Mucosal Leishmaniasis and Abnormalities on Computed Tomographic Scans of Paranasal Sinuses

Raphael A. Camargo Department of Infectious Diseases, Institute of Radiology, and Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, University of São Paulo, Medical School, São Paulo, Brazil; Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, Paraná, Brazil

Search for other papers by Raphael A. Camargo in
Current site
Google Scholar
PubMed
Close
,
Felipe F. Tuon Department of Infectious Diseases, Institute of Radiology, and Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, University of São Paulo, Medical School, São Paulo, Brazil; Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, Paraná, Brazil

Search for other papers by Felipe F. Tuon in
Current site
Google Scholar
PubMed
Close
,
Daniel V. Sumi Department of Infectious Diseases, Institute of Radiology, and Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, University of São Paulo, Medical School, São Paulo, Brazil; Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, Paraná, Brazil

Search for other papers by Daniel V. Sumi in
Current site
Google Scholar
PubMed
Close
,
Eloisa M. Gebrim Department of Infectious Diseases, Institute of Radiology, and Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, University of São Paulo, Medical School, São Paulo, Brazil; Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, Paraná, Brazil

Search for other papers by Eloisa M. Gebrim in
Current site
Google Scholar
PubMed
Close
,
Rui Imamura Department of Infectious Diseases, Institute of Radiology, and Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, University of São Paulo, Medical School, São Paulo, Brazil; Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, Paraná, Brazil

Search for other papers by Rui Imamura in
Current site
Google Scholar
PubMed
Close
,
Antonio C. Nicodemo Department of Infectious Diseases, Institute of Radiology, and Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, University of São Paulo, Medical School, São Paulo, Brazil; Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, Paraná, Brazil

Search for other papers by Antonio C. Nicodemo in
Current site
Google Scholar
PubMed
Close
,
Giovanni G. Cerri Department of Infectious Diseases, Institute of Radiology, and Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, University of São Paulo, Medical School, São Paulo, Brazil; Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, Paraná, Brazil

Search for other papers by Giovanni G. Cerri in
Current site
Google Scholar
PubMed
Close
, and
Valdir S. Amato Department of Infectious Diseases, Institute of Radiology, and Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, University of São Paulo, Medical School, São Paulo, Brazil; Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, Paraná, Brazil

Search for other papers by Valdir S. Amato in
Current site
Google Scholar
PubMed
Close
Restricted access

Studies evaluating radiologic aspects, local complications, and structural alterations of the paranasal sinus in patients with mucosal leishmaniasis (ML) are lacking. The aim of this study was to analyze alterations of the paranasal sinuses in patients with ML by using computed tomography (CT) scans. This prospective study evaluated 26 patients in Brazil with ML from December 2008 through June 2009. All patients underwent CT scans of the paranasal sinuses. Paranasal thickening was observed in 25 patients (96%). Nasal perforation was observed in 17 patients (65%). Those patients who received re-treatment showed more abnormalities on CT scan than cured patients (P < 0.05). Complications of ML are not limited to the nasal mucosa but extend to the paranasal sinuses. Mucosal thickening, opacified air cells, bony remodeling, and bony thickening caused by inflammatory osteitis of the sinus cavity walls are CT findings suggestive of chronic sinusitis.

Author Notes

*Address correspondence to Felipe F. Tuon, Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Avenida Dr. Enéas de Carvalho Aguiar 255, 4° Andar, Sala 4028 - ICHC, Cerqueira César, 05403-010, São Paulo, Brazil. E-mail: flptuon@gmail.com

Authors' addresses: Raphael A. Camargo, Rui Imamura, and Antonio C. Nicodemo, Department of Infectious Diseases, University of São Paulo, Medical School, São Paulo, Brazil. Felipe F. Tuon, Department of Infectious Diseases, University of São Paulo, Medical School, São Paulo, Brazil and Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, Paraná, Brazil. Daniel V. Sumi, Eloisa M. Gebrim, and Giovanni G. Cerri, Institute of Radiology, Hospital das Clínicas, University of São Paulo, Medical School, São Paulo, Brazil. Valdir S. Amato, Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, University of São Paulo, Medical School, São Paulo, Brazil.

  • 1.

    Reithinger R, Dujardin JC, Louzir H, Pirmez C, Alexander B, Brooker S, 2007. Cutaneous leishmaniasis. Lancet Infect Dis 7: 581596.

  • 2.

    Amato VS, Boulos MI, Amato Neto V, Filomeno LT, 1995. The use of a silicone T tube for the treatment of a case of American mucocutaneous leishmaniasis with tracheomalacia. Rev Soc Bras Med Trop 28: 129130.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Amato VS, Tuon FF, Bacha HA, Neto VA, Nicodemo AC, 2008. Mucosal leishmaniasis: current scenario and prospects for treatment. Acta Trop 105: 19.

  • 4.

    Marsden PD, 1986. Mucosal leishmaniasis (“espundia” Escomel, 1911). Trans R Soc Trop Med Hyg 80: 859876.

  • 5.

    Amato VS, Tuon FF, Imamura R, Abegão de Camarago R, Duarte MI, Neto VA, 2009. Mucosal leishmaniasis: description of case management approaches and analysis of risk factors for treatment failure in a cohort of 140 patients in Brazil. J Eur Acad Dermatol Venereol 23: 10261034.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Amato VS, Andrade HF, Amato Neto V, Duarte MI, 2003. Short report: persistence of tumor necrosis factor-alpha in situ after lesion healing in mucosal leishmaniasis. Am J Trop Med Hyg 68: 527528.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Amato VS, Tuon FF, de Andrade HF, Bacha H, Pagliari C, Fernandes ER, Duarte MI, Neto VA, Zampieri RA, Floeter-Winter LM, Celeste BJ, Oliveira J, Quiroga MM, Mascheretti M, Boulos M, 2009. Immunohistochemistry and polymerase chain reaction on paraffin-embedded material improve the diagnosis of cutaneous leishmaniasis in the Amazon region. Int J Dermatol 48: 10911095.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Hopkins C, Browne JP, Slack R, Lund V, Brown P, 2007. The Lund-Mackay staging system for chronic rhinosinusitis: how is it used and what does it predict? Otolaryngol Head Neck Surg 137: 555561.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Emedicine Web site, 2009. CT Scan, Paranasal Sinuses. Available at: http://emedicinemedscapecom/article/875244-overview. Accessed October 11, 2009.

  • 10.

    Amato VS, de Andrade HF, Duarte MI, 2003. Mucosal leishmaniasis: in situ characterization of the host inflammatory response, before and after treatment. Acta Trop 85: 3949.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Havas TE, Motbey JA, Gullane PJ, 1988. Prevalence of incidental abnormalities on computed tomographic scans of the paranasal sinuses. Arch Otolaryngol Head Neck Surg 114: 856859.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Moser FG, Panush D, Rubin JS, Honigsberg RM, Sprayregen S, Eisig SB, 1991. Incidental paranasal sinus abnormalities on MRI of the brain. Clin Radiol 43: 252254.

  • 13.

    Collins JG, 1993. Prevalence of Selected Chronic Conditions: United States, 1986–88. Vital Health Statistics 101-87. Atlanta, GA: National Center for Health Statistics.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Collins JG, 1997. Prevalence of Selected Chronic Conditions: United States, 1990–1992. Vital Health Statistics 101-89. Atlanta, GA: National Center for Health Statistics.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 114 101 12
Full Text Views 292 19 2
PDF Downloads 88 5 0
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save