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Rosa ACG, de Senna AM, Santos FP, Soares AB, de Araújo VC. Oral Leishmaniasis in HIV-Positive and HIV-Negative Patients: A Comparative Analysis with Two New Case Reports. Head Neck Pathol 2024; 18:69. [PMID: 39101990 DOI: 10.1007/s12105-024-01674-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 07/06/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE This case report examines the clinical presentation, diagnosis, treatment, and outcomes of mucocutaneous leishmaniasis with primary oral involvement in HIV-positive and HIV-negative patients diagnosed in Brazil. METHODS We discuss the clinical manifestations, diagnostic methods, and therapeutic strategies, highlighting the clinical and histopathologic diagnostic features and distinct progression patterns based on HIV status. Our findings are compared with patterns observed in other countries, emphasizing the differences between the Americas and Europe, Asia, and Africa. RESULTS In the Americas, particularly in Brazil, mucocutaneous leishmaniasis often presents with localized oral lesions, even in the presence of systemic immunosuppression, whereas in the Europe, Asia, and Africa, oral involvement is typically associated with visceral leishmaniasis in immunocompromised patients. These differences were due to variations in the parasite species involved. CONCLUSION This comparison underscores the importance of regional and immunological factors in diagnosing and managing this neglected infectious disease.
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Affiliation(s)
| | | | - Fabrício Passador Santos
- Department of Oral Pathology, São Leopoldo Mandic School of Dentistry, Campinas, São Paulo, Brazil
| | - Andresa Borges Soares
- Department of Oral Pathology, São Leopoldo Mandic School of Dentistry, Campinas, São Paulo, Brazil
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Yadav P, Azam M, Ramesh V, Singh R. Unusual Observations in Leishmaniasis-An Overview. Pathogens 2023; 12:pathogens12020297. [PMID: 36839569 PMCID: PMC9964612 DOI: 10.3390/pathogens12020297] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/06/2023] [Accepted: 01/19/2023] [Indexed: 02/15/2023] Open
Abstract
Leishmaniasis significantly affects the population of the tropics and subtropics. Clinical features and infective species of Leishmania are the primary factors driving the direction of diagnosis. The rise in incidences of atypical presentations present a challenge in patient treatment. Knowledge of unusual/rare presentations can aid in having a broader perspective for including the different aspects during the examination and thus avoid misdiagnosis. A comprehensive literature survey was performed to present the array of atypical presentations confounding clinicians which have been seen in leishmaniasis. Case reports of unusual findings based on the localizations and morphology of lesions and infective species and the predominant geographical sites over almost five decades highlight such presentations in the population. Information regarding the clinical features recorded in the patient and the chosen treatment was extracted to put forward the preferred drug regimen in such cases. This comprehensive review presents various unusual observations seen in visceral leishmaniasis, post-kala-azar dermal leishmaniasis, cutaneous leishmaniasis, and mucocutaneous leishmaniasis. It highlights the need to consider such features in association with differential diagnosis to facilitate proper treatment of the patient.
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Affiliation(s)
- Priya Yadav
- ICMR-National Institute of Pathology, New Delhi 110029, India
- Manipal Academy of Higher Education, Manipal 576104, India
| | - Mudsser Azam
- ICMR-National Institute of Pathology, New Delhi 110029, India
| | - V Ramesh
- Department of Dermatology, ESIC Hospital, Faridabad 1210026, India
| | - Ruchi Singh
- ICMR-National Institute of Pathology, New Delhi 110029, India
- Correspondence: or
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Kumari D, Perveen S, Sharma R, Singh K. Advancement in leishmaniasis diagnosis and therapeutics: An update. Eur J Pharmacol 2021; 910:174436. [PMID: 34428435 DOI: 10.1016/j.ejphar.2021.174436] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 12/11/2022]
Abstract
Leishmaniasis is regarded as a neglected tropical disease by World Health Organization (WHO) and is ranked next to malaria as the deadliest protozoan disease. The primary causative agents of the disease comprise of diverse leishmanial species sharing clinical features ranging from skin abrasions to lethal infection in the visceral organs. As several Leishmania species are involved in infection, the role of accurate diagnosis becomes pivotal in adding new dimensions to anti-leishmanial therapy. Diagnostic methods must be fast, reliable, easy to perform, highly sensitive, and specific to differentiate among similar parasitic diseases. Herein, we present the conventional and recent approaches impended for the disease diagnosis and their sensitivity, specificity, and clinical application in parasite detection. Furthermore, we have also elaborated various new methods to cure leishmaniasis, which include host-directed therapies, drug repurposing, nanotechnology, and combinational therapy. This review addresses novel techniques and innovations in leishmaniasis, which can aid in unraveling new strategies to fight against the deadly infection.
