1Immunology Department, Professor Edgar Santos University Hospital, Federal University of Bahia, Salvador, Brazil.
2Graduate Program in Health Science, Federal University of Bahia, Salvador, Brazil.
Am J Trop Med Hyg. 2020 Oct;103(4):1493-1495. doi: 10.4269/ajtmh.20-0219.
Mucosal leishmaniasis (ML) affects predominantly the nose and occurs usually weeks or months after the cure of the primary cutaneous lesion. The pathology of ML is characterized by an exaggerated inflammatory reaction with infiltration of lymphocytes, macrophages, and plasma cells. There is also a paucity of parasites and a strong delayed-type hypersensitivity reaction. Herein, we report a case of a young man who had a large ulcer in his left leg and complained of dysphagia. In nasofibrolaryngoscopy, there were nodular lesions in the oropharynx and rhinopharynx. The skin lesion biopsy showed a chronic inflammation with amastigotes inside macrophages, and DNA of confirmed the diagnosis of ML in tissue biopsied from the pharynx. The leishmaniasis skin test was negative. Cytokine evaluation showed lack of production of interferon (IFN)-γ, interleukin (IL)-1β, and IL-17 with enhancement of these cytokine levels after cure.
黏膜利什曼病（ML）主要影响鼻子，通常在原发性皮肤损伤治愈后数周或数月后发生。ML 的病理学特征是炎症反应过度，淋巴细胞、巨噬细胞和浆细胞浸润。寄生虫也很少，迟发型超敏反应强烈。在此，我们报告一例年轻男性，其左腿有一个大溃疡，并伴有吞咽困难。鼻纤维喉镜检查发现口咽和鼻咽有结节性病变。皮肤病变活检显示慢性炎症，巨噬细胞内有阿米巴原虫，组织活检 DNA 证实了咽黏膜利什曼病的诊断。利什曼病皮肤试验阴性。细胞因子评估显示缺乏干扰素（IFN）-γ、白细胞介素（IL）-1β 和 IL-17 的产生，这些细胞因子水平在治愈后增强。
