1/11. Mucocutaneous leishmaniasis in a patient with the human immunodeficiency virus.We report a case of mucocutaneous leishmaniasis (MCL) in a patient with the human immunodeficiency virus (hiv), Centers for disease Control (CDC) Stage A2, with no previous history of cutaneous or systemic leishmaniasis. The patient had not travelled outside the province of Malaga, on the Mediterranean coast of southern spain, so that it concerns an indigenous case, extremely unusual in this area. The hiv infection may well have influenced the defence against leishmania, but the exact mechanism by which this occurred is unknown.- - - - - - - - - - ranking = 1keywords = virus (Clic here for more details about this article) |
2/11. A case of mucocutaneous leishmaniasis.leishmaniasis is prevalent in most warm-climate areas of the world. We describe a long-undiagnosed case of mucocutaneous leishmaniasis in italy that might have been contracted in costa rica. The patient's signs and symptoms included granulomatous-like lesions on the forehead and legs, nasal obstruction accompanied by serous and crusted rhinorrhea, and diffuse granulomatous-like lesions in the septum and turbinates. The patient was treated with three on-off cycles of itraconazole. At the 1-year follow-up, all his lesions had nearly disappeared.- - - - - - - - - - ranking = 0.91877692095395keywords = world (Clic here for more details about this article) |
3/11. Autochthonous mucosal leishmaniasis in a hemodialyzed Italian patient.A case of mucosal leishmaniasis in a 60-year old hemodialysis patient who had never lived outside italy is described. The patient complained of fever, epistaxis and nasal obstruction. An anterior rhinoscopy disclosed a mass of two centimetres in diameter in the right nasal fossa. Histological examination revealed Leishmania amastigotes. serology for Leishmania was positive with antibody titer of 1/320. A culture yielded a very slow growth of leishmania infantum MON-24. In spite of a two-month treatment with oral itraconazole, the lesions progressively worsened. Treatment with topical paromomycin sulfate determined the complete resolution of the lesions within four months, with a residual perforation of the septum. This case demonstrates that localization of Leishmania spp must be considered in the differential diagnosis of mucosal lesions in hemodialyzed patients, even in countries not at risk for this parasite. Moreover, this case indicates the important role of the immune system in the evolution of the disease.- - - - - - - - - - ranking = 0.0054551480588581keywords = fever (Clic here for more details about this article) |
4/11. Oral leishmaniasis in a hiv-positive patient. Report of a case involving the palate.leishmaniasis is a parasitic disease caused by a protozoon (Leishmania), with different clinical forms that are endemic in certain countries. The association of this disease in patients who are seropositive to human immunodeficiency virus (hiv) has recently been described. leishmaniasis can develop in any stage of hiv infection, although the clinical manifestations - and hence the diagnosis - tend to coincide with the periods of maximum immune depression. We present the case of a hiv-positive, ex-intravenous drug abuser (in stage B2 of the CDC, 1992) with concomitant hepatitis c infection who presented with palatinal pain and bleeding for the past 2 months. Exploration revealed a vegetating tumoration of the hard palate. hematoxylin-eosin and Giemsa staining of the biopsy confirmed the diagnosis of leishmaniasis. The definitive diagnosis was mucocutaneous leishmaniasis (MCL), for a bone marrow aspirate proved negative, and no further lesions could be established. The patient was treated with meglumine antimoniate (Glucantime), followed by improvement of the lesions.- - - - - - - - - - ranking = 0.2keywords = virus (Clic here for more details about this article) |
