Interstitial keratitis caused by American (mucocutaneous) leishmaniasis

Area of Science:

• Ophthalmology
• Infectious Diseases
• Parasitology

Background:

• American leishmaniasis (mucocutaneous leishmaniasis) is a neglected tropical disease caused by Leishmania parasites.
• Ocular complications are rare but can be severe, impacting vision and quality of life.

Observation:

• A 58-year-old male presented with an unusual ocular complication of American leishmaniasis: interstitial keratitis.
• The patient exhibited ulcerative lesions consistent with leishmaniasis.

Findings:

• While Leishmania parasites were not directly identified in ocular tissue, clinical, laboratory, and histological findings strongly supported a diagnosis of leishmaniasis.
• Differential diagnoses, including other infectious and inflammatory conditions, were systematically excluded.
• The patient's ulcerative lesions showed improvement following treatment with 1g of amphotericin B.

Implications:

• This case highlights the importance of considering leishmaniasis in the differential diagnosis of interstitial keratitis, especially in endemic or returning travelers.
• Early diagnosis and appropriate treatment, such as amphotericin B, can lead to favorable outcomes for ocular leishmaniasis.
• Further research into the pathogenesis and management of ocular leishmaniasis is warranted to improve patient care.