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The Journal of Health, Population and Nutrition
icddr,b
ISSN: 1606-0997
EISSN: 1606-0997
Vol. 31, No. 2, 2013, pp. 294-297
Bioline Code: hn13034
Full paper language: English
Document type: Case Report
Document available free of charge

The Journal of Health, Population and Nutrition, Vol. 31, No. 2, 2013, pp. 294-297

 en Post-kala-azar Dermal Leishmaniasis with Mucosal Involvement: An Unusual Case Presentation including Successful Treatment with Miltefosine
Salam, Md. A.; Siddiqui, Muhammad A.; Nabi, Shah G.; Bhaskar, Khondaker R.H. & Mondal, Dinesh

Abstract

Post-kala-azar dermal leishmaniasis (PKDL) is a dermatologic manifestation that usually occurs after visceral leishmaniasis (VL) caused by Leishmania donovani check for this species in other resources . It is characterized by hypopigmented patches, a macular or maculopapular rash and nodular skin lesions on the body surface. Involvement of the mucosae is very rare and unusual in PKDL. We report a case of PKDL that presented with polymorphic skin lesions, along with involvement of peri-oral mucosa and tongue from an endemic area for kala-azar in Bangladesh. In the absence of a definite past history of kala-azar, a clinical suspicion for PKDL was confirmed by positive rapid serological tests against two recombinant (rK39 and rK28) leishmanial antigens, demonstration of Leishmania donovani (LD) body in the slit skin smear, and isolation of promastigotes by culture from a nodular lesion. The patient was treated with oral Miltefosine for three consecutive months and showed significant clinical improvement as demonstrated by a negative slit skin smear at two months after initiation of therapy. We report this case as an unusual presentation of mucosal involvement in PKDL and subsequent treatment success with Miltefosine.

Keywords
Miltefosine, treatment; Mucosal involvement; Post-kala-azar dermal leishmaniasis; Bangladesh

 
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