title: Conjunctival leishmaniasis in a case of disseminated cutaneous leishmaniasis.
abstract: A 15-year-old female patient presented with numerous, small, papulonodular skin lesions, and hepatosplenomegaly 9 months after a treated biopsy proved cutaneous leishmaniasis. In ocular examination there were two yellowish, raised gelatinous conjunctival lesions in the left eye. The exisional conjunctival lesion biopsy revealed many Leishman bodies inside tissue histiocytes. The patient had no systemic immunologic problems (normal serum immunoglobulins, nitroblue-tetrazolium test, complement CH50 test and flow cytometry of leukocytes). The indirect immunofluorescent antibody test for Leishmania tropica (titre of 1:1024) and the leishmanin skin test were positive. DNA of L. tropica was detected by a specific polymerase chain reaction on whole blood, bone marrow and skin biopsy specimens. The skin and conjunctival lesions disappeared with miltefosine and no intraocular tissue penetration of organism happened. Conjunctival leishmaniasis should be considered in the differential diagnosis of raised conjunctival lesions in a disseminated cutaneous leishmaniasis patient and needs proper systemic therapy.
authors.affiliation: Poostchi Eye Research Center, Shiraz University of Medical Sciences, Shiraz, Iran razeghinejad@yahoo.com.|Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA.
authors.forename: M Reza
authors.initials: MR
authors.lastname: Razeghinejad
authors.affiliation: Department of Pathology and Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Monabati
authors.affiliation: Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad Rahim
authors.initials: MR
authors.lastname: Kadivar
authors.affiliation: Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Abdolvahab
authors.initials: A
authors.lastname: Alborzi
mesh_terms: D000293:Adolescent; D001706:Biopsy; D003228:Conjunctiva / Q000469:parasitology* / Q000473:pathology; D003229:Conjunctival Diseases / Q000469:parasitology* / Q000473:pathology; D005260:Female; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000473:pathology*; D012867:Skin / Q000473:pathology
keywords: Conjunctiva; leishmaniasis; miltefosine