Sudan mucosal leishmaniasis

Abstract

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.

Bronchopulmonary and Mediastinal Leishmaniasis: An Unusual Clinical Presentation of Leishmania donovani Infection

“…Visceral leishmaniasis (kala-azar), which is caused by Leishmania donovani in Sudan, is the most serious form of leishmaniasis and has been a major health problem in Sudan [2]. Mucosal involvement due to L. donovani and Leishmania infantum occurs rarely in immunocompetent patients and is confined to the upper respiratory tract (nose, upper lip, tongue, and mouth) [3]. Cases of oral, nasal, nasopharyngeal, and laryngeal leishmaniasis have been recorded in the Sudan and other parts of Africa [3,4].…”

Mucosal Leishmania infantum infection

“…In southwestern Europe, L. (L.) infantum causes both CL and VL. The manifestation on the mucosa, although well known in the New World, has occasionally been reported with L. (L.) infantum and other Leishmania species of the so-called Old World (Abdalla et al 1975;Barnetson et al 1978;Borzoni et al 1991;Morsy et al 1995;Aliaga et al 2003;Kharfi et al 2003;Van Damme et al 2004;Casolari et al 2005;Mahdi et al 2005;Cobo et al 2007;Garcia de Marcos et al 2007;Benmously-Mlika et al 2008;El Fékih et al 2008;Pau et al 2009). Approximately half of the patients in one series were suffering from underlying conditions, especially from those associated with immunodeficiency such as HIV infection (Aliaga et al 2003).…”

“…While in New World ML the nasal mucosa is the most frequently affected area, in Mediterranean ML, predominantly other localisations such as buccal (cheeks, lips, hard and soft palate and gums), pharyngeal or laryngeal have been described (Abdalla et al 1975;Barnetson et al 1978;Borzoni et al 1991;Morsy et al 1995;Aliaga et al 2003;Kharfi et al 2003;Van Damme et al 2004;Casolari et al 2005;Mahdi et al 2005;Cobo et al 2007;Garcia de Marcos et al 2007;Benmously-Mlika et al 2008;El Fékih et al 2008;Pau et al 2009). …”

“…There are three main clinical manifestations, visceral (VL), cutaneous (CL) and mucosal leishmaniasis (ML). ML is usually caused by species belonging to the Leishmania (Viannia) subgenus in Central and South America and has occasionally been associated with infections caused by Leishmania species endemic in the Old World (Abdalla et al 1975; Barnetson et al 1978;Borzoni et al 1991;Morsy et al 1995;Aliaga et al 2003;Kharfi et al 2003;Van Damme et al 2004;Casolari et al 2005;Mahdi et al 2005;Cobo et al 2007;Garcia de Marcos et al 2007;Benmously-Mlika et al 2008;El Fékih et al 2008;Pau et al 2009). With the exception of sporadic Leishmania tropica infections in Greece (Berens-Riha et al 2009;Ready 2010) Leishmania infantum is the only species causing leishmaniasis in Europe: VL, CL and occasionally ML (Harms et al 2003).…”

A rare case of localized mucosal leishmaniasis due to Leishmania infantum in an immunocompetent italian host

“…A few reports have indicated that L. donovani [4][5][6][7][8][9], as well as L. infantum [10][11][12][13][14], may cause localized mucosal disease in the absence of concomitant visceral or cutaneous leishmaniasis.…”