Clinical manifestations of exuberant leishmaniasis mucocutaneous: case report
DOI:
https://doi.org/10.33448/rsd-v11i5.28029Keywords:
Mucocutaneous leishmaniasis; Leishmania; Communicable diseases; Health teaching.Abstract
Cutaneous mucosal leishmaniasis (LM) is a chronic infection that affects the upper respiratory tract and/or buccal mucosa and is caused by Leishmania protozoan parasites. A 71-year-old male smoker received dental care at the Stomatology Service of the Hospital Metropolitano Odilon Behrens (HMOB), after various appointments with medical specialists. He presented granulomatous and erythematous lesions on the skin of the nose, on upper lip mucosa, and along the entire soft palate and uvula, as well as the destruction of the nasal septum. Due to the suspicion of leishmaniasis, an incisional biopsy was performed. Histopathological examination was performed; however, polymerase chain reaction (PCR) and immunofluorescence were necessary to confirm the diagnosis of LM. The patient was treated with 27 doses of liposomal amphotericin B 20mg / Sbv / kg / day. Due to the lack of improvement, the patient was again hospitalized, and the medication was repeated adding Fluconazol 150mg, to which the patient showed significant improvement. The present case report shows an infectious lesion that is unusual in dental practice and its approach. The description of the characteristics and management, together with the pathological process, were presented.
References
Alvar J., Vélez I. D., Bern C., Herrero M., Desjeux P., & Cano J. (2012). Leishmaniasis worldwide and global estimates of its incidence. PLoS ONE, 7(5), 1-12.
Amato V. S., Tuon F. F., Siqueira A. M., Nicodemo A. C., & Amato Neto V. (2007). Treatment of mucosal leishmaniasis in Latin America: systematic review. Am J Trop Med Hyg, 77, 266-274.
Ameen M. (2010). Cutaneous leishmaniasis: advances in disease pathogenesis, diagnostics and therapeutics. Clin Exp Dermatol, 35, 699-705.
Amin M., & Manisali M. (1999). Cutaneous Leishmaniasis Affecting the Face: Report of a Case. J Oral Maxillofac Surg, 58, 1066-1069.
Aviles H., Belli A., Armijos R., Monroy F. P., & Harris E. (1999) Detection and identification of Leishmania parasites in clinical specimens in Ecuador: A comparison with classical diagnostic methods. Journal of Parasitology, 85, 181-187.
Bisetegn, H. et al. (2020). Clinical, parasitological and molecular profiles of Cutaneous Leishmaniasis and its associated factors among clinically suspected patients attending Borumeda Hospital, North-East Ethiopia. Plos Neglected Tropical Diseases, 14 (8), 8507.
BRASIL - Ministério da Saúde. Manual de Vigilância da Leishmaniose Tegumentar Americana. Segunda Edição Atualizada (2010). 17-31.
Brito M. E., Mendonça M.G., Gomes Y.M., Jardim M.L., & Abath F.G. (2000). Identification of potentially diagnostic Leishmania braziliensis antigens in human cutaneous leishmaniasis by immunoblot analysis. Clin Diagn Lab Immunol, 7 (2), 318-321.
Castling B., Layton S. A., & Pratt R. J. (1994). Cutaneous leishmaniasis. An unusual cause of facial swelling. Oral Surg Oral Med Oral Pathol, 78, 91-92.
Costa J. W. (2003). Mucocutaneous leishmaniasis in a US Citizen. Oral Surg Oral Med Oral Pathl Oral Radiol Endod, 96, 573-577.
Dimier‐David L., David C., Ravisse P., Bustillos R., Revollo S., & Lyevre P. (1991). Parasitological diagnosis of mucocutaneous leishmaniasis due to Leishmania braziliensis in Bolivia. Revista da Sociedade Brasileira de Medicina Tropical, 24, 231‐234.
Diniz J. L. C., Costa M. O. R., & Gonçalves D. U. (2011). Leishmaniose mucocutânea: marcadores clínicos em diagnóstico presuntivo. Braz J Otorhinolaryngol, 77: 380-384.
Escobar M. A., Smith D. S., & Palma G. I. (1992). American cutaneous and mucocutaneous leishmaniasis (tegumentary): A diagnostic challenge. Tropical Doctor, 22 (1), 69‐78.
Figueiredo Júnior, E. C., Silva, A. L., Oliveira, A. N., Marques, N. H. V. P., & Pereira, J. V. (2020). Leishmaniose tegumentar americana: perfil epidemiológico dos casos notificados no Brasil entre os anos de 2009 e 2018 e considerações sobre os aspectos e manifestações de importância odontologica. Research, Society and Develompment, 9 (9), 1-20.
