Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Sep 10;15(9):e44971.
doi: 10.7759/cureus.44971. eCollection 2023 Sep.

A Difficult-To-Diagnose Case of American Tegumentary Leishmaniasis

Fady Khoury  1   2   3   4 , Jaime E Campos  4
Affiliations
Case Reports

A Difficult-To-Diagnose Case of American Tegumentary Leishmaniasis

Fady Khoury et al. Cureus. .

Abstract

This case report presents a difficult-to-diagnose case of American tegumentary leishmaniasis (ATL) caused by Leishmania (Viannia) guyanensis in a 24-year-old Hispanic male with a travel history to the Panama jungle, an endemic region for tropical infectious diseases. The patient initially presented with persistent skin lesions that progressed to abscesses with ulceration. Despite negative initial diagnostic tests, including microbiological investigations and histopathological examination, a comprehensive diagnostic workup and subsequent polymerase chain reaction (PCR) confirmed the presence of Leishmania parasites. This case underscores the need to consider tropical infectious diseases despite initial negative tests. Accurate species identification is vital for proper drug treatment, with miltefosine as an emerging option. Early, precise diagnosis and tailored management are essential for successful treatment. This report emphasizes the significance of conducting a comprehensive diagnostic workup, including PCR, in individuals with a history of travel to endemic regions, to accurately diagnose and effectively manage complex infectious diseases.

Keywords: american tegumentary leishmaniasis; cutaneous leishmaniasis; infectious disease diagnosis; infectious disease medicine; leishmania guyanensis; medical and diagnostic microbiology; skin eruptions; skin infections; skin ulcer; visceral leishmania.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. A 3cm abscess with ulceration in the left anterior knee
Figure 2
Figure 2. A 3cm abscess in the left posterior thigh
Figure 3
Figure 3. A 3cm abscess in the left lower extremity
Figure 4
Figure 4. A 3cm abscess on the left anterior distal thigh
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Epidemiology of visceral leishmaniasis. Ready PD. Clin Epidemiol. 2014;6:147–154. - PMC - PubMed
    1. Climate change and risk of leishmaniasis in north america: predictions from ecological niche models of vector and reservoir species. González C, Wang O, Strutz SE, González-Salazar C, Sánchez-Cordero V, Sarkar S. PLoS Negl Trop Dis. 2010;4:0. - PMC - PubMed
    1. A review of leishmaniasis: current knowledge and future directions. Mann S, Frasca K, Scherrer S, Henao-Martínez AF, Newman S, Ramanan P, Suarez JA. Curr Trop Med Rep. 2021;8:121–132. - PMC - PubMed
    1. Cutaneous leishmaniasis: immune responses in protection and pathogenesis. Scott P, Novais FO. Nat Rev Immunol. 2016;16:581–592. - PubMed
    1. Epidemic visceral leishmaniasis in southern Sudan: treatment of severely debilitated patients under wartime conditions and with limited resources. Seaman J, Mercer AJ, Sondorp HE, Herwaldt BL. Ann Intern Med. 1996;124:664–672. - PubMed

Publication types

LinkOut - more resources