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

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology Vol. 122; no. 6; pp. e199 - e203
• Main Authors: Cruz, Aline Fernanda, DDS, Resende, Renata Gonçalves, PhD, Albuquerque, Daniel Ricaldoni, DDS, de Lacerda, Júlio César Tanos, MSc, Leite, Camila Ferreira, MSc, Ferreira Aguiar, Maria Cássia, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2016
• Subjects: Aged, 80 and over; Amphotericin B - therapeutic use; Antiprotozoal Agents - therapeutic use; Brazil; Dentistry; Fatal Outcome; Humans; Leishmaniasis, Mucocutaneous - diagnosis; Leishmaniasis, Mucocutaneous - drug therapy; Male; Meglumine - therapeutic use; Middle Aged; Mouth Mucosa - parasitology; Organometallic Compounds - therapeutic use; Polymerase Chain Reaction; Skin Tests; Surgery
• ISSN: 2212-4403; 2212-4411
• DOI: 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.