ENT involvement in Leishmania infections.

Area of Science:

• Medical Parasitology
• Infectious Diseases
• Dermatology

Background:

• Leishmaniasis is a group of diseases caused by Leishmania parasites, transmitted by sandflies from animal reservoirs.
• It presents in three main forms: cutaneous, mucocutaneous, and visceral (kala-azar).
• This study focuses on head and neck manifestations of leishmaniasis within a specific health area.

Purpose of the Study:

• To analyze the clinical, diagnostic, and therapeutic characteristics of leishmaniasis cases in the head and neck region.
• To determine the incidence and prevalence of leishmaniasis in the studied population.
• To highlight the importance of suspecting leishmaniasis in non-responsive cases and immunocompromised patients.

Main Methods:

• A 26-year retrospective review of leishmaniasis cases treated at a single hospital.
• Data collection included clinical presentation, diagnostic methods (primarily biopsy), treatment regimens, and patient outcomes.
• Epidemiological data such as age, immunodeficiency status, incidence, and prevalence were analyzed.

Main Results:

• Thirteen cases were identified: 7 cutaneous, 4 mucocutaneous, and 2 visceral.
• The mean age was 53.7 years, with 61% of cases occurring in immunocompromised individuals.
• Head and neck involvement, including the ear-nose-throat area, was present in 69% of patients. Diagnosis by biopsy was successful in 12 cases.
• Treatment with antimony compounds or amphotericin B resulted in a 92% clinical and parasitological cure rate.

Conclusions:

• Leishmaniasis in Spain frequently involves the head, face, neck, and upper airway mucosa.
• The clinical presentation is highly variable.
• Leishmaniasis should be suspected in cases with persistent lesions unresponsive to conventional treatment and in patients with immunodeficiency.