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Affiliation(s)
- Diksha Kumari
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Summaya Perveen
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Rashmi Sharma
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Kuljit Singh
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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Botelho MCB, Ferreira LL, Fikaris S, Prado-Ribeiro AC, Soubhia AMP, Biasoli ER, Miyahara GI, Bernabé DG. Tongue Nodule as Primary Manifestation of American Cutaneous Leishmaniasis in an Immunocompetent Patient. Head Neck Pathol 2021; 15:1069-1073. [PMID: 33372239 PMCID: PMC8384968 DOI: 10.1007/s12105-020-01253-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 11/17/2020] [Indexed: 01/01/2023]
Abstract
Leishmaniasis is a parasitic disease considered an endemic public health problem in developing countries, where it is a reportable disease. Isolated oral manifestation is rare, and its clinical manifestations are variable. In this paper we describe an unusual case of an immunocompetent patient, 57-year-old man with a painless reddish submucosal nodule located on the tongue dorsum. Microscopical analysis showed chronic inflammatory infiltrate with macrophages containing leishmania in cytoplasmic vacuoles. PCR assays confirmed the diagnosis and patient was treated with meglumine antimoniate for 30 days. Absence of the parasite was confirmed by PCR. Thirteen years after treatment, a scar fibrosis persisted on the tongue dorsum. The case reported reveals that leishmaniasis should be considered in the diagnosis of tongue nodules in immunocompetent patients.
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Affiliation(s)
- Maria Clara Bertolini Botelho
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Lígia Lavezo Ferreira
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Stelios Fikaris
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Ana Carolina Prado-Ribeiro
- Dental Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), University of São Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Ana Maria Pires Soubhia
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Eder Ricardo Biasoli
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Glauco Issamu Miyahara
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Daniel Galera Bernabé
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil.
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil.
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Pauli MA, Pereira LDM, Monteiro ML, de Camargo AR, Rabelo GD. Painful palatal lesion in a patient with COVID-19. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:620-625. [PMID: 33867304 PMCID: PMC8005255 DOI: 10.1016/j.oooo.2021.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 01/01/2023]
Affiliation(s)
- Monique Abreu Pauli
- Dentistry Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Maria Luiza Monteiro
- Medical School, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | | | - Gustavo Davi Rabelo
- Dentistry Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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Silveira HA, Panucci BZM, Silva EV, Mesquita ATM, León JE. Microscopical Diagnosis of Oral Leishmaniasis: Kinetoplast. Head Neck Pathol 2021; 15:1085-1086. [PMID: 33599946 PMCID: PMC8385019 DOI: 10.1007/s12105-021-01304-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Heitor Albergoni Silveira
- grid.11899.380000 0004 1937 0722Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, SP Brazil
| | - Beatriz Zamboni Martins Panucci
- grid.11899.380000 0004 1937 0722Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, SP Brazil
| | - Evanio Vilela Silva
- grid.11899.380000 0004 1937 0722Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, SP Brazil
| | - Ana Terezinha Marques Mesquita
- Department of Dentistry, Clinical Stomatology, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, MG Brazil
| | - Jorge Esquiche León
- grid.11899.380000 0004 1937 0722Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, SP Brazil
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Gonçalves IMF, Rocha ÍM, Pires EG, Muniz IDAF, Maciel PP, de Lima JM, Dos Santos IMG, Batista RBD, de Medeiros ELG, de Medeiros ES, de Oliveira JE, Goulart LR, Bonan PRF, Castellano LRC. Effectiveness of Core-Shell Nanofibers Incorporating Amphotericin B by Solution Blow Spinning Against Leishmania and Candida Species. Front Bioeng Biotechnol 2020; 8:571821. [PMID: 33195132 PMCID: PMC7662013 DOI: 10.3389/fbioe.2020.571821] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/26/2020] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to develop polymeric nanofibers for controlled administration of Amphotericin B (AmpB), using the solution centrifugation technique, characterizing its microstructural and physical properties, release rate, and activity against