63-year-old woman with mucocutaneous leishmaniasis of the nose: a case report

Introduction Leishmaniasis is a parasitic disease caused by protozoa and is a major infectious disease with over 1 million new cases worldwide. Especially the mucocutaneous form of the disease is associated with a high level of suffering and social exclusion for those affected due to its local destruction.

Case presentation We present the case of a 63-year-old Syrian woman with mucocutaneous leishmaniasis of the nose with involvement of the nasal septum. The initial presentation was made for a second opinion in case of a rapidly progressive ulcerative skin change of the nose and already planned ablatio nasi alio loco. In cooperation with colleagues from tropical medicine we performed a re-biopsy of the soft tissue of the nose in case of V.a. leishmaniasis. The subsequent PCR diagnostics confirmed the suspected diagnosis. In consultation with our colleagues in tropical medicine, a therapy scheme was developed, which was systemic due to the complex course of the disease. After 4 months a clear cosmetic change could already be observed. A new clinical control took place after another 5 months. The next therapeutic step includes the reconstruction and thus also the restoration of the nose. For this purpose an autologous transplantation of rib cartilage for the total reconstruction of the nasal skeleton is discussed with the patient. The result of the reconstruction is still pending at the time of submission.

Conclusion Mucocutaneous leishmaniasis is a rare infectious disease in Germany. Nevertheless, it should be considered from a differential diagnostic perspective in order to be able to provide patients with a targeted therapy in interdisciplinary consultation.

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Artikel online veröffentlicht:
13. Mai 2021