5/11. Localized mucosal leishmaniasis due to Leishmania (Leishmania) infantum: clinical and microbiologic findings in 31 patients.The clinical and microbiologic characteristics of 31 patients with mucosal leishmaniasis due to Leishmania (Leishmania) infantum are described. Twenty-eight (90%) patients were male. Mean age at presentation was 48 /- 14 years. Thirteen (42%) patients had no underlying disease, while 18 (58%) patients had several other medical conditions. Fifteen (48%) patients were immunocompromised, 7 patients were infected with human immunodeficiency virus (hiv), and 3 were graft recipients. The primary location of lesions was the larynx in 11 (35%) patients, oral mucosa in 10 (32%) patients, and the nose in 5 (16%) patients. Mucosal lesions were painless in all patients but 2 and consisted of whitish, red, or violaceous nodular swelling or tumorlike masses. Ulceration was reported in 6 patients. Pathologically, the lesions showed a chronic inflammatory infiltrate. granuloma may be seen.The localization of the lesions determined the symptomatology of the disease. Symptoms included hoarseness, difficulty swallowing, and nasal obstruction. The disease presentation was usually protracted, with a mean time from the onset of symptoms to diagnosis of 13 months (range, 3 wk-4.5 yr), and the clinical diagnosis was usually mistaken for neoplasia of the upper aerodigestive tract. No laboratory abnormalities were found in these patients due to the localized disease, apart from those attributed to underlying diseases.parasites were easily identified in smears or sections by Giemsa stain or hematoxylin-eosin stain. Leishmania was grown in culture in 12 (60%) patients; culture was negative in 8 (40%) patients. Leishmania (Leishmania) infantum was identified in only 9 instances. The following zymodemes were reported: MON-1 (2 patients), MON-24 (2 patients), MON-27 (1 patient), and MON-34 (1 patient). Serologic test results were known in 25 patients. serology was usually positive at low titer; 6 (24%) patients had negative serologic test results.Twenty patients were treated with antimonial compounds for between 3 and 36 days. Three patients were given drugs other than antimonial drugs. Five patients were treated only locally, by surgery (3 patients) or topical medical therapy. One patient received no therapy, and treatment was not reported in 2 cases. patients were cured in 25 (89%) cases, and sequelae were uncommon (14%). Relapse was detected in 2 individuals and 1 patient developed visceral leishmaniasis after treatment. Two hiv-coinfected patients died of causes unrelated to leishmaniasis.The results of the present report stress the clinical importance of searching for the presence of Leishmania in patients with suspected neoplasia of the upper respiratory tract if they have visited or resided in zones endemic for Leishmania (Leishmania) infantum. The treatment of choice for these patients is not established yet, but most patients respond to antimonial compounds given for 28 days or less.- - - - - - - - - - ranking = 0.2keywords = virus (Clic here for more details about this article) |
6/11. Oral leishmaniasis associated with kala-azar. A case report.Mucosal leishmaniasis as an oral disease in the form of chronic periodontitis with involvement of the oral mucosa is described. Leishmania parasites were isolated from the oral lesions, lymph nodes, and bone marrow. The patient had a low-grade fever and hepatosplenomegaly that regressed along with the oral lesions after treatment with stibogluconate sodium.- - - - - - - - - - ranking = 0.0054551480588581keywords = fever (Clic here for more details about this article) |
7/11. Therapy of Venezuelan patients with severe mucocutaneous or early lesions of diffuse cutaneous leishmaniasis with a vaccine containing pasteurized Leishmania promastigotes and bacillus Calmette-Guerin: preliminary report.Severe mucocutaneous (MCL) and diffuse (DCL) forms of American cutaneous leishmaniasis (ACL) are infrequent in venezuela. Chemotherapy produces only transitory remission in DCL, and occasional treatment failures are observed in MCL. We have evaluated therapy with an experimental vaccine in patients with severe leishmaniasis. Four patients with MCL and 3 with early DCL were treated with monthly intradermal injections of a vaccine containing promastigotes of Leishmania (Viannia) braziliensis killed by pasteurization and viable bacillus Calmette- Guerin. Clinical and immunological responses were evaluated. Integrity of protein constituents in extracts of pasteurized promastigotes was evaluated by gel electrophoresis. Complete remission of lesions occurred after 5-9 injections in patients with MCL or 7-10 injections in patients with early DCL. DCL patients developed positive skin reactions, average size 18.7 mm. All have been free of active lesions for at least 10 months. Adverse effects of the vaccine were limited to local reactivity to BCG at the injection sites and fever in 2 patients. Extracts of pasteurized and fresh promastigotes did not reveal differences in the integrity of protein components detectable by gel electrophoresis. immunotherapy with this modified vaccine offers an effective, safe option for the treatment of patients who do not respond to immunotherapy with vaccine containing autoclaved parasites or to chemotherapy.- - - - - - - - - - ranking = 0.0054551480588581keywords = fever (Clic here for more details about this article) |
