title: Mucosal leishmaniasis mimicking squamous cell carcinoma in a liver transplant recipient.
abstract: Organ transplant recipients living in endemic regions are at increased risk of Leishmania infections. Visceral leishmaniasis is the most common kind of presentation in the Mediterranean basin. Rarely, Leishmania infantum may cause localized mucosal disease. We present the first case, to our knowledge, of a liver transplant recipient with localized mucosal leishmaniasis. Twenty-two years after transplantation, a painless, very slow growing ulcer appeared on the inner side of the patient's upper lip. A biopsy performed in the community hospital showed non-specific chronic inflammation without neoplastic signs. Because of a high suspicion of malignancy, the patient was transferred to the referral hospital to consider complete excision. The excisional biopsy revealed a granulomatous inflammatory reaction together with intracellular Leishmania amastigotes within macrophages. Leishmaniasis was confirmed by the nested polymerase chain reaction assay. The clinical and laboratory findings did not suggest visceral involvement. The patient received meglumine antimoniate for 21 days without relevant adverse effects.
authors: Infectious Diseases Unit (Internal Medicine), Universidad Autónoma de Madrid, HU Puerta de Hierro, Majadahonda, Madrid, Spain.
authors: A
authors: A
authors: Ramos
authors: Infectious Diseases Unit (Internal Medicine), Universidad Autónoma de Madrid, HU Puerta de Hierro, Majadahonda, Madrid, Spain.
authors: E
authors: E
authors: Múñez
authors: Plastic Surgery Department, HU Puerta de Hierro, Majadahonda, Madrid, Spain.
authors: J
authors: J
authors: García-Domínguez
authors: Microbiology Department, HU Puerta de Hierro, Majadahonda, Madrid, Spain.
authors: R
authors: R
authors: Martinez-Ruiz
authors: Parasitology Department, Instituto Nacional de Salud "Carlos III", Majadahonda, Madrid, Spain.
authors: C
authors: C
authors: Chicharro
authors: Liver Transplantation Unit (Internal Medicine), Universidad Autónoma de Madrid, HU Puerta de Hierro, Majadahonda, Madrid, Spain.
authors: I
authors: I
authors: Baños
authors: Pathology Department, HU Puerta de Hierro, Majadahonda, Madrid, Spain.
authors: D
authors: D
authors: Suarez-Massa
authors: Liver Transplantation Unit (Internal Medicine), Universidad Autónoma de Madrid, HU Puerta de Hierro, Majadahonda, Madrid, Spain.
authors: V
authors: V
authors: Cuervas-Mons
mesh_terms: D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D007891:Leishmania / Q000235:genetics / Q000302:isolation & purification*; D007897:Leishmaniasis, Mucocutaneous / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008536:Meglumine / Q000627:therapeutic use*; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009055:Mouth / Q000469:parasitology; D009942:Organometallic Compounds / Q000627:therapeutic use*; D016133:Polymerase Chain Reaction
chemical_list: D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate
keywords: Leishmania infantum; leishmaniasis; liver transplantation; meglumine antimoniate; mucocutaneous