Primary lesion of Mucocutaneous Leishmaniasis simulating external otitis

Otorhinolaryngologic Manifestations in Leishmaniasis

“…In more advanced forms (Stage V), total destruction of the columella may occur and may drop, thus transforming the nasal cavity into a similar cloaca and sometimes there is perforation of the dorsum of the nasal pyramid [17]. For some researchers, the specific destruction of the nasal cartilage could also indicate an autoimmune reaction that would explain why some patients undergo severe tissue destruction and others only present mucosal involvement years later [21]. In some cases there may be total destruction of the anterior septum, only the entire columella remaining, with the nose being sealed.…”

“…The ENT examination associated with the Montenegro test remains the most important element for diagnosis, although it is usually of a presumptive character [20]. The encounter of Leishmania is the gold standard for the diagnosis of ATL [21]. The diagnosis can be confirmed by various tests: 1) Direct investigation of the parasite, which can be done by scraping the ulcerated surface or by compression of the slide on the wounded area of the lesion.…”

“…Larger lesions may be treated with surgical excision, curettage or cryotherapy [13]. Secondary infection may occur in 54.2% of patients and the germ most frequently found is Staphylococcus aureus [21], which is why local care should be prescribed such as local cleansing with soap and water and if possible compresses with KMnO (potassium permanganate in a dilution of 1/5000ml) [8,16].…”