First case report of atypical disseminated cutaneous leishmaniasis in an opium abuser in Iran

Hashemi, Seyed Ahmad; Badirzadeh, Alireza; Sabzevari, Sadaf; Nouri, Ali; Seyyedin, Mohammad

doi:10.1590/s1678-9946201860005

Cited by 18 publications

(12 citation statements)

References 18 publications

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“…Despite the fact that all forms of CL are mainly caused by the same species, it is uncommon to see a relapse of MCL that manifests as DCL. 17 This might be evidence for increasing recent reports of DCL in the old world. 15 DCL could be with or without mucosal involvement and most of the time do not respond to treatment.…”

Section: Discussionmentioning

confidence: 74%

<p>Progress of Mucocutaneous Leishmaniasis to Drug Nonresponsive Diffuse Cutaneous Leishmaniasis in Ethiopia. A Case Report</p>

Tegegne¹,

Alemu²

2020

IMCRJ

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Background: Leishmaniasis is one of the neglected tropical diseases, yet it is associated with high mortality and morbidity. It is caused by intracellular protozoan parasites of the genus Leishmania. Based on the infecting parasite species and host factors, leishmaniasis could be manifested as cutaneous (localized or diffuse), mucocutaneous or visceral clinical forms. In Ethiopia, L. aethiopica is well known to cause all forms of cutaneous leishmaniasis, the localized form being mostcommon. Case Presentation: An adult patient from Yayu district, west Oromia region of Ethiopia presents with multiple skin lesions on his face, hands and mutilation of nose through both nostrils. Eight years before the present symptoms, he has developed spontaneously healed cutaneous ulcer on his face leaving a permanent scar. Physical examination revealed multiple nodular lesions on his hands, face and nose as well as swelling of the upper lip. Parasitological examination of ulcer lesion revealed presence of amastigotes, and the patient was diagnosed with mucocutaneous leishmaniasis. He was treated with sodium stibogluconate (20 mg/kg/day IM for 30 days) and clinically cured. After two years, he presented with clinical outcomes typical of diffuse cutaneous leishmaniasis. After confirmation by parasitological examination, he was put on sodium stibogluconate (20 mg/kg/day IM for 30 days) and paromomycin (15 mg/kg/day IM for 30 days) combination therapy. As he showed no progress, he was treated with prolonged sodium stibogluconate (20 mg/kg/day IM for 60 days) monotherapy. He was still nonresponsive and discharged uncured. Conclusion: The present case is unusual in Ethiopia with relapse of mucocutaneous leishmaniasis progressing to diffuse form. The later form was nonresponsive for both mono and combination therapy, therefore, formulating new drugs or evaluating other anti-Leishmania drugs is required.

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Section: Discussionmentioning

confidence: 74%

<p>Progress of Mucocutaneous Leishmaniasis to Drug Nonresponsive Diffuse Cutaneous Leishmaniasis in Ethiopia. A Case Report</p>

Tegegne¹,

Alemu²

2020

IMCRJ

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“…One important finding is the association of scarred skin lesions and also disseminated cutaneous lesions or coexistence of VL, particularly with L. major in immunosuppressed persons such as HIV‐positive persons, organ transplant recipients, and drug‐induced immunosuppression patients. Unfortunately, these extensive forms of CL owing to L. major and also other atypical forms of leishmaniasis are increasing in Iran . In the pathogenesis of MCL, high variability of Leishmania species and also Leishmania RNA viruses (LRVs) are involved.…”

Section: Discussionmentioning

confidence: 99%

Mucosal and mucocutaneous leishmaniasis in Iran from 1968 to 2018: a narrative review of clinical features, treatments, and outcomes

2020

Self Cite

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Leishmaniases are worldwide zoonotic infectious diseases caused by different types of intracellular protozoan species of the genus Leishmania. Leishmaniasis as an important vector-borne parasitic disease is transmitted between mammalian hosts by female sandflies. There are three main clinical forms of disease with varied severity: visceral leishmaniasis (VL), cutaneous leishmaniasis (CL), and mucocutaneous leishmaniasis (MCL). MCL is the most uncommon form of this syndrome in the Old World. Accordingly, the reports have characterized that patients with the involvement of mucous membranes are rare even in endemic areas. It is well-known that MCL is a rare clinical manifestation in Iran, but there have been several different cases of patients with mucosal (ML) or MCL in some parts of Iran during the past 50 years. Therefore, we aimed to report and present clinical and epidemiological features of ML or MCL in different regions of the country. Also, we demonstrated specified Leishmania species causing the ML in some cases. The present narrative review indicates that ML or MCL is not unexpected in Iran. Based on the findings of the recent studies, it is concluded that diagnosis of ML should be considered by physicians in Iran.

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“…There are few reports of diffuse CL from Iran. In 2018, Hashemi et al [9] reported a 78-yearold man with multiple papules, crusted and severely ulcerated cutaneous lesions that involved his arms and chest. This patient was known the case of chronic obstructive pulmo-…”

Section: Discussionmentioning

confidence: 99%

Chronic Skin Lesions as the Presentation of Diffuse Cutaneous Leishmaniasis in the HIV-infected Woman: A Case Report and Review of Literatures

Davarpanah

Dehghanian

Akbari

et al. 2019

GMJ

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Background: Cutaneous leishmaniasis (CL) is the most form of leishmaniasis that caused by intracellular parasites, Leishmania. Case Report: A 39-year-old woman, known case of HIV infection, presented with a 6-month history of skin lesions initially on her face, then extending onto the chest, abdomen, and extremities. Laboratory examinations revealed leukopenia and a CD4 cell count of 280 cells / mm3. A biopsy was taken from skin lesions, and histopathological studies showed aggregates of macrophages filled with numerous Leishman bodies, the diagnosis of diffuse CL was confirmed. Consequently, she received liposomal amphotericin B (total dose of 40 mg/kg) as a case of diffuse CL. The skin lesions showed significant improvement after completion of treatment. Conclusion: Diffuse CL should be considered as a differential diagnosis in all patients with diffuse skin lesions mainly in the cases that suffer from disorders of cell-mediated immunity. [GMJ.2019;inpress:e1297]

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First case report of atypical disseminated cutaneous leishmaniasis in an opium abuser in Iran

Cited by 18 publications

References 18 publications

<p>Progress of Mucocutaneous Leishmaniasis to Drug Nonresponsive Diffuse Cutaneous Leishmaniasis in Ethiopia. A Case Report</p>

<p>Progress of Mucocutaneous Leishmaniasis to Drug Nonresponsive Diffuse Cutaneous Leishmaniasis in Ethiopia. A Case Report</p>

Mucosal and mucocutaneous leishmaniasis in Iran from 1968 to 2018: a narrative review of clinical features, treatments, and outcomes

Chronic Skin Lesions as the Presentation of Diffuse Cutaneous Leishmaniasis in the HIV-infected Woman: A Case Report and Review of Literatures

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