%0 Case Reports
%T A Case of Cutaneous Leishmaniasis with Mucosal Involvement in the Northern United States.
%A Graziano T
%A Ferdock AJ
%A Rossi CM
%A Schultz KL
%J J Emerg Med
%V 66
%N 6
%D 2024 Jun 26
%M 38772754
%F 1.473
%R 10.1016/j.jemermed.2024.01.015
%X BACKGROUND: Cutaneous leishmaniasis (CL) is a vector-borne parasitic infection endemic to many sub-tropical regions worldwide. In the Americas, Leishmania braziliensis is responsible for most reported CL cases. Variable symptom presentation and susceptibility to secondary infection make diagnosing CL a difficult proposition for physicians who may not encounter cases frequently.
METHODS: We present the case of a 50-year-old man with multiple progressive lesions, diagnosed initially as a bacterial infection, who presented to a North American emergency department after several unsuccessful trials of antibiotic therapy. Eventually, polymerase chain reaction testing of a wound biopsy sample confirmed the presence of L. braziliensis. After a complicated course, the patient's infection resolved after tailored antiparasitic therapy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the need to include travel history in the evaluation of atypical dermatologic infections.