Mucocutaneous Leishmaniasis: Case report and literature review of a rare endonasal infection

Background:

According to the World Health Organization, mucocutaneous leishmaniasis (MCL) is endemic in Central and South America. Almost 90% of mucocutaneous leishmaniasis cases occur in Bolivia, Brazil and Peru. In Germany leishmaniasis of the mucous membranes is a rare condition and usually due to extension of local skin disease into the mucosal tissue via direct extension, bloodstream or lymphatics. Because of the chronic local destruction of facial structures, MCL may deface the patient if not recognized and adequately treated.

Case:

We report a case of endonasal leishmaniasis in a female german resident who presented in a university hospital with nasal obstruction. The medical history includes cutaneous leishmaniasis in the left elbow after a travel history to Mallorca, rheumatoid arthritis and hypothyroidism. Histology of the left nasal septum biopsy was suggestive of leishmaniasis. The molecular detection of parasite DNA was positive for leishmania infantum.

Results:

The patient was successfully treated as a case of Mucocutaneous leishmaniasis receiving liposomal Amphotericin Follow up visits showed significant improvement with no recurrence.

Conclusions:

The otolaryngologist in european countries have to be aware of mucocutaneous leishmaniasis as a differential diagnosis of mucocutaneous lesions especially in patient with travel history to endemic areas. Patients with endonasal leishmaniasis complain nasal obstruction, epistaxis or rhinorrhea-impaired breathing as well as septal perforation.

Publication History

Publication Date:
23 April 2019 (online)