Leishmania donovani mucosal leishmaniasis in Malta.

Authors :: Grech P
Vella SM
Piscopo T
Source :: BMJ case reports [BMJ Case Rep] 2020 Nov 02; Vol. 13 (11). Date of Electronic Publication: 2020 Nov 02.
Publication Year :: 2020
Abstract: We report a case of a 76-year-old British man living in Malta who presented with a 7-month history of recurrent epistaxis and an enlarging right nasal vestibular lesion. Of note, his medical history included rheumatoid arthritis for which he was on long-term methotrexate. Blood results were unremarkable other than a mild lymphopaenia. Despite the use of various antibiotics and intranasal steroids, the lesion failed to resolve. This was eventually biopsied, and the histological picture was that of mucosal leishmaniasis. Leishmania donovani complex was detected by PCR. The patient was treated with liposomal amphotericin B on alternate days for a total of 20 doses. The lesion was found to have healed well at follow-up and the patient denied any further episodes of epistaxis.<br />Competing Interests: Competing interests: None declared.<br /> (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)