Leishmania and Candida species. The core-shell nanofibers incorporated with AmpB were synthesized by Solution Blow Spinning (SBS) and characterized by scanning electron microscopy (SEM), differential scanning calorimetry, X-Ray diffraction, and drug release assay. In vitro leishmanicidal and antifungal activity were also evaluated. Fibrous membranes with uniform morphology and smooth surfaces were produced. The intensity of the diffraction peaks becomes slightly more pronounced, assuming the increased crystallization in PLA/PEG at high AmpB loadings. Drug release occurred and the solutions with nanofibers to encourage greater incorporation of AmpB showed a higher concentration. In the results of the experiment with promastigotes, the wells treated with nanofibers containing concentrations of AmpB at 0.25, 0.5, and 1%, did not have any viable cells, similar to the positive control. Various concentrations of AmpB improved the inhibition of fungal growth. The delivery system based on PLA/PEG nanofibers was properly developed for AmpB, presenting a controlled release and a successful encapsulation, as well as antifungal and antileishmanial activity.
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Affiliation(s)
- Ingrid Morgana Fernandes Gonçalves
- Human Immunology Research and Education Group (GEPIH), Escola Técnica de Saúde da UFPB, Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Dentistry (PPGO), Federal University of Paraíba, João Pessoa, Brazil
| | - Ítalo Martins Rocha
- Human Immunology Research and Education Group (GEPIH), Escola Técnica de Saúde da UFPB, Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Dentistry (PPGO), Federal University of Paraíba, João Pessoa, Brazil
| | - Emanuene Galdino Pires
- Human Immunology Research and Education Group (GEPIH), Escola Técnica de Saúde da UFPB, Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Dentistry (PPGO), Federal University of Paraíba, João Pessoa, Brazil
| | - Isis de Araújo Ferreira Muniz
- Human Immunology Research and Education Group (GEPIH), Escola Técnica de Saúde da UFPB, Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Dentistry (PPGO), Federal University of Paraíba, João Pessoa, Brazil
| | - Panmella Pereira Maciel
- Human Immunology Research and Education Group (GEPIH), Escola Técnica de Saúde da UFPB, Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Dentistry (PPGO), Federal University of Paraíba, João Pessoa, Brazil
| | - Jefferson Muniz de Lima
- Human Immunology Research and Education Group (GEPIH), Escola Técnica de Saúde da UFPB, Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Dentistry (PPGO), Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Dentistry, Federal University of Pernambuco, Recife, Brazil
| | | | - Roberta Bonan Dantas Batista
- Human Immunology Research and Education Group (GEPIH), Escola Técnica de Saúde da UFPB, Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Dentistry, Federal University of Pernambuco, Recife, Brazil
| | | | - Eliton Souto de Medeiros
- Postgraduate Program in Dentistry (PPGO), Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Materials Engineering, Federal University of Paraíba, João Pessoa, Brazil
| | | | - Luiz Ricardo Goulart
- Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia, Uberlândia, Brazil.,Institute of Biochemistry and Genetics, Federal University of Uberlândia, Uberlândia, Brazil.,Department of Medical Microbiology and Immunology, University of California Davis, Davis, CA, United States
| | - Paulo Rogério Ferreti Bonan
- Human Immunology Research and Education Group (GEPIH), Escola Técnica de Saúde da UFPB, Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Dentistry (PPGO), Federal University of Paraíba, João Pessoa, Brazil
| | - Lúcio Roberto Cançado Castellano
- Human Immunology Research and Education Group (GEPIH), Escola Técnica de Saúde da UFPB, Federal University of Paraíba, João Pessoa, Brazil.,Postgraduate Program in Dentistry (PPGO), Federal University of Paraíba, João Pessoa, Brazil
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Parasitological association between human leishmaniosis mucosa and paracoccidioidomycosis. Case report. Int J Surg Case Rep 2020; 76:170-173. [PMID: 33035956 PMCID: PMC7553885 DOI: 10.1016/j.ijscr.2020.09.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/19/2020] [Accepted: 09/19/2020] [Indexed: 11/29/2022] Open
Abstract
It affects the upper part of the aerodigestive tract, with mainly lesions in the oral and nasal mucosa and occasionally in the larynx and pharynx. The exclusive involvement of oral mucosa is quite rare. The diagnosis of leishmaniasis is a real challenge for all professional team. In Brazil, the highest incidence of Leishmaniasis is in the Northern Region, which comprises the States of Acre, Amapá, Amazonas, Pará, Rondônia, Roraima and Tocantins. Coexistence of parasitic diseases between Paracoccidioidomycosis and Leishmaniasis.
