Department of General Medicine, Mater Dei Hospital, Msida, Malta
Department of Medicine, Mater Dei Hospital, Msida, Malta.
BMJ Case Rep. 2020 Nov 2;13(11):e237687. doi: 10.1136/bcr-2020-237687.
We report a case of a 76-year-old British man living in Malta who presented with a 7-month history of recurrent epistaxis and an enlarging right nasal vestibular lesion. Of note, his medical history included rheumatoid arthritis for which he was on long-term methotrexate. Blood results were unremarkable other than a mild lymphopaenia. Despite the use of various antibiotics and intranasal steroids, the lesion failed to resolve. This was eventually biopsied, and the histological picture was that of mucosal leishmaniasis. complex was detected by PCR. The patient was treated with liposomal amphotericin B on alternate days for a total of 20 doses. The lesion was found to have healed well at follow-up and the patient denied any further episodes of epistaxis.
我们报告了一例 76 岁的英国男性，居住在马耳他，他因反复发作的鼻出血和右侧鼻腔前庭病变进行性增大而就诊。值得注意的是，他的病史包括类风湿关节炎，为此他长期服用甲氨蝶呤。除轻度淋巴细胞减少外，血液检查结果无异常。尽管使用了各种抗生素和鼻内类固醇，但病变仍未消退。最终进行了活检，组织学表现为黏膜利什曼病。PCR 检测到复合利什曼原虫。患者接受隔天一次的脂质体两性霉素 B 治疗，共 20 剂。随访时发现病变已愈合良好，患者也未再出现鼻出血。
