Leishmaniose nasale

Mucosal Leishmania infantum leishmaniasis: Specific pattern in a multicentre survey and historical cases

“…Misdiagnosis as neoplasia or autoimmune disease led sometimes to unnecessary radiotherapy or steroid treatment. 5,8,17 Concerning diagnostic procedures, mucosal sample histologic examination was initially negative in two cases, 8,17 but positive in all other. In vitro culture was positive in 14/23 cases.…”

“…5,7e9,13e15,17 Six patients reported pain. 5,9,13,17 Difficulties in diagnosis were frequently observed: delay between first manifestation and diagnosis was described in 31 cases, ranging from 3 weeks to 4.5 years (mean value: 12 months). Misdiagnosis as neoplasia or autoimmune disease led sometimes to unnecessary radiotherapy or steroid treatment.…”

“…5,7,8,13e15,17 Topical treatments (in situ meglumine, in situ paromomycin, surgery, or cryotherapy) were successfully applied in 7 cases (follow-up up to 2 years). 5,14 Various systemic treatments were also used: meglumine (21/40), associated with pentamidine for one patient, and with allopurinol for another 5,7e9,13,15 ; liposomal amphotericin B (6/40), associated in one case with ketoconazole (1/40) 5,7,15 ; antimony tartrate (2/40) 5 ; solustibosan (1/40) 5 ; itraconazole associated with allopurinol, with terbinafine, and with topical paromomycin (1 case each) 5,17 ; aminosidine (1/40). 23 All systemic treatments were initially successful except aminosidine in one case (14 mg/kg for 17 days).…”

“…5 However, since 2003, this condition has been increasingly reported. 6e18 Until now, no study reported more than 3 consecutive cases, so that many points remain controversial: predisposing conditions are badly determined, diagnostic efficiency of pathological examination is uncertain, 5,7,8,17 and local treatments are sometimes used although parenteral treatment remains the reference. 5,14 Overall, LIML seems insufficiently evoked: misdiagnosis as neoplasia or vasculitis sometimes leads to undue therapeutics such as radiotherapy or steroids.…”

“…5,14 Overall, LIML seems insufficiently evoked: misdiagnosis as neoplasia or vasculitis sometimes leads to undue therapeutics such as radiotherapy or steroids. 5,8,9,16,17 To raise awareness and clarify remaining issues, we conducted a 12-year-long study among the 3 academic hospitals in French endemic zone and updated the literature review.…”