A case of adnexal cutaneous leishmaniasis in Washington DC

Authors

Sinan Akosman, Department of Ophthalmology, George Washington University School of Medicine, 2150 Pennsylvania Avenue Suite 2A, Washington, DC, USA. sakosman@gwu.edu.
Heeyah Song, Department of Ophthalmology, George Washington University School of Medicine, 2150 Pennsylvania Avenue Suite 2A, Washington, DC, USA.
Paul Sheils, Department of Ophthalmology, George Washington University School of Medicine, 2150 Pennsylvania Avenue Suite 2A, Washington, DC, USA.
Tamer Mansour, Department of Ophthalmology, George Washington University School of Medicine, 2150 Pennsylvania Avenue Suite 2A, Washington, DC, USA.
Keith J. Wroblewski, Department of Ophthalmology, George Washington University School of Medicine, 2150 Pennsylvania Avenue Suite 2A, Washington, DC, USA.
Lamise Rajjoub, Department of Ophthalmology, George Washington University School of Medicine, 2150 Pennsylvania Avenue Suite 2A, Washington, DC, USA.

Document Type

Journal Article

Publication Date

8-23-2024

Journal

Journal of ophthalmic inflammation and infection

Volume

14

Issue

1

DOI

10.1186/s12348-024-00423-z

Keywords

Cutaneous leishmaniasis; Non-endemic; Ocular leishmaniasis; Parasites; Punch biopsy; United States; Washington DC

Abstract

PURPOSE: To report a rare non-endemic case of Leishmania aethiopica in Washington DC. CASE REPORT: A 68-year-old female presented for a routine examination with a complaint of right upper eyelid lesions for the past 5 months. On examination, a cluster of elevated and erythematous lesions extending from the medial canthus to the brow area of the right eye were seen. Initial treatment with Valtrex based on a suspected viral etiology failed. Although a biopsy was recommended at this time, the patient declined, and subsequent workup included nasolacrimal duct irrigation, blood work to rule out autoimmune etiology, a course of doxycycline, and an MRI, which yielded no improvement. Upon progression of the lesions into persistent plaques on the eyelids, a punch biopsy was performed, confirming leishmaniasis. The patient was then started on a 28-day course of oral miltefosine which led to complete resolution of her symptoms. CONCLUSION: This case underlines the importance of a broad differential including non-endemic diseases, particularly in urban areas with frequent patient travel. Furthermore, the delayed punch biopsy in this case highlights the importance of patient counseling to ensure prompt diagnosis and treatment.

APA Citation

Akosman, Sinan; Song, Heeyah; Sheils, Paul; Mansour, Tamer; Wroblewski, Keith J.; and Rajjoub, Lamise, "A case of adnexal cutaneous leishmaniasis in Washington DC" (2024). GW Authored Works. Paper 5443.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5443

Department

Ophthalmology