Conjunctival leishmaniasis in a case of disseminated cutaneous leishmaniasis

Tropical Doctor
M Reza RazeghinejadAbdolvahab Alborzi

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.

References

Mar 4, 2000·Eye·Y OzdemirG Kural
May 1, 2004·European Journal of Epidemiology·Ahmet SaticiIrfan Ozturk
Nov 1, 2005·Lancet·Henry W MurrayNancy G Saravia
Apr 11, 2008·Clinical Microbiology Reviews·Jorge AlvarJavier Moreno
Nov 3, 2009·European Journal of Ophthalmology·Panagiotis SalvanosElias Feretis

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Citations

Aug 29, 2019·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Orlando Jorge M TorresEduardo de Souza M Fernandes
Sep 25, 2019·The American Journal of Tropical Medicine and Hygiene·Nilesh TejuraDebra Chew
Dec 24, 2019·The Journal of Dermatological Treatment·Alireza FiroozYahya Dowlati
Feb 7, 2019·Tropical Doctor·Amber Amar BhayanaMandeep S Bajaj
Apr 30, 2021·Indian Journal of Ophthalmology·Guillaume MignotAravind Reddy

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Methods Mentioned

BETA
biopsy
flow cytometry

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