Pseudo-hemoptise por leishmaniose

Abstract

É apresentado caso de leishmaniose tegumentar americana (LTA) acometendo a mucosa da laringe que, dentre as manifestações clínicas iniciais, apresentou pseudo-hemoptise, levando ao diagnóstico e tratamento errôneo de tuberculose pulmonar. A confirmação etiológica foi estabelecida através de estudo histopatológico. A localização primária na laringe é relativamente rara. É muito importante a experiência do broncoscopista em vias aéreas superiores para fazer diagnóstico exato.

Otorhinolaryngologic Manifestations in Leishmaniasis

“…Leishmaniasis is the second most common parasitic disease in the world, with an estimated 600,000 new cases per year [6]. It can also be considered an occupational disease, since it has affected workers in mining areas, geologists, scientific expeditions, military personnel in training [2]. It has been documented in several countries, with an estimated preva-lence of 12 million worldwide [3].…”

“…It is estimated that every year there are new cases in Brazil and the growth of this number is due in part to the emergence and growth of AIDS and deforestation areas [2]. It mostly affects young and adult males [16].…”

“…However, in some patients the disease appears primarily in the mucosa membrane, without leaving traces on the skin. [2]. The most common manifestation is leishmaniotic ulcer: a single skin ulcer or only in small numbers, with raised edges, framed and the absence of local pain.…”

“…Complications include pneumonia due to aspiration, bacterial infections, secondary myiasis, cachexia due to difficulties in swallowing, laryngeal edema and asphyxiation, which may be lead on to the patient's death mainly due to respiratory failure and sepsis [5]. The presentation of the clinical form with lesions exclusive of mucosa of the larynx and trachea is relatively uncommon [2]. The ear is not usually affected in mucosal Leishmaniasis.…”

“…Leishmaniasis is considered by the World Health Organization (WHO) as one of the five endemic infectious and parasitic diseases of greatest importance and as a world-wide public health problem [1]. It is an infectious disease that evolves chronically and is caused by a protozoon of the genus Leishmania, which may appear as a clinical form which is visceral, cutaneous, mucocutaneous, mucousal and rarely diffuse [2]. The term Leishmaniasis refers to the infection of vertebrate hosts Leishmania, which, like the other trypanosomatids of the order Kinetoplastida, characteristically present an extranuclear DNA in its cytoplasm in a mitochondrial organelle, the kinetoplast.…”