Ga-Lai M Chong1, David S Y Ong2, Mariana de Mendonça Melo3, Jaap J van Hellemond4. 1. Erasmus MC University Medical Center, Department of Medical Microbiology & Infectious Diseases, Rotterdam, the Netherlands. Electronic address: g.chong@erasmusmc.nl. 2. Franciscus Gasthuis & Vlietland, Department of Medical Microbiology and Infection Control, Rotterdam, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Department of Epidemiology, Utrecht, the Netherlands. 3. Erasmus MC University Medical Center, Department of Medical Microbiology & Infectious Diseases, Rotterdam, the Netherlands; Erasmus MC University Medical Center, Department of Internal Medicine, Rotterdam, the Netherlands. 4. Erasmus MC University Medical Center, Department of Medical Microbiology & Infectious Diseases, Rotterdam, the Netherlands.
Abstract
BACKGROUND: Leishmaniasis is a parasitic disease caused by different Leishmania species. L. infantum is found in the Mediterranean area. It usually causes visceral or cutaneous leishmaniasis, but rarely mucosal leishmaniasis (ML). METHODS: A 62-year-old man with metastatic non-small-cell lung carcinoma visited the outpatient clinic because of a painful and swollen tongue. Initially, oral candidiasis was suspected and patient was unsuccessfully treated accordingly. Subsequently, a biopsy from the tongue was taken. RESULTS: Histology of the tongue biopsy showed an inflammation with histiocytes and Leishmania amastigotes. Molecular analysis determined these parasites as L. donovani complex. Based on the patient's travel history, ML caused by L. infantum was diagnosed. CONCLUSION: ML is an unusual presentation of L. infantum. ML is not only caused by Leishmania species endemic in Latin America, but also should be considered in the differential diagnosis for European patients. A biopsy of the affected location is needed to confirm the diagnosis.
BACKGROUND: Leishmaniasis is a parasitic disease caused by different Leishmania species. L. infantum is found in the Mediterranean area. It usually causes visceral or cutaneous leishmaniasis, but rarely mucosal leishmaniasis (ML). METHODS: A 62-year-old man with metastatic non-small-cell lung carcinoma visited the outpatient clinic because of a painful and swollen tongue. Initially, oral candidiasis was suspected and patient was unsuccessfully treated accordingly. Subsequently, a biopsy from the tongue was taken. RESULTS: Histology of the tongue biopsy showed an inflammation with histiocytes and Leishmania amastigotes. Molecular analysis determined these parasites as L. donovani complex. Based on the patient's travel history, ML caused by L. infantum was diagnosed. CONCLUSION: ML is an unusual presentation of L. infantum. ML is not only caused by Leishmania species endemic in Latin America, but also should be considered in the differential diagnosis for European patients. A biopsy of the affected location is needed to confirm the diagnosis.