A case of mucosal leishmaniasis: Mimicking intranasal tumor with perforation of septum.

A 79-year-old male suffering from nasal congestion was referred to our hospital. Endoscopic examination revealed a hyperemic mass obstructing the left nasal passage. The lesion's surface was smooth. The findings of imaging studies were consistent with a benign tumor despite the erosion and perforation of the septum. The lesion originated from the middle concha and was attached to it with a thin stalk. It was removed easily by endoscopic resection. Histopathology revealed significant infiltration of mononuclear inflammatory cells, mostly lymphocytes and histiocytes, into the edematous subepithelial connective tissue. High-power magnification showed numerous Leishmania amastigotes in the cytoplasm of the histiocytes. A polymerase chain reaction experiment for Leishmania also confirmed the morphological diagnosis. No relapse was observed in the 12 months after surgery and the patient was doing well.

Leishmaniasis laríngea, modificación quirúrgica tras estudio intraoperatorio. Comunicación de un caso / Modified surgical procedure following intraoperative frozen section of laringeal leishmaniasis. A case report

La leishmaniasis es una metazoonosis crónica de distribución mundial que está producida por cualquier integrante del género Leishmania, y su infección afecta la piel, las mucosas o las vísceras. Presentamos el caso de un varón de 67 años con disfonía y disfagia, valorado por el servicio de otorrinolaringología, quienes realizaron cirugía laríngea sospechando un carcinoma y solicitaron un estudio intraoperatorio que evidenció ausencia de malignidad y la presencia de microorganismos intracelulares. Por este motivo se suspendió la cirugía. Al ser una enfermedad endémica en España, conviene tener presente la leishmaniasis entre los diagnósticos diferenciales de las lesiones excrecentes de la laringe para evitar actitudes quirúrgicas agresivas(AU)

Leishmaniasis is a chronic metazoonosis caused by any member of the genus Leishmania and occurs throughout the world. Infection affects the skin, mucous membranes and viscera. We report a case in a 67 year old man with dysphonia and dysphagia who underwent surgery for suspected laryngeal carcinoma. Intraoperative frozen section revealed no malignancy and the presence of intracellular organisms and no further surgery was performed. As leishmaniasis is endemic in Spain, it should be included in the differential diagnosis of excrescent lesions of the larynx in order to prevent unnecessary surgery(AU)

[Laryngeal leishmaniasis]. / Leishmaniasis laríngea.

Leishmaniasis consists in a zoonotic infection, that means affect animals. Due to the puncture of the female sand fly type Phlebotomus (Ancient World) or Lutzomya (New World) the human being can be also affected. The clinical manifestations are very varied, depending to factors related with host, vector and the proper parasit. In this present work, we expose the three unic cases of Leishmaniasis affecting the larynx, diagnosticated in the sanitary area of Toledo. Due to the specific characteristics that present each case different treatments for each one have been realised, and its results and treatment exposed.

Leishmaniasis laríngea / Laryngeal leishmaniasis

La leishmaniasis consiste en una infección zoonótica, es decir, que afecta a los animales. Debido a la picadura de la hembra de la mosca de arena del género Phlebotomus (en el Viejo Mundo) o Lutzomyia (en el Nuevo Mundo), el ser humano también la puede padecer. Las manifestaciones clínicas son muy variadas, dependiendo de factores relacionados con el huésped, el vector y el propio parásito. En el presente trabajo se exponen los tres únicos casos de leishmaniasis que afectan a la laringe, diagnosticados en el área sanitaria de Toledo. Debido a las características específicas que presentan cada caso, se han realizado diferentes tratamientos para cada uno de ellos, exponiéndose su resultado y seguimiento. Se presenta una revisión bibliográfica actualizada de la enfermedad, donde se hace referencia a los últimos conocimientos publicados sobre esta peculiar parasitosis

Leishmaniasis consists in a zoonotic infection, that means affect animals. Due to the puncture of the female sand fly type Phlebotomus (Ancient World) or Lutzomya (New World) the human being can be also affected. The clinical manifestations are very varied, depending to factors related with host, vector and the proper parasit. In this present work, we expose the three unic cases of Leishmaniasis affecting the larynx, diagnosticated in the sanitary area of Toledo. Due to the specific characteristics that present each case different treatments for each one have been realised, and its results and treatment exposed

A modification of the transverse forked flap to allow three-dimensional columella reconstruction.

The original transverse forked flap is effective in reconstructing the anterior wall of columella in a single stage without leaving a noticeable secondary deformity. A modification was done to allow reconstruction of the lateral walls of columella in addition. This three-dimensional reconstruction will provide enough coverage for a cartilage graft if used. This modification was applied to three patients with columella defects. A costal cartilage graft was used in one of these patients. All flaps survived and donor site scarring was unnoticeable. Elevation of the base of the forked flap allowed using it to reconstruct the anterior wall of columella while sparing the lateral wings to reconstruct the lateral walls of columella.

