title: Laryngeal leishmaniasis.
abstract: BACKGROUND
  Leishmaniasis is classified into three clinical presentations: visceral, coetaneous and mucocutaneous. The latter is usually secondary to hematogenous spread after months or years of skin infection and can manifest as infiltrative lesions, ulcerated or vegetating in nose, pharynx, larynx and mouth, associated or not with ganglionics infarction. Laryngeal involvement is part of the differential diagnosis of lesions in this topography as nonspecific chronic laryngitis, granulomatosis and even tumors of the upper aerodigestive tract presenting atypical evolution. Sometimes it is difficult for the correct diagnosis of Leishmaniasis, with description of cases in the literature were conducted improperly.
  
  
  OBJECTIVE
  The objective of this study is to report a case of laryngeal Leishmaniasis addressing the difficulty of diagnosis, complications and treatment applied.
  
  
  METHODS
  A patient with pain throat, dysphagia, odynophagia, dysphonia and weight loss, with no improvement with symptomatic medication. At telelaringoscopy, infiltrative lesion showed nodular supraglottis. He underwent a tracheotomy for airway obstruction and biopsy with immunohistochemical study for a definitive diagnosis of laryngeal Leishmaniasis. The patient was referred to the infectious diseases that initiated treatment with N-methylglucamine antimoniate with satisfactory response to therapy. Final Comments: Faced with a clinical suspicion of granulomatous diseases, it is essential to follow protocol laboratory evaluation associated with histological injury, to get a precise definition etiological without prolonging the time of diagnosis. Medical treatment for mucosal Leishmaniasis, recommended by the World Health Organization, was adequate in the case of laryngeal disorders, with complete resolution of symptoms.
authors.affiliation: ENT. Master in Health Sciences Department of Otolaryngology and Head and Neck Surgery, Federal University of São Paulo.
authors.forename: Bruno Teixeira de
authors.initials: BT
authors.lastname: Moraes
authors.affiliation: Head and Neck Surgeon. PhD in Health Sciences Department of Otolaryngology and Head and Neck Surgery, Federal University of São Paulo.
authors.forename: Francisco de Souza Amorim
authors.initials: Fde S
authors.lastname: Filho
authors.affiliation: ENT. Assistant Professor, Department of Otolaryngology and Head and Neck Surgery, Federal University of São Paulo.
authors.forename: José Caporrino
authors.initials: JC
authors.lastname: Neto
authors.affiliation: Medical. Resident Department of Otolaryngology and Head and Neck Surgery, Federal University of São Paulo.
authors.forename: Paulo Saraceni
authors.initials: PS
authors.lastname: Neto
authors.affiliation: Physician. Specializing Department of Otolaryngology and Head and Neck Surgery, Federal University of São Paulo.
authors.forename: José Elson Santiago de
authors.initials: JE
authors.lastname: Melo
keywords: Leishmaniasis; chronic granulomatous disease; larynx; mucocutaneous Leishmaniasis