unusual case of mucosal leishmaniasis with cutaneous dissemination in Sudan and its epidemiological significance

Sudan is endemic for visceral, cutaneous and mucosal leishmaniasis. The latter is the least common of the three forms of leishmaniasis. It is caused by L. donovani, the same parasite that causes visceral leishmaniasis [VL] in the country. Most of the cases were reported from VL endemic areas, the majority in adults. The disease may be primary in the oral and or the upper respiratory mucosa or may follow or accompany visceral leishmaniasis. This paper is a report of a case of mucosal leishmaniasis of the nose and lips. It is unusual in several aspects: the disease was acquired in a village where no cases of VL or mucosal leishmaniasis were recorded within living memory, before an outbreak in 1981 during which the patient was infected; the patient was infected at the age of five years and the disease remained active for 22 years causing physical deformity and psychological trauma to the patient