ATYPICAL ORAL MANIFESTATION OF VISCERAL LEISHMANIASIS IN HUMAN IMMUNODEFICIENCY VIRUS--INFECTED CHILD

Abstract

A 7-year-old white boy presented with weight loss, coughing, hepatosplenomegaly, and pancytopenia with 2 months of evolution and a diagnosis of visceral leishmaniasis (VL). The medical pediatrician team referred to a dentistry team reporting “Painful lesions in the oral cavity with feeding impaired.” The mother reported 4 days of evolution, pain for eating, speaking, and tooth brushing. Extra-oral examination showed dry lips and skin. Intra-oral examination revealed multiple ulcers on the right side of the hard palate with erythematous dotting and slight mucosal thickening and a single ulcer on the tongue. The hypothetical diagnoses were herpetic gingivostomatitis and oral manifestation of VL. A biopsy in hard palate was performed. The histopathologic exam revealed vacuolated macrophages and structures compatible with Leishmania within the macrophages. This atypical oral manifestation of VL led to the suspicion of other comorbidities, which confirmed by serologic tests that the patient was positive for HIV.