Oral Leishmaniasis: diagnostic and therapeutic journey

Sonia Maria Soares Ferreira; Catarina Rodrigues Rosa de Oliveira; Glória Maria de França; Eulina Maria Vieira de Abreu; Ivisson Alexandre Pereira da Silva; Anne Caroline Barbosa dos Santos; João Carlos de Melo Araújo; Nicole Lonni; Caroline Alfaia Silva; Elena Riet Correa Rivero; Rogério de Oliveira Gondak; Ricardo Luiz Cavalcanti de Albuquerque-Júnior

doi:10.5327/2525-5711.303

Autores

Sonia Maria Soares Ferreira University Center CESMAC – Maceió (AL), Brazil. https://orcid.org/0000-0002-4825-171X
Catarina Rodrigues Rosa de Oliveira University Center CESMAC – Maceió (AL), Brazil. https://orcid.org/0000-0001-9178-8902
Glória Maria de França University Center CESMAC – Maceió (AL), Brazil. https://orcid.org/0000-0002-0483-6601
Eulina Maria Vieira de Abreu University Center CESMAC – Maceió (AL), Brazil. https://orcid.org/0000-0002-3746-0831
Ivisson Alexandre Pereira da Silva University Center CESMAC – Maceió (AL), Brazil. https://orcid.org/0000-0002-1682-3648
Anne Caroline Barbosa dos Santos University Center CESMAC – Maceió (AL), Brazil. https://orcid.org/0009-0004-3170-5190
João Carlos de Melo Araújo Maceió Pathology Center – Maceió (AL), Brazil. https://orcid.org/0000-0001-8063-6786
Nicole Lonni Federal University of Santa Catarina – Florianópolis (SC), Brazil. https://orcid.org/0000-0002-5577-0294
Caroline Alfaia Silva Federal University of Santa Catarina – Florianópolis (SC), Brazil. https://orcid.org/0000-0002-0043-527X
Elena Riet Correa Rivero Federal University of Santa Catarina – Florianópolis (SC), Brazil. https://orcid.org/0000-0002-8516-8771
Rogério de Oliveira Gondak Federal University of Santa Catarina – Florianópolis (SC), Brazil. https://orcid.org/0000-0001-7547-660X
Ricardo Luiz Cavalcanti de Albuquerque-Júnior Federal University of Santa Catarina – Florianópolis (SC), Brazil. https://orcid.org/0000-0003-4444-7632

DOI:

https://doi.org/10.5327/2525-5711.303

Palavras-chave:

Leishmaniasis, mucocutaneous, Oral manifestations, Diagnostics, Case reports

Resumo

Leishmaniasis, caused by protozoan parasites, is a widespread infectious disease and a prominent example of neglected tropical diseases. Brazil is among the countries most severely affected by this condition globally. Mucocutaneous leishmaniasis rarely involves oral sites, presenting diagnostic challenges. This study explores a case of mucocutaneous leishmaniasis discussing clinical presentation, diagnostic process and treatment. An 85-year-old woman presented with a progressively enlarging, painful palatal ulcer. The patient had a history of treated tuberculosis and reported additional symptoms including breathing difficulties, nosebleeds, osteoarthritis, hearing loss, and insomnia. Initial biopsy showed ulcerated squamous epithelium and nodular granulomatous inflammation. Despite negative diagnostic tests for tuberculosis, syphilis, HIV, and viral hepatitis, sarcoidosis was initially considered but treatment was ineffective. Worsening symptoms later revealed structures consistent with Leishmania sp. amastigote forms, confirmed by immunohistochemistry, leading to a diagnosis of oral leishmaniasis. Treatment with liposomal amphotericin B resulted in successful management. The rarity of oral manifestations further complicates diagnosis, highlighting the critical role of dentists in conducting a thorough assessment, administering the correct treatment, and ensuring proper follow-up to guarantee patient compliance.

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