Abstract
Mucocutaneous Leishmaniasis (ML) can lead to serious sequela; however, early diagnosis can prevent complications. AimTo evaluate clinical markers for the early diagnosis of ML. Materials and MethodsA series study of 21 cases of ML, which were evaluated through clinical interview, nasal endoscopy, biopsy and the Montenegro test. ResultsA skin scar and previous diagnosis of cutaneous leishmaniasis (CL) were reported in 8(38%) patients, and 13(62%) of them denied having had previous CL and had no scar. Nasal/oral symptom onset until the ML diagnosis varied from 5 months to 20 years, mean value of 6 years. In the Montenegro test, the average size of the papule was 14.5 mm, which did not correlate with disease duration (p=0.87). The nose was the most often involved site and the extension of the injured mucosa did not correlate with disease duration. The parasite was found in 2 (9.52%) biopsy specimens. ConclusionsML diagnosis was late. Finding the parasite in the mucosa, cutaneous scar and/or previous diagnosis of CL were not clinical markers for ML. ML diagnosis must be based on the Montenegro test, chronic nasal and/or oral discharge and histological findings ruling out other granulomatous diseases.
Highlights
American tegumentary leishmaniasis (ATL) is a severe public health problem in Brazil and throughout the world, as well
Mucocutaneous Leishmaniasis (ML) diagnosis must be based on the Montenegro test, chronic nasal and/or oral discharge and histological findings ruling out other granulomatous diseases
The goal of the present study is to assess the clinical markers which may have an impact on the early diagnosis of mucosal leishmaniasis
Summary
American tegumentary leishmaniasis (ATL) is a severe public health problem in Brazil and throughout the world, as well. It is endemic in 88 countries and it is the second most important disease among those caused by protozoa with medical relevance, second only to malaria. ATL is a non-contagious infectious disease, caused by different species of protozoa of the Leishmania genus, which affects the skin and mucosae. It is primarily a zoonotic infection, involving other animals besides humans, which can be a secondary infestation[2]
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