Detection of Leishmania infantum kinetoplast DNA in laryngeal tissue from an immunocompetent patient.
Mucosal leishmaniasis of the upper respiratory tract is usually associated with the visceral form or is found in immunosuppressed individuals. This report presents a case of isolated mucosal leishmaniasis in an immunocompetent patient, whose diagnosis mainly rested on histology and positive polymerase chain reaction result for Leishmania donovani in the laryngeal tissue. A 59-year-old man, who never lived outside Italy, showed a subglottic mucosal polypoid-like lesion. The typical morphological picture and positive polymerase chain reaction result for L donovani by DNA extracted from laryngeal biopsy specimens allowed the diagnosis of mucosal leishmaniasis. Specific amphotericin B therapy was started, resulting in clinical and endoscopic improvement. Increased knowledge about the histological and molecular tissue analysis of Leishmania enhances the diagnostic testing for mucosal leishmaniasis, as primary mucosal leishmaniasis may occur in both immunosuppresed and immunocompetent patients who travel to or reside in areas endemic for Leishmania.
Guddo
Francesca
F
Unità Operativa di Anatomia ed Istologia Patologica, Ospedale V. Cervello, Palermo 90148, Italy. francesca.guddo@tin.it
Gallo
Elena
E
Cillari
Enrico
E
La Rocca
Anton Maria
AM
Moceo
Piero
P
Leslie
Kevin
K
Colby
Thomas
T
Rizzo
Aroldo G
AG
D000666:Amphotericin B / Q000627:therapeutic use; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood / Q000276:immunology; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001399:Azure Stains / Q000378:metabolism; D001706:Biopsy; D001999:Bronchoscopy; D018105:DNA, Kinetoplast / Q000235:genetics*; D016054:DNA, Protozoan / Q000032:analysis* / Q000235:genetics; D004724:Endoscopy; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007121:Immunocompetence; D007558:Italy; D007830:Larynx / Q000469:parasitology / Q000473:pathology* / Q000601:surgery; D007893:Leishmania donovani / Q000187:drug effects / Q000235:genetics / Q000276:immunology; D018314:Leishmania infantum / Q000235:genetics* / Q000276:immunology; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000469:parasitology* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D013194:Staining and Labeling; D016896:Treatment Outcome
D000913:Antibodies, Protozoan; D000981:Antiprotozoal Agents; D001399:Azure Stains; D018105:DNA, Kinetoplast; D016054:DNA, Protozoan; D000666:Amphotericin B