Abstract
Mucocutaneous leishmaniasis, which mostly occurs in the New World, is mainly associated with Leishmania braziliensis and to a lesser degree L. panamensis and L. amazonensis infections. Primary mucosal leishmaniasis is very rare in Iran in spite of high prevalence of cutaneous and visceral leishmanisis. A nine-year-old boy had cutaneous leishmaniaisis for five years involving the left side of his face; he then developed swelling and ulceration of the lip and left side buccal mucosa five months before hospital admission. He had severe swelling of the lower lip and there was ulceration and bleeding of the buccal mucosa. Direct smear revealed leishman bodies and nested PCR confirmed the presence of kinetoplast DNA of L. major in the oral mucosal specimen. The patient received amphotericin B deoxycholate 1 mg/kg/day for one month. The lip and face inflammatory reaction disappeared to nearly normal after one month of therapy. The patient was discharged with ketoconazole (5mg/kg/day) for six weeks. To our knowledge, this is the first report of mucocutaneous leishmaniasis caused by L. major in Iran.
Highlights
Leishmaniasis has several diverse clinical manifestations including ulcerative skin lesions, destructive mucosal inflammation, and disseminated visceral infection [1]
Mucocutaneous leishmaniasis (MCL), characterized by the spread of skin ulcers to surrounding tissues, mostly occurs in the New World. It is mainly associated with Leishmania braziliensis and to a lesser degree L. panamensis and L. amazonensis infections [1,2]
To the best of our knowledge, this is the first case of MCL with an unusual strain of L. major reported in Iran and worldwide
Summary
Leishmaniasis has several diverse clinical manifestations including ulcerative skin lesions, destructive mucosal inflammation, and disseminated visceral infection ( known as kala-azar) [1]. Introduction Leishmaniasis has several diverse clinical manifestations including ulcerative skin lesions, destructive mucosal inflammation, and disseminated visceral infection ( known as kala-azar) [1]. It is mainly associated with Leishmania braziliensis and to a lesser degree L. panamensis and L. amazonensis infections [1,2]. Cutaneous and visceral types of leishmaniasis are the common types in Iran, whereas primary mucosal disease without skin involvement has been reported in singular cases [3,4].
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