8/11. New world mucosal and cutaneous leishmaniasis: an emerging health problem among British travellers.BACKGROUND: Mucosal leishmaniasis (ML) is an important complication of new world cutaneous leishmaniasis (CL) caused by species of the Leishmania Viannia subgenus. Previous reports of ML among travellers to latin america are few. AIMS: To determine the annual number of cases of CL due to L. Viannia species diagnosed at this institution and to correlate this with changing patterns of travel. Secondly, to document the clinical presentation, diagnosis, treatment and outcome of ML at this institution. DESIGN: Retrospective observational study. methods: Data were collected from a clinical database, laboratory records, patient case notes and an international passenger survey. RESULTS: Between 1995 and 2003, the annual number of cases of CL (total 79) steadily increased from 4 per year to 18 per year; the estimated number of travellers from the UK to latin america increased 3.5-fold. Six cases of ML were diagnosed among British travellers in 1995 (1), 1997 (1) and 2002 (4). These infections were acquired in bolivia (3), colombia (2) and belize (1). Nasopharyngeal symptoms developed 0-15 months after returning to the UK. Four patients had concurrent CL at diagnosis. diagnosis of ML was delayed up to 6 months from the onset of symptoms. Mucosal biopsies from all 6 patients were PCR-positive for L. (Viannia) dna; microscopy and culture were less sensitive. ML relapsed in one patient following treatment. DISCUSSION: Increasing travel to latin america from the UK was associated with an increasing number of diagnoses of L. Viannia CL. ML is likely to emerge as a more frequently imported infection among such travellers. Familiarity with these diseases is important for prompt diagnosis and optimal management.- - - - - - - - - - ranking = 13752.49451944keywords = new world, world (Clic here for more details about this article) |
9/11. New world leishmaniasis. Serologic aids to diagnosis.The increase in travel to endemic areas of South and central america has led to an increase in the number of cases of cutaneous leishmaniasis diagnosed in the united states. Traditional methods of diagnosis for this disease include microscopical examination of infected tissue, culture of Leishmania on special media, and the leishmanin skin test. The present communication describes a case of cutaneous leishmaniasis and the difficulties that were encountered in diagnosis. New methods of serologic testing allow more prompt and accurate diagnosis.- - - - - - - - - - ranking = 3.6751076838158keywords = world (Clic here for more details about this article) |
10/11. Concurrent human infection with leishmania donovani and leishmania braziliensis braziliensis.In the suburban district of Campo Grande, Municipality of Rio de Janeiro (Brazil) cases of both Leishmania domovani and L. b. braziliensis infections occur. In March 1982 we examined a white male child, five years old, with fever, weight loss and distended abdomen, symptoms said to have started three months before. After the first month a papular lesion appeared on his forehead, rapidly increasing in size and becoming ulcerated: parasites were isolated from both the ulcer and the bone marrow by culturing in BHI-agar with rabbit blood and a liquid overlay of modified LIT medium. Using the techniques of zymodeme analysis, schizodeme analysis and serodeme analysis using monoclonal antibodies, the parasite from the ulcer was identified as L. b. braziliensis and that from the bone marrow as L. donovani. This seems to be the first described case of concurrent infection of man with a visceral and cutaneous Leishmania. It indicates that, at least in humans, a previous infection with L. donovani does not protect against L. b. braziliensis. This result has important implications for the development of vaccines against leishmaniases.- - - - - - - - - - ranking = 0.0054551480588581keywords = fever (Clic here for more details about this article) |
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