Parasitology Research

, Volume 109, Issue 3, pp 959–962

Mucosal Leishmania infantum infection

  • Joachim Richter
  • Ingrid Hanus
  • Dieter Häussinger
  • Thomas Löscher
  • Gundel Harms
Short Communication

Abstract

Mucosal leishmaniasis is a well-known clinical manifestation of infections caused by species belonging to the Leishmania (Viannia) subgenus in Central and South America but not of Leishmania species endemic in the so-called Old World. We report on three cases of mucosal leishmaniasis caused by Leishmania (Leishmania) infantum contracted in southern Europe. Two patients were immunocompromised; one patient had no underlying condition. Lesions were located in the oral mucosa, oesophagus and nose. All lesions relapsed under standard treatment with liposomal amphotericin B. A cure was achieved after secondary and extended treatment with liposomal amphotericin B or miltefosine. Mucosal leishmaniasis contracted in southern Europe has to be considered in the differential diagnosis of lesions in the naso–buccal–oesophageal mucosa and may occur in previously healthy persons.

References

  1. Abdalla RE, El Hadi A, Ahmed MA, El Hassan AM (1975) Sudan mucosal leishmaniasis. Trans R Soc Trop Med Hyg 69:443–449PubMedCrossRefGoogle Scholar
  2. Aliaga L, Cobo F, Mediavilla JD, Bravo J, Osuna A, Amadour JM, Martín-Sánchez J, Corder E, Navarro JMl (2003) Localized mucosal leishmaniasis due to Leishmania infantum: clinical and microbiologic findings in 31 patients. Medicine (Baltimore) 82:147–158Google Scholar
  3. Barnetson RS, Ridley RS, Wheate HW (1978) A form of muco-cutaneous leishmaniasis in the Old World. Trans R Soc Trop Med Hyg 172:516–518CrossRefGoogle Scholar
  4. Benmously-Mlika R, Fenniche S, Kerkeni N, Aoun K, Khedim A, Mokhtar I (2008) Primary Leishmania infantum MON-80 endonasal leishmaniasis in Tunisia. Ann Dermatol Vénéréol 135:389–392PubMedCrossRefGoogle Scholar
  5. Berens-Riha N, Fleischmann E, Pratlong F, Bretzel G, von Sonnenburg F, Löscher T (2009) Cutaneous leishmaniasis (Leishmania tropica) in a German tourist after travel to Greece. J Travel Med 16(3):220–222PubMedCrossRefGoogle Scholar
  6. Borzoni F, Gradoni L, Gramiccia M, Maccioni A, Valdes E, Loddo S (1991) A case of lingual and palatine localization of a viscerotropic Leishmania infantum zymodeme in Sardinia, Italy. Trop Med Parasitol 42:193–194PubMedGoogle Scholar
  7. Casolari C, Guaraldi G, Pecorari M et al (2005) A rare case of localized mucosal leishmaniasis due to Leishmania infantum in an immunocompetent Italian host. Eur J Epidemiol 20:559–561PubMedCrossRefGoogle Scholar
  8. Cobo F, Aliaga L, Talavera P, Concha A (2007) The histological spectrum of non-granulomatous localized mucosal leishmaniasis caused by Leishmania infantum. Ann Trop Med Parasitol 101:689–694PubMedCrossRefGoogle Scholar
  9. El Fékih N, Sliti N, Kharfi M, Trabelsi S, Khaled S, Fazaa B, Kamoun MR (2008) Mucosal leishmaniasis by contiguity with a skin lesion: another case report from Tunisia. Med Trop 68:634–636Google Scholar
  10. Garcia de Marcos JA, Dean Ferrer A, Granados FA et al (2007) Localized leishmaniasis of the oral mucosa. A report of three cases. Med Oral Patol Cir Bucal 12:281–286Google Scholar
  11. Guimaraes MC, Celeste BJ, Franco EL, Cuce LC, Belda W Jr (1989) Evaluation of serological diagnostic indices for mucocutaneous leishmaniasis: immunofluorescence tests and enzyme-linked immunoassays for IgG, IgM and IgA antibodies. Bull World Health Organ 67:643–648PubMedGoogle Scholar
  12. Guimaraes MC, Celeste BJ, Franco EL (1990) Diagnostic performance indices for immunofluorescence tests and enzyme immunoassays of leishmaniasis sera from northern and north-eastern Brazil. Bull World Health Organ 68:39–43PubMedGoogle Scholar
  13. Hailu A (2002) The use of direct agglutination test (DAT) in serological diagnosis of Ethiopian cutaneous leishmaniasis. Diagn Microbiol Infect Dis 42:251–256PubMedCrossRefGoogle Scholar
  14. Harms G, Schönian G, Feldmeier H (2003) Leishmaniasis in Germany. Emerg Infect Dis 9:872–875PubMedGoogle Scholar
  15. Kar K (1995) Serodiagnosis of leishmaniasis. Crit Rev Microbiol 21:123–152PubMedCrossRefGoogle Scholar
  16. Kharfi M, Fazaa B, Chaker E, Kamoun MR (2003) Mucosal localization of leishmaniasis in Tunisia: 5 cases. Ann Dermatol Vénéréol 130:27–30PubMedGoogle Scholar
  17. Mahdi M, Elamin EM, Melville SE et al (2005) Sudanese mucosal leishmaniasis: isolation of a parasite within the Leishmania donovani complex that differs genotypically from L. donovani causing classical visceral leishmaniasis. Infect Genet Evol 5:29–33PubMedCrossRefGoogle Scholar
  18. Morsy TA, Khalil NM, Salama MM, Hamdi KN, al Shamrany YA, Abdalla KF (1995) Mucosal leishmaniasis caused by Leishmania tropica in Saudi Arabia. J Egypt Soc Parasitol 25:73–79PubMedGoogle Scholar
  19. Pau M, Azzori L, Aste N, Aste N (2009) Two cases of primary endonasal leishmaniasis in Sardinia (Italy). Dermatol Online J 15:5PubMedGoogle Scholar
  20. Ready PD (2010) Leishmaniasis emergence in Europe. Euro Surveill 15(10):19505Google Scholar
  21. Romero GA, de la Gloria Orge Orge M, de Farias Guerra MV, Paes MG, de Olivera MV, Carvalho EM (2005) Antibody response in patients with cutaneous leishmaniasis infected by Leishmania (Viannia) braziliensis or Leishmania (Viannia) guyanensis in Brazil. Acta Trop 93:49–56PubMedCrossRefGoogle Scholar
  22. Schönian G, Nasereddin A, Schweynoch C, Schallig HD, Presber W, Jaffe CL (2003) PCR diagnosis and characterization of Leishmania in local and imported clinical samples. Diagn Microbiol Infect Dis 47:349–358PubMedCrossRefGoogle Scholar
  23. Van Damme PA, Keuter M, Van Assen S, DeWilde PCM, Beckers JA (2004) A rare case of oral leishmaniasis. Lancet Infect Dis 4:53PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Joachim Richter
    • 1
  • Ingrid Hanus
    • 2
  • Dieter Häussinger
    • 1
  • Thomas Löscher
    • 2
  • Gundel Harms
    • 3
  1. 1.Tropical Medicine Unit, Clinics for Gastroenterology, Hepatology and Infectious Diseases, University Clinics DüsseldorfHeinrich-Heine-University DüsseldorfDüsseldorfGermany
  2. 2.Department of Infectious Diseases and Tropical MedicineUniversity of MunichMunichGermany
  3. 3.Institute of Tropical Medicine and International HealthCharité-Universitätsmedizin BerlinBerlinGermany

Personalised recommendations