A case with two unusual findings: cutaneous leishmaniasis presenting as panniculitis and pericarditis after antimony therapy.
BACKGROUND
Cutaneous leishmaniasis is a parasitic disease caused by a Protozoan. Clinically and histopathologically, it can be confused with various dermatologic diseases.


METHODS
We report a case of cutaneous leishmaniasis (CL) with two unusual findings. A 49-year-old male patient presented to our clinic with a 3-month history of multiple nodules exhibiting arciform arrangement on the lateral side of the left leg.


RESULTS
Histopathologic examination revealed it as nodular vasculitis. Leishmania smear showed suspicious parasites. Although leishmania culture was negative, PCR was positive for Leishmania. The patient was considered to have CL and was treated with systemic meglumine antimoniate for 14 d. Three days after the end of the treatment, the patient presented to emergency room with a sharp, pleuritic chest pain. He was diagnosed with pericarditis based on clinical and electrocardiogram findings. As other causes of pericarditis were absent, it was thought to be related to antimony therapy.


CONCLUSIONS
The histopathologic presentation of CL as panniculitis is a very rare and this is the first case of pericarditis after the antimony treatment.
Eryilmaz
Aydolu
A
Department of Dermatology, Faculty of Medicine, Başkent University, Adana Hospital, Adana, Turkey. aydolue@yahoo.com
Durdu
Murat
M
Baba
Mete
M
Bal
Nebil
N
Yiğit
Fatma
F
D000981:Antiprotozoal Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002637:Chest Pain / Q000139:chemically induced / Q000175:diagnosis; D016054:DNA, Protozoan / Q000032:analysis; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008536:Meglumine / Q000009:adverse effects* / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D015434:Panniculitis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D010493:Pericarditis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy
D000981:Antiprotozoal Agents; D016054:DNA, Protozoan; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate