The histological spectrum of non-granulomatous localized mucosal leishmaniasis caused by Leishmania infantum.

Although human mucosal leishmaniasis is much more common in Latin America, a few cases that are the result of local transmission occur in Europe. A suspected case of leishmaniasis is usually confirmed by the demonstration of amastigotes in smears, the culture of promastigotes from blood or tissue samples, or the PCR-based demonstration of leishmanial DNA. Biopsies may contain too few parasites to be found positive by microscopy or culture, however, and then a diagnosis may be difficult, especially in regions where human leishmaniasis in general or particular forms of the disease are rarely seen. The aim of the present study was to investigate the histopathological characteristics of three Spanish cases of non-granulomatous mucosal leishmaniasis caused by Leishmania infantum. The hope was that the information collected will help European clinicians diagnose such cases, even when amastigotes cannot be readily demonstrated.