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Mucosal Leishmaniasis Involving the Nostril and Maxillary Sinus: A Case Report
Rahul R Bhowate1, Pragati A Bhargava1, Simran D Badki1
1Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND.
Cureus
|November 16, 2022
Summary
A child migrant from India presented with nasal leishmaniasis, a rare parasitic infection. Prompt diagnosis and endoscopic surgery, followed by combined therapy, led to a successful recovery without recurrence.
Area of Science:
- Parasitology
- Otolaryngology
- Tropical Medicine
Background:
- Mucosal leishmaniasis (ML) is a neglected tropical disease, often presenting with chronic, debilitating symptoms.
- Nasal involvement in ML can lead to significant morbidity, including destructive lesions and secondary infections.
- Early diagnosis and appropriate management are crucial to prevent complications and improve patient outcomes.
Observation:
- An eight-year-old child migrant from a leishmaniasis-endemic region presented with nasal discharge, congestion, and polypoid masses.
- Clinical examination revealed Bitot's spots, suggesting Vitamin A deficiency.
- CT imaging demonstrated extensive involvement of the left nasal cavity and maxillary sinus.
Findings:
- Blood work indicated leukocytosis, eosinophilia, elevated alkaline phosphatase, and low Vitamin A levels.
- Histopathology confirmed Leishman-Donovan bodies within the nasal polypoid tissue, diagnosing mucosal leishmaniasis.
- Demographic data highlighted the patient's origin from a known endemic area in Bihar, India.
Implications:
- This case underscores the importance of considering ML in the differential diagnosis of chronic nasal conditions, especially in migrant populations from endemic areas.
- Endoscopic surgery combined with a multimodal therapeutic approach (allopathic and polyherbal) proved effective in managing nasal ML.
- Successful treatment resulted in complete symptom resolution and no recurrence at six-month follow-up, suggesting the efficacy of the combined treatment strategy.
