Mesh : Aged Amphotericin B / therapeutic use Antiprotozoal Agents / therapeutic use Brazil Coinfection / diagnosis parasitology DNA, Protozoan / genetics Fluorescent Antibody Technique, Indirect Humans Leishmania guyanensis / genetics isolation & purification Leishmania mexicana / genetics isolation & purification Leishmaniasis, Cutaneous / diagnosis drug therapy parasitology Male Molecular Typing Rural Population Skin / parasitology pathology

来  源:   DOI:10.4269/ajtmh.17-0760   PDF(Pubmed)

Abstract:
The disseminated form of leishmaniasis is a serious and rare disease, being diagnosed in 2% of the cutaneous cases registered per year in Brazil. The main characteristic is the appearance of multiple pleomorphic lesions on the cutaneous surface. A 68-year-old male from the rural area of Tocantins, Brazil, presented atypical disseminated cutaneous leishmaniasis (ACL). The clinical course and histopathological and immunological findings presented a mixed pattern that hindered diagnosis and therapeutic management. Molecular typing revealed a mixed infection with Leishmania (V.) guyanensis and Leishmania (L.) amazonensis. Molecular identification of the agents responsible for ACL is important for adequate therapeutic planning, minimizing the possibility of sequellae that impact the quality of life of the patient.
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