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[Disseminated cutaneous leishmaniasis]
Summary
This study reports a rare case of disseminated oriental sore in a Japanese man, potentially caused by an unknown Leishmania tropica strain. The patient experienced extensive lesions and a prolonged disease course before successful treatment with amphotericin B.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Dermatology
Background:
- Disseminated oriental sore is a rare clinical manifestation of cutaneous leishmaniasis.
- Leishmania tropica is the causative agent of cutaneous leishmaniasis, typically presenting with localized skin lesions.
Observation:
- A 54-year-old Japanese man presented with extensive, numerous lesions of disseminated oriental sore, including nodules, tumors, and infiltrated erythema on the face, neck, trunk, extremities, and tongue.
- The condition had a prolonged incubation period of approximately 13 years and a duration exceeding 15 years without spontaneous healing.
- Physical examination, laboratory tests, and immunological results were normal. Attempts to isolate the causative organism via animal inoculation and NNN-medium culture were unsuccessful.
Findings:
- The patient demonstrated a complete recovery following intravenous administration of amphotericin B (880 mg total dose over 1 month).
- The clinical presentation and lack of organism isolation suggest a possible variant strain of Leishmania tropica.
Implications:
- This case highlights the potential for atypical and severe presentations of leishmaniasis.
- The successful treatment with amphotericin B provides a therapeutic option for similar challenging cases.
- Further research into variant Leishmania tropica strains may be warranted to understand their unique pathogenic mechanisms.