Leishmaniasis difusa

Abstract

The clinical and histopathologic picture of four patients with diffuse leishmaniasis (DL) from four different areas of Colombia are presented. The initial diagnosis was made Ly histopathology in all of them. A 10 year old girl and an 80 year old male had disseminated lesions; the other two cases were two men of 33 and 62 years old who presented with nodular lesions treated succesfully with local heat and Glutantime (R). The four cases had a negative Montenegro test. We confirm that DL may be cured when treated early before it becomes a disseminated disease. Local heat was a powerful tool in treating one of the two cases with a unique nodular lesion. L. m. amazonensis was identified in this case by culture and isoenzyme analysis and L. mexicana was identified in the 80 year old patient by the same procedures. Hamsters inoculated with suspensions of the ground biopsies developed huge mouth and footpad histiocytomes. We illustrate the clinical aspects of the disease and discuss the histopathology and the electronmicroscopic leishmania-macrophage relationships. An overview of the characteristics of this entity and a review of the literature are presented.