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Mucocutaneous Leishmaniasis — SCE Infectious Diseases MCQ

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HardTropical & Imported InfectionsMucocutaneous LeishmaniasisSCE Infectious Diseases

A 42-year-old woman from Brazil presents with chronic nasal congestion, septal perforation, and destructive midline granuloma of the nasal septum and palate. Tissue biopsy shows amastigotes. Leishmania species PCR identifies L. braziliensis. What form of leishmaniasis is this?

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Correct answer: D — Mucocutaneous leishmaniasis

Destructive mucosal disease involving the nasal septum and palate (espundia) with Leishmania braziliensis is mucocutaneous leishmaniasis (MCL). This occurs weeks to years after initial cutaneous infection, with haematogenous spread to naso-oropharyngeal mucosa. L. braziliensis (New World) is the species most associated with MCL. Treatment requires systemic therapy: Liposomal Amphotericin B (preferred in UK) or pentavalent antimonials for prolonged courses. MCL does not respond to topical or local treatments.

Reference: WHO 2022 – Leishmaniasis; LSTMH/BSAC 2019 – UK leishmaniasis guidelines