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Mucosal leishmaniasis in Adult
See also in: Oral Mucosal Lesion
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Mucosal leishmaniasis in Adult

See also in: Oral Mucosal Lesion
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Contributors: Edith Lederman MD, Belinda Tan MD, PhD, Noah Craft MD, PhD
Other Resources UpToDate PubMed

Synopsis

Mucosal leishmaniasis (ML), a potential sequela of New World cutaneous leishmaniasis (NWCL), results from hematogenous or lymphatic dissemination of leishmanial parasites from the skin to the naso-oropharyngeal mucosa. The most common etiologic agents are those in the Viannia subgenus; particularly, Leishmania (V.) braziliensis, Leishmania (V.) panamensis, and Leishmania (V.) guyanensis. Leishmania amazonensis can also cause ML.

The risk factors for ML are poorly understood but include both parasite and host factors. Even what apparently is the same leishmanial species is not necessarily associated with the same risk for ML in different countries. For example, L. (V.) braziliensis infection in Brazil and Peru more commonly results in ML than does infection with this species in Guatemala. Most patients who develop ML did not receive optimal therapy for NWCL; some patients do not recall a history of NWCL and do not have scars suggestive of prior cutaneous infection. In some settings, the risk for ML in patients not optimally treated for NWCL may be approximately 5%.

Usually, ML is first evident in the nasal mucosa (sometimes in the mouth). Patients with a history of NWCL, however remote, caused by relevant leishmanial species should be evaluated for ML if they develop persistent, unusual (for them) nasal symptoms (eg, persistent nasal congestion or stuffiness, epistaxis). If untreated, progressive, disfiguring, naso-oropharyngeal destruction may follow (eg, ulceration and destruction of the nasal mucosa or septum).

Codes

ICD10CM:
B55.2 – Mucocutaneous leishmaniasis

SNOMEDCT:
403135004 – American mucocutaneous leishmaniasis

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Last Updated: 09/29/2017
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Mucosal leishmaniasis in Adult
See also in: Oral Mucosal Lesion
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Mucosal leishmaniasis (Early Stage) : Erythema, Mexico and Central America, Nasal congestion, Nasal irritation, Smooth nodule, South America, Verrucous scaly papule, Epistaxis, Sandfly exposure
Clinical image of Mucosal leishmaniasis
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