Cutaneous leishmaniasis: Texas case diagnosed by electron microscopy.

Area of Science:

• Dermatology
• Infectious Diseases
• Parasitology

Background:

• Cutaneous leishmaniasis is a parasitic disease caused by Leishmania species.
• While endemic in some regions, autochthonous cases in Texas are infrequently reported.
• Early diagnosis and treatment are crucial for managing cutaneous leishmaniasis.

Observation:

• A 78-year-old woman in south-central Texas presented with a persistent skin lesion.
• Initial biopsy showed inflammation, but subsequent examination revealed intracellular parasites.
• The patient had no history of travel outside Texas.

Findings:

• Electron microscopy confirmed the presence of Leishmania parasites, diagnosing autochthonous cutaneous leishmaniasis.
• The case adds to the documented occurrences of this infection in Texas.
• The lesion was resistant to topical steroid treatment.

Implications:

• This case underscores the endemic nature of cutaneous leishmaniasis in Texas.
• It highlights the importance of considering leishmaniasis in patients with recalcitrant skin lesions, even without a travel history.
• Increased awareness and diagnostic vigilance are necessary for healthcare providers in endemic areas.