Date Published: January 10, 2018
Publisher: The American Society of Tropical Medicine and Hygiene
Author(s): Raphael A. Camargo, Lázaro M. Camargo, Marcelo T. Sapienza, Carlos A. Buchpiguel, Valdir S. Amato, Felipe Francisco Tuon.
A male patient from the northeast of Brazil reported history of ML treated with meglumine antimoniate 20 mg/kg/day during 30 days with improvement of the lesion. Eight months later the patient presented itching, pain, whitish secretion, and increased lesion size, associated with epistaxis. He was then submitted to a head and neck low-dose protocol 18F-FDG –PET/CT, which showed increased glycolytic metabolism in facial structures (Figure 1A and B). After biopsy, the immunohistochemical analysis was positive for Leishmania antigens.
A male patient, 69 years old, from the Northeast of Brazil was treated for ML in 2005. After eight annual checkups, the patient presented worsening of the nasal obstruction. A head and neck low-dose protocol 18F-FDG–PET/CT was requested, showing preserved glycolytic metabolism in facial structures (Figure 1E and F). Otorhinolaryngologic examination did not show mucosal alterations or signs of disease activity. CT revealed signs of chronic rhinosinusitis and facial structure alterations related to previous ML (Figure 1H). The patient was treated for chronic sinusitis and presented improvement of nasal obstruction and other symptoms. He is asymptomatic until last medical visit.