Co-infection of mucosal leishmaniasis and extra pulmonary tuberculosis in a patient with inherent immune deficiency.
BACKGROUND
In Sri Lanka, cutaneous leishmaniasis is a well-established disease caused by Leishmania donovani. Only a few cases of visceral disease and mucosal localization have been reported to date.


METHODS
A 52-year-old man presented with severe local destruction of his upper and lower lip and total destruction of the anterior nasal septum and was diagnosed with mucosal leishmaniasis. The causative organism was confirmed to be Leishmania donovani. In addition he had tuberculous lymphadenitis and inherent immune deficiency. His previous medical history was unremarkable. The patient was successfully treated with intramuscular sodium stibogluconate.


CONCLUSIONS
The clinical picture and satisfactory treatment response to antimony are similar to mucosal leishmaniasis caused by L. donovani reported in India and Sudan and with the absence of primary skin lesions make it different from new world mucosal leishmaniasis. Even though leishmania and tuberculous co-infection has been reported in association with HIV this has not been reported in inherent immune deficiency.
Rathnayake
Deepani
D
Dermatology Unit, The National Hospital of Sri Lanka, Colombo, Sri Lanka. deepsrat@yahoo.com
Ranawake
Ranthilaka R
RR
Sirimanna
Ganga
G
Siriwardhane
Yamuna
Y
Karunaweera
Nadeera
N
De Silva
Rajiv
R
D000967:Antimony Sodium Gluconate / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications*; D007893:Leishmania donovani / Q000276:immunology / Q000302:isolation & purification; D007897:Leishmaniasis, Mucocutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*
D000981:Antiprotozoal Agents; D000967:Antimony Sodium Gluconate