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Published on: July 27, 2010
A Case of Cutaneous Leishmaniasis with Mucosal Involvement in the Northern United States
Timothy Graziano1, Andrew J Ferdock2, Carla M Rossi3
1Department of Internal Medicine, Lehigh Valley Health Network, University of South Florida Morsani College of Medicine, Lehigh Valley Campus, Allentown, Pennsylvania.
Background:
Cutaneous leishmaniasis (CL) is a vector-borne parasitic infection endemic to many sub-tropical regions worldwide. In the Americas, Leishmania braziliensis is responsible for most reported CL cases. Variable symptom presentation and susceptibility to secondary infection make diagnosing CL a difficult proposition for physicians who may not encounter cases frequently.
Case Report:
We present the case of a 50-year-old man with multiple progressive lesions, diagnosed initially as a bacterial infection, who presented to a North American emergency department after several unsuccessful trials of antibiotic therapy. Eventually, polymerase chain reaction testing of a wound biopsy sample confirmed the presence of L. braziliensis. After a complicated course, the patient's infection resolved after tailored antiparasitic therapy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the need to include travel history in the evaluation of atypical dermatologic infections.