Introduction Leishmaniasis Mucosa (LM) is a tropical disease that affects the upper respiratory tract and/or oral mucosa. Its etiological agent is Leishmania spp. Paracoccidioidomycosis disease caused by the fungus Paracoccidioides brazilienses. The aim is to report a case of Leishmaniasis Mucosa in association with Paracoccidioidomycosis. Presentation of case A male patient, 24 years old; Intraorally, presence of a non-bleeding erythro-leucoplastic lesion that affected the soft palate and oropharynx; 3 years of evolution. On the face Computerized Tomography (CT) examination, it was possible to observe muco-periosteal thickening in the soft palate region; immunohistochemical markings for Paracoccidiodes brasiliensis. He was diagnosed with Leishmaniasis by Montenegro intradermoreaction (MIDR). Discussion The predisposition to Paracocodioidomycosis after Leishmaniasis infection is justified by factors already elucidated – hygiene, nutrition habits and immunodeficiency, but the reason for the non-progression of the fungus after years of evolution could be related to its inhibition due to the presence of the protozoan in the same wound. Conclusion This phenomenon may be explained by future studies that need to be performed to answer such questions.
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Dos Santos RLO, Tenório JR, Fernandes LG, Moreira Ribeiro AI, Pinho Costa SA, Trierveiler M, Lemos CA, Sugaya NN. Oral leishmaniasis: Report of two cases. J Oral Maxillofac Pathol 2020; 24:402. [PMID: 33456261 PMCID: PMC7802832 DOI: 10.4103/jomfp.jomfp_306_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 05/11/2020] [Accepted: 05/18/2020] [Indexed: 11/04/2022] Open
Abstract
Leishmaniasis is a chronic inflammatory disease caused by several species of the parasite Leishmania that is transmitted by insects of the genus Phlebotomus spp. or Lutzomyia spp. This disease can affect skin, mucous membranes and viscera being classified as cutaneous, mucocutaneous and visceral leishmaniasis, depending on the spectrum of clinical manifestations. Diagnosis can be achieved through biopsy, microscopical analysis, Montenegro intradermoreaction and/or ELISA. The dentist plays an important role in the diagnosis of this disease due to frequent involvement of oral mucosa. This article reports two clinical cases of leishmaniasis with oral mucosa involvement, their diagnosis workup and treatment.
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Affiliation(s)
| | | | | | | | | | - Marília Trierveiler
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Celso Augusto Lemos
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Norberto Nobou Sugaya
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Sánchez-Romero C, Júnior HM, Matta VLRD, Freitas LM, Soares CDM, Mariano FV, de Almeida OP, Nascimento de Aquino S. Immunohistochemical and Molecular Diagnosis of Mucocutaneous and Mucosal Leishmaniasis. Int J Surg Pathol 2019; 28:138-145. [PMID: 31566041 DOI: 10.1177/1066896919876706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Leishmaniasis is a parasitic infection transmitted by the bite of infected female sandflies. It principally affects the skin, and the frequency of mucosal involvement is about 5% to 20%. Considering the rarity of leishmaniasis affecting the upper aerodigestive tract mucosa, we evaluated the characteristics of mucocutaneous leishmaniasis and mucosal leishmaniasis and the diagnostic difficulty when the parasites are scarce in tissue samples. The clinical, histopathological, histochemical, immunohistochemical, and molecular features of 17 cases of mucocutaneous leishmaniasis and mucosal leishmaniasis were assessed. Mucosal disease was principally found in the soft palate, oropharynx, and nose, manifesting mainly as a solitary ulcer. In hematoxylin and eosin-stained sections, 10 cases revealed abundant amastigotes within the macrophages. Giemsa staining was not shown to be helpful to confirm the diagnosis in 6 cases with scarce or nondetectable amastigotes. Immunohistochemistry (IHC) showed high sensitivity by positive staining in 14 out of 17 cases (82.3%). Polymerase chain reaction was shown to be more sensitive than IHC with 13 out of 14 (92.8%) positive cases, including the 3 IHC negative cases; however, this technique is not available in many endemic regions. In summary, we suggest that the IHC is a simple technique with rapid results and relatively low cost, when compared with other laboratorial procedures; thus, IHC is a helpful tool that should be implemented in the routine diagnosis of leishmania.
