Research Day
EAR SWELLING AND AN UNUSUAL DIAGNOSIS OF CUTANEOUS LEISHMANIASIS
Document Type
Abstract
Date
2021
Abstract
Introduction: Leishmaniasis is recognized as an endemic human disease in tropical countries but is uncommon in the United States. Its manifestations are broad and mimic inflammatory processes and neoplastic diseases. Whereas in endemic areas the diagnosis may be simple, it could be a real challenge in places with a low incidence of this disease.
Case presentation: Patient is a 51-year-old woman with diabetes complaining of ear pain and redness. Her symptoms started one month after a trip to Mexico. She noticed a small nodule in her ear which became swollen and red within weeks. An initial diagnosis of cellulitis was given, and she started on antibiotics. As the lesion was progressing, her antibiotics were switched, and drainage was attempted. However, no significant improvement was seen, and prednisone was added for possible polychondritis. A biopsy was performed with suspicion of possible skin cancer. Pathology reported a granulomatous inflammation process with parasitized histiocytes. Further investigation showed the presence of Leishmaniasis. Patient started on appropriate treatment with good recovery.
Discussion: Infection with protozoan parasites of the genus Leishmania leads to a wide variety of clinical disease syndromes. Cutaneous leishmaniasis (CL) includes different presentations with the most common being typical chronic, ulcerative lesion. Usually, it starts with a slowly progressing, nonhealing skin ulcer. The differential is broad including inflammatory and neoplastic diseases. Most CL resolves over time without specific treatment, but often patients seek medical care because of the location of disease, cosmetic concerns or secondary bacterial infection.