amphotericin-b and Lip-Diseases

The worldwide prevalence of leishmaniasis is increasing because of ecologic changes and increased medical profession awareness. Furthermore, solitary cases have been recently reported in Western countries. The authors describe the epidemiology, mode of transmission, and diagnosis of leishmaniasis and present 4 oral cases treated with systemic, localized, or combined therapy. The authors suggest that clinicians should maintain a high index of suspicion for atypical, resistant, oral and perioral lesions in individuals with a history of traveling in certain geographic regions. After diagnosis, treatment should be determined jointly by experts from the fields of oral and maxillofacial surgery, oral medicine, and dermatology based on leishmaniasis species and clinical presentation.

Topics: Adolescent; Adult; Aged; Amphotericin B; Animals; Antimony Sodium Gluconate; Antiprotozoal Agents; Diagnosis, Differential; Endemic Diseases; Female; Humans; Leishmania braziliensis; Leishmania infantum; Leishmania major; Leishmaniasis; Leishmaniasis, Cutaneous; Lip Diseases; Male; Mouth Diseases; Young Adult

Topics: Acquired Immunodeficiency Syndrome; Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Antigens, Fungal; Biopsy; Chronic Disease; Female; Histoplasma; Histoplasmosis; Humans; Lip Diseases; Mouth Mucosa; Staining and Labeling; Ulcer

Topics: Amphotericin B; Antiprotozoal Agents; Chronic Disease; Edema; Humans; Leishmaniasis, Mucocutaneous; Lip Diseases; Male; Middle Aged

This clinical case presents a patient with a raised and ulcerative lesion with erythematous edges in the mouth, on the lower lip that was unsuccessfully treated as herpes labialis. Clinical data and laboratory tests (Montenegro skin test, indirect immunofluorescence, direct parasite search and polymerase chain reaction) led to the diagnosis of American tegumentary leishmaniasis caused by Leishmania (Viannia) sp. Treatment with pentavalent antimonial (Glucantime®) for 120 days was not effective and administration of amphotericin B for 30 days resulted in wound healing. Glucantime® treatment protocol was longer than the recommended by the Brazilian Ministry of Health in the handbook of mucosal leishmaniasis. This suggests that amphotericin B should have been administered earlier, preventing the psychological and social problems faced by the patient. This study reports a rare clinical case of primary mucosal leishmaniasis on the lip that had a delayed diagnosis, highlighting the precariousness in the management of disease and showing that, despite the importance of leishmaniasis in Brazil, it is still neglected by health professionals.

Topics: Adult; Amphotericin B; Antiprotozoal Agents; Fluorescent Antibody Technique, Indirect; Humans; Leishmania; Leishmaniasis, Mucocutaneous; Lip Diseases; Male

Rhinocerebral mucormycosis (RCM) is a rare, fulminating opportunistic fungal infection caused by a fungus of order Mucorales. These fungi are ubiquitus, subsisting on decaying vegetation and diverse organic material. Although fungi and spores of Mucorales show minimal intrinsic pathogenicity towards normal person, they can initiate aggressive and fulminating infection in immunocompromised host. Since RCM occurs infrequently, it may pose a diagnostic and therapeutic dilemma for those who are not familiar with its clinical presentation.. We present a patient with classical presentation of RCM involving paranasal sinuses, orbit, and cranial base who was treated by combination of aggressive surgical and medical therapy.. The purpose of this paper is to draw attention to the clinical presentation and pathogenesis of RCM and to emphasize need for high index of suspicion in diagnosis and treatment.

Topics: Amphotericin B; Antifungal Agents; Combined Modality Therapy; Debridement; Diabetes Mellitus, Type 2; Diabetic Ketoacidosis; Fatal Outcome; Female; Humans; Infusions, Intravenous; Lip Diseases; Maxilla; Middle Aged; Mouth Diseases; Mucormycosis; Nose; Nose Diseases; Opportunistic Infections; Orbital Diseases; Paranasal Sinus Diseases; Tomography, X-Ray Computed

Topics: Amphotericin B; Antifungal Agents; Coccidioides; Coccidioidomycosis; Diabetes Mellitus, Type 1; Diabetic Nephropathies; Fluconazole; Humans; Kidney Transplantation; Lip Diseases; Male; Middle Aged; Pancreas Transplantation; Ulcer

Topics: Adult; Aged; Amphotericin B; Blastomycosis; Diagnosis, Differential; Histoplasmosis; Humans; Laryngeal Diseases; Laryngeal Neoplasms; Lip Diseases; Male; Middle Aged; Mouth Diseases; Mouth Neoplasms; Mycoses

Topics: Aged; Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis; Candidiasis, Oral; Carcinoma; Diagnosis, Differential; Female; Granuloma; Humans; Lip Diseases; Pityriasis; Skin Neoplasms

Topics: Africa; Amphotericin B; Asia; Cheek; Europe; Fungi; Humans; Hydrocortisone; Lip Diseases; Mycoses; Nose Diseases; Paranasal Sinuses; Potassium Iodide; South America