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Updated: Jun 14, 2026
08:41
Investigating the Phagocytosis of Leishmania using Confocal Microscopy
Published on: July 29, 2021
Mucocutaneous leishmaniasis masquerading as Wegener granulomatosis
Ernest Brahn1, David A Pegues, Qingping Yao
1Division of Rheumatology, UCLA School of Medicine, Los Angeles, CA 90095, USA. ebrahn@mednet.ucla.edu
Summary
Mucocutaneous leishmaniasis can mimic Wegener's granulomatosis, presenting diagnostic challenges. Early diagnosis and appropriate treatment, such as pentavalent antimony, are crucial for remission.
Area of Science:
- Rheumatology
- Infectious Diseases
- Dermatology
Background:
- A 43-year-old Brazilian female initially presented with symptoms suggestive of Wegener's granulomatosis, including nasal stuffiness and sinusitis.
- Initial biopsies were consistent with limited Wegener's granulomatosis, but antineutrophil cytoplasmic antibodies were negative, raising diagnostic uncertainty.
Observation:
- The patient's condition progressed despite various immunosuppressive treatments, leading to septal perforation and significant nasal destruction.
- A subsequent diagnosis of Leishmania braziliensis infection was made after the development of a rash, revealing the underlying cause.
Findings:
- Cyclophosphamide initially improved mucocutaneous lesions by reducing inflammation but paradoxically facilitated the dissemination of cutaneous leishmaniasis.
- Remission was ultimately achieved with pentavalent antimony, highlighting its efficacy in treating mucocutaneous leishmaniasis.
Implications:
- This case underscores the importance of considering infectious etiologies, particularly leishmaniasis, in patients with refractory granulomatous inflammation of the sinonasal tract.
- Misdiagnosis can lead to delayed and inappropriate treatment, potentially causing disease progression and complications.
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