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Affiliation(s)
- Celeste Sánchez-Romero
- University of Campinas (UNICAMP), Piracicaba, Brazil.,Universidad de la República, Montevideo, Uruguay
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Falcão GGVSC, Lins-Kusterer L, Leite-Ribeiro PM, Sarmento VA. Orofacial manifestations of mucocutaneous leishmaniasis: a case series from Brazil. F1000Res 2019; 8:756. [PMID: 33042516 PMCID: PMC7527865 DOI: 10.12688/f1000research.19056.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 11/20/2022] Open
Abstract
Dentists play a fundamental role in the early diagnosis of oral leishmaniasis. Although these lesions are rare at oral mucosa, this is one of the manifestations sites of the disease This study reports seven clinical cases of orofacial mucocutaneous leishmaniasis. All had leishmaniasis diagnosis confirmed by laboratory tests, with orofacial involvement. Five out of the seven cases were males, and in four cases, patients had associated comorbidities. Late diagnosis was observed, resulting in treatment delay and increased hospitalization stay. One patient had severe psychological consequences due to facial deformity. The lack of differential diagnosis due the great variability of clinical presentation of the lesions and frequent unspecific histopathology represent a challenge for the dentist. In two reported cases, there were unspecific biopsy results. This series of cases highlights the importance of a multidisciplinary approach in the diagnosis and treatment of oral and perioral leishmaniasis. Patients with atypical lesions, originating from or living in endemic regions, should be investigated for leishmaniasis. These procedures could avoid delays in diagnosis and decrease the risk of disease dissemination.
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Affiliation(s)
| | - Liliane Lins-Kusterer
- Professor Edgard Santos Hospital, Federal University of Bahia, Salvador, BA, 40110060, Brazil
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12
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Borghi SM, Fattori V, Conchon-Costa I, Pinge-Filho P, Pavanelli WR, Verri WA. Leishmania infection: painful or painless? Parasitol Res 2016; 116:465-475. [PMID: 27933392 DOI: 10.1007/s00436-016-5340-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/28/2016] [Indexed: 11/25/2022]
Abstract
The complex life cycle and immunopathological features underpinning the interaction of Leishmania parasites and their mammalian hosts poses frequent poorly explored and inconclusively resolved questions. The altered nociceptive signals over the course of leishmaniasis remain an intriguing issue for nociceptive and parasitology researchers. Experimental investigations have utilized behavioral, morphological, and neuro-immune approaches in the study of experimental cutaneous leishmaniasis (CL). The data generated indicates new venues for the study of the pathological characteristics of nociceptive processing in this parasitic disease. Leishmania-induced pain may be easily observed in mice and rats. However, nociceptive data is more complex in human investigations, including the occurrence of painless lesions in mucocutaneous and cutaneous leishmaniasis. Data from recent decades indicate that humans can also be affected by pain-related symptoms, often distinct from the region of body infection. The molecular and cellular mechanisms underlying such variable nociceptive states in humans during the course of leishmaniasis are an active area of research. The present article reviews nociception in leishmaniasis, including in experimental models of CL and clinical reports.
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Affiliation(s)
- Sergio M Borghi
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Victor Fattori
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Ivete Conchon-Costa
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Phileno Pinge-Filho
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Wander R Pavanelli
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Waldiceu A Verri
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil.
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