PMC5813666_01
- Patient's clinical history: A) Lesion on the lower lip at the time of leishmaniasis diagnosis (one-month-old); B) Direct search of parasite in the material obtained by scraping of the lesion, stained by Giemsa; C) Polymerase chain reaction (PCR) showing the 70-bp fragment of the kinetoplast minicircle DNA (kDNA) from subgenera Leishmania (Viannia) sp.; lane 1: the patient's lesion sample; lane 2: positive control [DNA from blood sample containing 5x10-3 promastigotes of Leishmania (Viannia) braziliensis]; lane 3: the patient's blood sample; lane 4: negative control (sterile water); lane 5: positive control [DNA from promastigotes of Leishmania (Viannia) braziliensis]; lane 6: molecular weight marker 25-bp ladder; D) Patient after treatment with amphotericin B (19 months after correct diagnosis)
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During examination of the lower lip, an ulcerated lesion was observed, it was erythematous with raised edges and there was the presence of granulomatous, purulent and crusty contents characteristic of mucosal leishmaniasis (Figure 1A). The Montenegro skin test was reactive with an induration of 6 mm in diameter, indirect immunofluorescence was positive for anti-Leishmania IgG antibodies with titer of 1:80 and the direct parasite search was also positive (Figure 1B). Only the scraping material was positive (Figure 1C). In March 2017, three months after treatment with amphotericin B and 19 months after correct diagnosis, the patient was in remission and under observation (Figure 1D).