The Value of the Otorhinolaryngologic Exam in Correct Mucocutaneous Leishmaniasis Diagnosis

Boaventura, Viviane; Oliveira, Jene Greyce S.; Costa, Jackson Maurício Lopes; Novais, Fernanda O.; Oliveira, Camila I. de; Barral‐Netto, Manoel; Barral, Aldina

doi:10.4269/ajtmh.2009.81.384

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…Though a complete otorhinolaryngologic examination (i.e., anterior rhinoscopy, oropharynx exam and a fiberoptic exam) is indispensable in patients with ML, it does not provide a more detailed assessment of the involvement of deeper osteocartilaginous structures [39]. Hence, in this scenario, the CT scan can be an interesting tool due to its proper assessment of structural alterations of bone and soft tissue structures of the face in the patients with ML.…”

Section: Discussionmentioning

confidence: 99%

Facial Structure Alterations and Abnormalities of the Paranasal Sinuses on Multidetector Computed Tomography Scans of Patients with Treated Mucosal Leishmaniasis

et al. 2014

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Background/ObjectivesMucosal leishmaniasis (ML) is a progressive disease that affects cartilage and bone structures of the nose and other upper respiratory tract structures. Complications associated with ML have been described, but there is a lack of studies that evaluate the structural changes of the nose and paranasal sinuses in ML using radiological methods. In this study, we aimed to assess the opacification of the paranasal sinuses in patients with treated ML and any anatomical changes in the face associated with ML using multidetector computed tomography scans (MDCT) of the sinuses. We compared the findings with a control group.Methodology/Principal FindingsWe evaluated 54 patients with treated ML who underwent CT scans of the sinuses and compared them with a control group of 40 patients who underwent orbital CT scans. The degree of sinus disease was assessed according to the Lund-Mackay criteria. Forty of the 54 patients with a history of ML (74.1%) had a tomographic score compatible with chronic sinusitis (Lund-Mackay ≥4). CT scans in the leishmaniasis and control groups demonstrated significant differences in terms of facial structure alterations. Patients from the ML group showed more severe levels of partial opacification and pansinus mucosal thickening (42.6%) and a greater severity of total opacification. Patients from the ML group with a Lund-Mackay score ≥4 presented longer durations of disease before treatment and more severe presentations of the disease at diagnosis.Conclusion/SignificanceCT scans of the sinuses of patients with ML presented several structural alterations, revealing a prominent destructive feature of the disease. The higher prevalence in this study of chronic rhinosinusitis observed in CT scans of patients with treated ML than in those of the control group suggests that ML can be considered a risk factor for chronic rhinosinusitis in this population (p<0.05).

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Section: Discussionmentioning

confidence: 99%

Facial Structure Alterations and Abnormalities of the Paranasal Sinuses on Multidetector Computed Tomography Scans of Patients with Treated Mucosal Leishmaniasis

et al. 2014

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“…24,41,[50][51][52] Species identification in leishmaniasis is important as clinical manifestation of the disease and therapeutic response varies in relation to the infectious species, immune status of the host, pharmacokinetics of the medication, and other factors. [53][54][55][56] Our study reports on one case that displayed an amplification profile compatible with L. amazonensis, thus constituting the first reported case in Colombia of this species as causative for mucocutaneous leishmaniasis. This finding is even more significant when considering that most mucocutaneous leishmaniasis cases in Colombia are associated with the species L. braziliensis, L. guyanensis, and L. panamensis.…”

Section: Discussionmentioning

confidence: 70%

“…guyanensis , and L. amazonensis . Species identification in leishmaniasis is important as clinical manifestation of the disease and therapeutic response varies in relation to the infectious species, immune status of the host, pharmacokinetics of the medication, and other factors . Our study reports on one case that displayed an amplification profile compatible with L. amazonensis , thus constituting the first reported case in Colombia of this species as causative for mucocutaneous leishmaniasis.…”

Section: Discussionmentioning

confidence: 83%

Polymerase chain reaction–miniexon: a promising diagnostic method for mucocutaneous leishmaniasis

2015

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“…Combined dermatological and otolaryngologist examination is important for the clinical management of ML [28]. A biopsy of the lesion is mandatory to perform a parasitological diagnosis, thus allowing the prompt introduction of antileishmanial therapy.…”

Section: Discussionmentioning

confidence: 99%

Autochthonous Cases of Mucosal Leishmaniasis in Northeastern Italy: Clinical Management and Novel Treatment Approaches

et al. 2020

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Mucosal leishmaniasis (ML) is a rare clinical variant of tegumentary leishmaniasis in Mediterranean Europe. Here we report on three autochthonous cases of head and neck ML in patients living in Northeastern Italy. Patients presented with non-specific, long-standing symptoms of upper respiratory tract involvement, mimicking other diseases. Parasitological diagnosis was reached by histopathology, immunohistochemistry and molecular biology on tissue specimens. Leishmania infantum was identified by molecular typing in all three cases. All patients reached a complete remission with protracted multivalent antileishmanial drugs; in one case, a novel approach of combined medical and endoscopic surgical treatment was carried out. High clinical suspicion led to a prompt diagnosis and deployment of a multivalent treatment. ML should be considered in the differential diagnosis of nasal, oral, and pharyngolaryngeal lesions in endemic areas. A prompt diagnosis is mandatory to establish a correct management; different antileishmanial medications as well as endoscopic surgical options may be required to reach a complete remission.

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The Value of the Otorhinolaryngologic Exam in Correct Mucocutaneous Leishmaniasis Diagnosis

Cited by 6 publications

References 15 publications

Facial Structure Alterations and Abnormalities of the Paranasal Sinuses on Multidetector Computed Tomography Scans of Patients with Treated Mucosal Leishmaniasis

Facial Structure Alterations and Abnormalities of the Paranasal Sinuses on Multidetector Computed Tomography Scans of Patients with Treated Mucosal Leishmaniasis

Polymerase chain reaction–miniexon: a promising diagnostic method for mucocutaneous leishmaniasis

Autochthonous Cases of Mucosal Leishmaniasis in Northeastern Italy: Clinical Management and Novel Treatment Approaches

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