Gontijo B., & Carvalho M. L. R. (2003). Leishmaniose Tegumentar Americana. Revista da Sociedade Brasileira de Medicina Tropical, 36 (1), 71-80.
Goto H., & Lindoso J. A. (2010). Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis. Expert Rev Anti Infect Ther, 8, 419-433.
Klasco R. K. (Ed): Drugdex System. Thomson MICROMEDEX, Greenwood Village, Colorado, USA. Disponível em: http://www.thomsonhc.com/.
Lessa H. A., Lessa M. M., Guimarães L. H., Lima C. M., Arruda S., & Machado P. R. (2012). Um novo sistema de estadiamento clínico proposto para pacientes com leishmaniose mucosa. Trans R Soc Trop Med Hyg, 106, 376-381.
Lessa M. M., Lessa H. A., Castro T. W. N., Oliveira A., Scheifer A., & Machado P. (2007) Leishmaniose mucosa: aspectos epidemiológicos e clínicos. Braz J Otorhinolaryngol, 73, 843-847.
Maretti-Mira A. C., Rodrigues K. M. P., de Oliveira-Neto M. P., & Pirmez C. (2011). A atividade da MMP-9 é induzida pela infecção por Leishmania brazi-lisensis e se correlaciona com a leishmaniose mucosa. Acta Trop, 119, 160-164.
Manual de Controle da Leishmaniose Tegumentar Americana / Organização: Gerência Técnica de Doenças Transmitidas por Vetores e Antropozoonoses. - Coordenação de Vigilância Epidemilógica - Centro Nacional de Epidemiologia - Fundação Nacional de Saúde - Ministério da Saúde Brasília - 2000 62 p.
Palmeiro M. R., Rosalino C. M. V., Quintella L. P., Morgado F. N., Martins A. C. C., Moreira J., Schubach A. O., & Conceição-Silva F. (2007) Gingival leishmaniasis in an HIV-negative patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 104, 12-16.
Paiva-Cavalcanti M., Dantas-Torres F., Albuquerque S. C. G., Morais R. C. S., Brito M. E. F., & Otranto D. (2013). Quantitative real time PCR assays for the detection of Leishmania (Viannia) braziliensis in animals and humans. Mol Cell Probes, 27, 122–128.
Paiva-Cavalcanti M., de Morais R. C. S., Pessoa-e-Silva R., Trajano-Silva L. A. M., Gonçalves-de-Albuquerque S. C., & Tavares D. H. C. (2015). Leishmaniases diagnosis: an update on the use of immunological and molecular tools. Cell Biosci, 5 (31).
Pedras, M. J. et al. (2018) Mucosal leishmaniasis: the experience of a brazilian referral center. Revista da Sociedade Brasileira de Medicina Tropical, 51 (3), 318-323.
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. UFSM.
Pirmez C., Silva‐Trajano V., Paes‐Oliveira M., Cruz A. M., & Gonolves‐Da Costa S. C. (1999). Use of PCR in diagnosis of human American tegumentary leishmaniasis in Rio de Janeiro, Brazil. Journal of Clinical Microbiology, 37, 1819‐1823.
Sampaio R. N. R., Salaro C. P., Resende P., & de Paula C. D. R. (2002). Leishmaniose tegumentar americana associada à AIDS: relato de quatro casos. Revista da Sociedade Brasileira de Medicina Tropical, 35 (6), 651-654.
Silva, F. S., Silva, J. O., Aguiar, M. F. F., Neto, J. J. L. S., Porto, R. H. D., Ortega, J. R., Silva, F. M., de Sá, G. O., da Rocha, R. G., & Guimarães, V. H. D. (2021) American Tegumentary Leishmaniasis in Montes Claros: an epidemiological study. Research Society and Development, 10 (13), 1-8.
Van Griensven, J., & Diro, E. (2012). Visceral Leishmaniasis. Infectious Disease Clinics Of North America, 26 (2), 309-322.
Weiranther J. L., Jeronimo S. M. B., Gautam S., Sundar S., Kang M., & Kurtz M. A. (2011). Serial quantitative PCR assay for detection, species discrimination, and quantification of Leishmania spp. in human samples. J Clin Microbiol, 49, 3892–3904.
Word Health Organization (WHO). Control of the leishmaniasis: Report of a meeting of the WHO Expert Committee on the Control of Leishmaniases. Geneva: WHO technical report series; 202p.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Clebson Pereira Abreu; Fernanda Luiza Araújo de Lima Castro; Sérgio Henrique Benfenatti Botelho; Henrique Bemfica de Faria Freitas; Felipe Paiva Fonseca; Júlio César Tanos Lacerda; Renata Gonçalves Resende
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.