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Case report
Leishmania donovani mucosal leishmaniasis in Malta
  1. Paula Grech1,
  2. Sarah M Vella2 and
  3. Tonio Piscopo3
  1. 1Department of General Medicine, Mater Dei Hospital, Msida, Malta
  2. 2Department of Medicine, Mater Dei Hospital, Msida, Malta
  3. 3Department of Infectious Disease, Mater Dei Hospital, Tal Qroqq, Malta
  1. Correspondence to Dr Paula Grech; paulagrech93{at}gmail.com

Abstract

We report a case of a 76-year-old British man living in Malta who presented with a 7-month history of recurrent epistaxis and an enlarging right nasal vestibular lesion. Of note, his medical history included rheumatoid arthritis for which he was on long-term methotrexate. Blood results were unremarkable other than a mild lymphopaenia. Despite the use of various antibiotics and intranasal steroids, the lesion failed to resolve. This was eventually biopsied, and the histological picture was that of mucosal leishmaniasis. Leishmania donovani complex was detected by PCR. The patient was treated with liposomal amphotericin B on alternate days for a total of 20 doses. The lesion was found to have healed well at follow-up and the patient denied any further episodes of epistaxis.

  • ear
  • nose and throat
  • infections
  • infectious diseases

https://doi.org/10.1136/bcr-2020-237687

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    Footnotes

    • Contributors PG accepted full responsibility of the work, the conduct of the study, data collection and controlled the decision to publish. SMV contributed also in the planning, conduction and acquisition of data. TP contributed in the interpretation of data, critical revision of the case report and approved the final version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.