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Clinical Problem Solving: Pathology
Aug 2012

Pathology Quiz Case 1: Diagnosis

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2012;138(8):778. doi:10.1001/archotol.138.8.778

Diagnosis: Leishmaniasis of the tongue

Leishmaniasis is a vector-borne disease that is transmitted by the female sandfly. According to the World Health Organization, the incidence rate of visceral leishmaniasis (VL) is 500 000 cases per year, with the mortality rate at 60 000 cases annually.1 It can manifest as cutaneous leishmaniasis (skin infections), mucocutaneous leishmaniasis (skin infections with involvement of mucosa of nose, mouth, or throat), or VL (multiorgan infections). There are more than 20 Leishmania species that can cause leishmaniasis. Visceral leishmaniasis is generally transmitted by Leishmania donovani or Leishmania infantum. Leishmania donovani occurs in South Asia or East Africa and affects healthy adults. Leishmania infantum has occurred in the Mediterranean, Middle East, Afghanistan, Pakistan, Iran, and Brazil and has been largely reported to occur in children who are younger than 10 years and who are immunocompromised. Because military personnel that are deployed to endemic regions are at increased risk of acquiring the infection, preventive techniques are taught and used before and during active duty in these areas.2,3