Gingival leishmaniasis in an HIV-negative patient.
Gingival leishmaniasis is unusual and is mainly observed in immunocompromised patients. We report a case involving the palate, uvula, and gingiva of an HIV-negative patient who was initially diagnosed as having paracoccidioidomycosis. The patient underwent a biopsy for parasite isolation and in situ histopathology and immunohistochemistry. The Leishmania spp. were detected in lesions of the uvula and gingiva. Despite the poor state of teeth, the gingival lesions were caused by American tegumentary leishmaniasis (ATL). The gingival lesions presented an intense inflammatory infiltrate permeated by neutrophils. Immunohistochemistry revealed a predominantly lymphocytic infiltrate. The patient responded well to treatment, with no reactivation during follow-up. The rarity of gingival involvement in immunocompetent patients and the need for inclusion of ATL in the differential diagnosis of gingival lesions are discussed.
Palmeiro
Mariana Reuter
MR
Laboratory of Immunoparasitology, Oswaldo Cruz Institute (IOC), FIOCRUZ, Rio de Janeiro, Brazil.
Rosalino
Claúdia Maria Valette
CM
Quintella
Leonardo Pereira
LP
Morgado
Fernanda Nazaré
FN
da Costa Martins
Ana Cristina
AC
Moreira
João
J
de Oliveira Schubach
Armando
A
Conceição-Silva
Fátima
F
D000368:Aged; D000818:Animals; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005882:Gingival Diseases / Q000188:drug therapy / Q000469:parasitology* / Q000473:pathology; D018023:HIV Seronegativity; D006801:Humans; D007892:Leishmania braziliensis / Q000302:isolation & purification*; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D010159:Palate / Q000469:parasitology; D014609:Uvula / Q000469:parasitology