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Mucocutaneous Leishmaniasis: clinical markers in presumptive diagnosis / Leishmaniose mucosa: marcadores clínicos no diagnóstico presuntivo
Diniz, João Luiz Cioglia Pereira; Costa, Manoel Otávio da Rocha; Gonçalves, Denise Utsch.
  • Diniz, João Luiz Cioglia Pereira; s.af
  • Costa, Manoel Otávio da Rocha; UFMG. Graduate Studies Program in Health Sciences: Infectology and Tropical Medicine.
  • Gonçalves, Denise Utsch; Federal University of Minas Gerais. Graduate Studies Program in Health Sciences: Infectology and Tropical Medicine.
Braz. j. otorhinolaryngol. (Impr.) ; 77(3): 380-384, May-June 2011. ilus, tab
Article in English | LILACS | ID: lil-595776
ABSTRACT
Mucocutaneous Leishmaniasis (ML) can lead to serious sequela; however, early diagnosis can prevent complications.

AIM:

To evaluate clinical markers for the early diagnosis of ML. MATERIALS AND

METHODS:

A series study of 21 cases of ML, which were evaluated through clinical interview, nasal endoscopy, biopsy and the Montenegro test.

RESULTS:

A skin scar and previous diagnosis of cutaneous leishmaniasis (CL) were reported in 8(38 percent) patients, and 13(62 percent) of them denied having had previous CL and had no scar. Nasal/oral symptom onset until the ML diagnosis varied from 5 months to 20 years, mean value of 6 years. In the Montenegro test, the average size of the papule was 14.5 mm, which did not correlate with disease duration (p=0.87). The nose was the most often involved site and the extension of the injured mucosa did not correlate with disease duration. The parasite was found in 2 (9.52 percent) biopsy specimens.

CONCLUSIONS:

ML diagnosis was late. Finding the parasite in the mucosa, cutaneous scar and/or previous diagnosis of CL were not clinical markers for ML. ML diagnosis must be based on the Montenegro test, chronic nasal and/or oral discharge and histological findings ruling out other granulomatous diseases.
RESUMO
A leishmaniose cutâneo-mucosa (LM) pode deixar sequelas graves. O diagnóstico precoce evita complicações.

OBJETIVO:

Avaliar marcadores clínicos para o diagnóstico precoce da LM. MATERIAL E

MÉTODO:

Estudo de série de 21 casos avaliados com diagnóstico confirmado de LM por meio de entrevista, endoscopia nasal, biópsia e teste cutâneo de Montenegro.

RESULTADOS:

A cicatriz cutânea ou história de leishmaniose cutânea foram observadas em 8 (38 por cento) pacientes e 13(62 por cento) negaram terem tido forma cutânea e não tinham cicatriz. O início dos sintomas nasais/orais até a definição do diagnóstico variou de 5 meses a 20 anos, média de 6 anos. No teste de Montenegro, o tamanho médio da pápula foi de 14,5mm e não se correlacionou com a duração da doença (p=0,87). O comprometimento nasal predominou e a extensão da lesão não se correlacionou com a duração da doença. Parasitas foram encontrados em 2(9,52 por cento) espécimes de lesões biopsiadas.

CONCLUSÃO:

O diagnóstico da LM foi tardio. O encontro do parasito na mucosa, a cicatriz típica e leishmaniose cutânea prévia não foram marcadores para o diagnóstico de LM. O diagnóstico de LM pode se basear no teste de Montenegro alterado associado a sintomas nasais e/ou orais e exclusão de outras doenças granulomatosas.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Leishmaniasis, Mucocutaneous Type of study: Diagnostic study / Screening study Limits: Adult / Aged / Female / Humans / Male Language: English Journal: Braz. j. otorhinolaryngol. (Impr.) Journal subject: Otolaryngology Year: 2011 Type: Article Affiliation country: Brazil

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Full text: Available Index: LILACS (Americas) Main subject: Leishmaniasis, Mucocutaneous Type of study: Diagnostic study / Screening study Limits: Adult / Aged / Female / Humans / Male Language: English Journal: Braz. j. otorhinolaryngol. (Impr.) Journal subject: Otolaryngology Year: 2011 Type: Article Affiliation country: Brazil