Mucocutaneous Leishmaniasis: clinical markers in presumptive diagnosis

• Autor(a) principal: Diniz,João Luiz Cioglia Pereira
• Data de Publicação: 2011
• Outros Autores: Costa,Manoel Otávio da Rocha, Gonçalves,Denise Utsch
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian Journal of Otorhinolaryngology
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942011000300018
• topic: diagnosis; leishmaniasis; mucocutaneous; otolaryngology

Mucocutaneous Leishmaniasis (ML) can lead to serious sequela; however, early diagnosis can prevent complications. AIM: To evaluate clinical markers for the early diagnosis of ML. MATERIALS AND METHODS: A series study of 21 cases of ML, which were evaluated through clinical interview, nasal endoscopy, biopsy and the Montenegro test. RESULTS: A skin scar and previous diagnosis of cutaneous leishmaniasis (CL) were reported in 8(38%) patients, and 13(62%) of them denied having had previous CL and had no scar. Nasal/oral symptom onset until the ML diagnosis varied from 5 months to 20 years, mean value of 6 years. In the Montenegro test, the average size of the papule was 14.5 mm, which did not correlate with disease duration (p=0.87). The nose was the most often involved site and the extension of the injured mucosa did not correlate with disease duration. The parasite was found in 2 (9.52%) biopsy specimens. CONCLUSIONS: ML diagnosis was late. Finding the parasite in the mucosa, cutaneous scar and/or previous diagnosis of CL were not clinical markers for ML. ML diagnosis must be based on the Montenegro test, chronic nasal and/or oral discharge and histological findings ruling out other granulomatous diseases.