Isolated lingual leishmaniasis.

Cutaneous leishmaniasis is endemic in Fars Province, southern Iran. However, mucosal leishmaniasis is extremely uncommon. Herein, we report a patient with isolated lingual leishmaniasis in an immunocompetent 40-year-old man. The lesion was totally excised. The patient was cured completely and is doing well after four years of follow-up, with no medical treatment.

Management of leishmanial osteolytic lesions in a hypothyroid dog by partial tarsal arthrodesis.

A five-year-old male boxer, previously diagnosed with leishmaniasis and hypothyroidism, had gradually become unable to bear weight on its left hindlimb. Physical examination revealed a left popliteal lymphadenopathy, mild crepitus, and severe swelling of the left tarsal joint, a radiographic examination of which revealed severe bone destruction of the talus and a periosteal reaction of the calcaneus. Laboratory findings and serological tests suggested an active leishmanial infection, and a Leishmania species was identified by direct cytology of a sample from the osteolytic area and by indirect immunohistochemistry of a bone biopsy. The dog's condition improved when it was treated with meglumine antimonate and allopurinol. Because of the large osteolytic area and the increased use of the affected leg, a partial tarsal arthrodesis was performed to prevent a fracture. Five months after the surgery, the osteolytic area had healed completely and the calcaneus periosteal reaction had disappeared.

Isolated laryngeal leishmaniasis in an immunocompetent patient: successful treatment with surgery.

The localization of Leishmania spp. in the larynx is rare but it has recently been described in patients infected by human immunodeficiency virus (HIV). The normal treatment given is antimonials. We describe a case of isolated leishmaniasis in the larynx which was cured by surgery. Our patient was a 47-year-old man who had suffered visceral leishmaniasis in his childhood with no immunosuppression.

Treatment of cutaneous leishmaniasis using a carbon dioxide laser.

Use of a carbon dioxide laser to vaporize the local lesions caused by cutaneous leishmaniasis is reported. A total of 108 patients have been treated in this way and followed up. The treatment reduces the management time of patients at least 1.5 times and is followed by satisfactory aesthetic outcomes. No recurrences have been observed among the 82 patients who have been followed up for 7 years.

[Cutaneous leishmaniasis: treatment with cryotherapy and intramuscular injections of meglumine antimonate (glucantime)]. / Die kutane Leishmaniose: Behandlung mit Kryotherapie und intramuskulären Injektionen von Meglumine Antimonat (Glucantime).

A 37-year-old female patient with cutaneous leishmaniasis of the helix of the left ear is reported. The diagnosis was based on her past history, clinical appearance and histological examination (detection of Leishman-Donovan bodies). Initial cryotherapy failed to cure the lesions completely. Treatment with intramuscular injections of meglumine antimonate (Glucantime) was successful. The discussion focuses on the pathophysiology, diagnosis and therapy.

[The successful treatment of cutaneous leishmaniasis with an argon laser]. / Uspeshnoe lechenie kozhnogo leishmanioza argonovym lazerom.

A patient suffering from skin leishmaniasis is described. Clinical diagnosis was confirmed by histologic findings and isolation of Leishmania tropica. Since antibiotic therapy was ineffective, the patient was exposed to argon laser for the coagulation of nodular elements. Six sessions of laser therapy under local anesthesia with intervals of 4-5 days were carried out, this resulting in complete clinical cure.

Cryotherapy in acute cutaneous leishmaniasis.

Fourteen patients with acute cutaneous leishmaniasis entered a study testing the efficacy of liquid nitrogen. All lesions were cured clinically and protozoologically within 3-8 weeks, without noticeable scarring. The patients did not experience adverse side effects, and there was no relapse 4 months after cessation of therapy. The results of this study indicate that cryotherapy is a safe and effective method for treating cutaneous leishmaniasis.

Early surgical treatment of cutaneous leishmaniasis.

Cutaneous leishmaniasis, treated or untreated, is known to leave disfiguring scars. These scars are usually on exposed parts, for which plastic surgery may be required. The present work deals with the treatment of cutaneous leishmaniasis using surgical techniques from the onset. In 20 patients, 35 lesions were excised down to the deep fascia. To cover the resulting defect, subcuticular sutures were used in 7 small lesions. Dufourmental (LLL flap) and Limberg flaps were used in 23 lesions of moderate size. Free grafting was resorted to in five large lesions. Using these techniques, morbidity was reduced and cosmetic results were satisfactory.