Sudan mucosal leishmaniasis.

New cases of mucosal leishmaniasis and the first case of espundia-like muco-cutaneous leishmaniasis are reported from the Sudan. Cases previously reported are reviewed and the geographical distribution, clinical features, pathology, immunology and treatment of the disease are described. The majority of cases came from the known kala azar endemic regions of the central Sudan. The disease was seen in adult males, it commonly affected the mouth and nose causing in some cases permanent damage to teeth and nasal septi. In the lesions, the cellular infiltrate was composed mainly of histiocytes, lymphocytes and plasma cells. The number of parasites present was inversely related to the number of lymphocytes but was not related to the number of plasma cells. The level of the increased serum immunoglobulins was not constantly correlated with the number of any particular cell in the infiltrate. Treatment with sodium stibogluconate (Pentostam) was effective in the majority of cases.