Abstract

ANEZ, Néstor; ROJAS, Agustina; CRISANTE, Gladys  and  JEREZ, Mauricio. Detection of Leishmania braziliensis in a mucosal lesion with 16 years of evolution: A case report. Bol Mal Salud Amb [online]. 2012, vol.52, n.1, pp.15-19. ISSN 1690-4648.

The detection of Leishmania (Viannia) braziliensis from a chronic mucosal lesion with 16 years of clinical evolution in a 48 years old male patient is reported. The patient showed destruction of the nasal septal cartilage with no evidence of primary leishmanial lesion. Due to his professional work he frequently visited areas of western Venezuela where leishmaniasis is endemic. Frequent clinical, immunologic and histopathologic evaluations carried out during several years failed to establish a right diagnosis, increasing the severity of the mucosal lesion. The finding of a sparse number of amastigotes in a sample from the mucosal lesion stained by Giemsa stain, suggested a mucosal infection by Leishmania. The identification of the parasite as L. braziliensis and the verification of the infection by this parasite in the reported case were carried out using a PCR assay and a Western Blot test, respectively. It is concluded that the patient was suffering a long-lasting, reluctant to heal and severe lesion with a low immunological response due to infection by L. braziliensis causing mucocutaneous leishmaniasis (MCL). The fail in the diagnosis of this particular case of MCL and the potential epidemiological risk in similar cases are discussed.

Keywords : Mucocutaneous leishmaniasis; long-lasting lesion; Leishmania braziliensis; Venezuela.