasis, Mucocutaneous/diagnosis , Cocaine-Related Disorders/complications , Meglumine Antimoniate/administration & dosage , Antiprotozoal Agents/administration & dosage , Leishmaniasis, Mucocutaneous/complications , Leishmaniasis, Mucocutaneous/drug therapy
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