Laryngeal Leishmaniasis- A Rare Clinical Entity

Chettri ST¹, Karki Smriti², Paudel D^1, , Shah BP¹, Shah SP¹, Manandhar S¹ and Jayaswal R¹

¹Department of Otorhinolaryngology, BPKIHS, Dharan, Nepal

²Department of Pathology, BPKIHS, Dharan, Nepal

Cite this paper:
Chettri ST, Karki Smriti, Paudel D, Shah BP, Shah SP, Manandhar S and Jayaswal R. Laryngeal Leishmaniasis- A Rare Clinical Entity. American Journal of Medical Case Reports. 2014; 2(9):181-183. doi: 10.12691/ajmcr-2-9-5

Abstract

Isolated laryngeal leishmaniasis is a rare condition and we report a 46 years old patient who presented with progressive, non fluctuating hoarseness of voice for 8 months along with foreign body sensation of throat and difficulty in swallowing. Indirect laryngoscopy followed by flexible nasoendoscopy revealed grossly edematous epiglottis, right arytenoid, right aryepiglottic fold and medial wall of the right pyriform sinus. Direct laryngoscope was performed under general anesthesia and biopsy was taken. The histopathology report section revealed numerous extracellular L.D. bodies in an inflammatory milieu comprising of lymphocytes, neutrophils and macrophages set in an edematous subepithelial stroma. He has no other systemic manifestation. He had no HIV infection or immunocompromised condition nor took immunosuppressive drugs. He responded well with liposomal Amphotericin B.

Keywords:
leishmania donovani LD Bodies larynx

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	González U, Pinart M, Rengifo-Pardo M, Macaya A, Alvar J, Tweed JA: Interventions for American cutaneous and mucocutaneous leishmaniasis (Review): The Cochrane Library. 2012, Issue 6: 3.
[2]	Santangeli L, McCluney NA, Hathorn I, Shakeel M, Anderson C. Leishmaniasis presenting to the otolaryngologist: a rare but important cause of persistent hoarseness. Laryngol Otol. 2009; 123: 1181-1183.
[3]	Trevor A. Teemul, Montserrat Giles-Lima, John Williams, Shane E. Lester: Laryngeal leishmaniasis: Case report of a rare infection: HEAD & NECK DOI 10.1002/HED. 2013 sept; 35 (9): E277-9.
[4]	Fsadni C, Fsadni P, Piscopo T, Mallia Azzopardi C: Laryngeal Leishmaniasis in Malta. J Infection. 2007; 54:61-63.
[5]	Centers for Disease Control and Prevention. Parasite home: leishmaniasis. Biology. Available at http://www.cdc.gov/parasites/leishmaniasis/epi.html. Accessed September 8, 2014.
[6]	Centers for Disease Control and Prevention. Parasite home: leishmaniasis. Epidemiology & risk factors. Available at http://www.cdc.gov/parasites/leishmaniasis/epi.html. Accessed September 8, 2014
[7]	Rosenthal PJ. Antiprotozoal drugs. In: Katzung BG, Masters SB, Trevor AJ, editors. Basics and Clinical Pharmacology. 11th ed. New Delhi:McGraw-Hill. 2009:919.
[8]	Kumar B, Ghimire A, Karki S, Upadhyaya P. Primary laryngeal leishmaniasis: A rare case report. Indian J Pathol Microbiol. 2009; 52: 62-4
[9]	Cox FEG: History of human Parasitology: Clinical Microbiology Reviews. 2002; 15: 595-612.
[10]	Kamran Iqbal, Ziaul Islam Abbasi, Habib-ullah Khan: Leishmania of the vocal cord: An Unusual Site: Gomal Journal of Medical Sciences: Jan-June, 2005, Vol. 3, No. 1: 25-6.
[11]	Finch RG, Moss P, Jeffries DJ, Anderson J. infection diseases. Leishmaniasis. 5th edition. Clinical Medicine by Kumar and Clark. 2002 pp 105.
[12]	Di Lella F, Vincenti V, Zennaro D, Afeltra A, Baldi A, Giordano D, et al. Mucocutaneous leishmaniasis: Report of a case with massive involvement of nasal, pharyngeal and laryngeal mucosa. Int J Oral Maxillofac Surg. 2006 sept; 35 (9): 870-2.
[13]	Grant A, Spraggs PD, Grant HR, Bryceson AD. Laryngeal leishmaniasis. J Laryngol Otol 1994 dec; 108 (12): 1086-8.
[14]	Osorio LE, Castillo CM, Ochoa MT. Mucosal leishmaniasis due to Leishmania (Viannia) panamensis in Colombia: Clinical characteristics. Am J Trop Med Hyg. 1998; 59: 49-52.
[15]	Herwaldt BL. Infectious disease-Leishmaniasis. In: Kasper DL,. Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s Principles of Internal Medicine. 16th ed. McGraw-Hill; 2005: 196: 1233-8.