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Authors’ addresses: Lorena Pinheiro Figueiredo, Federal University of Bahia, Salvador, Brazil, E-mail: [email protected]. Laiana do Carmo Almeida, Andréa Magalhães, and Marcus M. Lessa, Otorhinolaryngologist at Otorhinolaryngology Department, Professor Edgar Santos University Hospital, Federal University of Bahia, Salvador, Brazil, E-mails: [email protected], [email protected], and [email protected]. Sérgio Arruda, Pathologist at Gonçalo Moniz Research Center, Salvador, Brazil, E-mail: [email protected]. Edgar M. Carvalho, Head of the Clinical Research Laboratory in the Gonçalo Moniz Institute, Fiocruz-Ba, Professor of Medicine, Federal University of Bahia, Salvador, Brazil, E-mail: [email protected].
Abstract.
Mucosal leishmaniasis (ML) affects predominantly the nose and occurs usually weeks or months after the cure of the primary cutaneous lesion. The pathology of ML is characterized by an exaggerated inflammatory reaction with infiltration of lymphocytes, macrophages, and plasma cells. There is also a paucity of parasites and a strong delayed-type hypersensitivity reaction. Herein, we report a case of a young man who had a large ulcer in his left leg and complained of dysphagia. In nasofibrolaryngoscopy, there were nodular lesions in the oropharynx and rhinopharynx. The skin lesion biopsy showed a chronic inflammation with amastigotes inside macrophages, and DNA of Leishmania braziliensis confirmed the diagnosis of ML in tissue biopsied from the pharynx. The leishmaniasis skin test was negative. Cytokine evaluation showed lack of production of interferon (IFN)-γ, interleukin (IL)-1β, and IL-17 with enhancement of these cytokine levels after cure.