Tegumentary leishmaniasis mimicking visceralization in a cirrhotic patient: atypical cutaneous lesions and local immunological features

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Sebastian Vernal, Yuri Casal, Lucas T. Vieira, Valdir S. Amato, María Irma S. Duarte, Ana Catharina S.S. Nastri
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2020
• Subjects: Leishmaniasis; Cutaneous Leishmaniasis; Visceral Leishmaniasis; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/0037-8682-0380-2019; https://doaj.org/article/728f757d04b347adb3103138b77faea0

Abstract Tegumentary leishmaniasis (TL) diagnosis is challenging due to the lack of a gold standard diagnostic tool. The diagnosis is significantly harder in regions where visceral leishmaniasis (VL) is also prevalent since immunological tests may present cross-reactivity. A cirrhotic patient from an endemic Brazilian region for TL and VL presented with atypical cutaneous lesions, a usual clinico-laboratory feature of VL (including a positive rk39 test result), but he was diagnosed with TL histopathologically; VL was ruled out by necropsy. Physicians working in co-prevalent areas should be aware of atypical features, unusual clinical course, and unexpected laboratory findings of leishmaniasis.