Images in Otorhinolaryngology
Lingual Mucocutaneous Leishmaniasis
Leishmaniasis mucocutánea lingual
Cristina Isabel Sanz Sánchez
, Eduardo Rodríguez Pastor, Rafael Cabanás Vega
Corresponding author
Servicio de Otorrinolaringología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
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A) Spontaneous nystagmus with occlusion of vision and in central vision. A spontaneous horizontal nystagmus was observed (conjugated binocular in instrumental examination) changing direction, with a pattern which initially goes towards the left to then change direction and go towards the right after a transition period. The extent of the nystagmus during the slow phase changes since when it begins towards one direction until it ends. Specifically, nystagmuses closest to the transition period have a smaller amplitude and this increase as it gets further away from this. The speed of the nystagmus is also changing. B) Head impulse test. Normal values of gain of the bilateral vestibular-ocular reflex are observed, and also overt saccades which jerk in the inverse direction to the one expected. C) Saccades study. A reduction of saccade precision is observed, greater towards the left side, being mostly hypometric. The speed and latency of them is within normal range.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carolina Moreno-de-Jesús, Lucía Prieto-Sánchez-de-Puerta, Irene Mármol-Szombathy, Emilio Domínguez-Durán" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Carolina" "apellidos" => "Moreno-de-Jesús" ] 1 => array:2 [ "nombre" => "Lucía" "apellidos" => "Prieto-Sánchez-de-Puerta" ] 2 => array:2 [ "nombre" => "Irene" "apellidos" => "Mármol-Szombathy" ] 3 => array:2 [ "nombre" => "Emilio" "apellidos" => "Domínguez-Durán" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001651920301965" "doi" => "10.1016/j.otorri.2020.10.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001651920301965?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573521000995?idApp=UINPBA00004N" "url" => "/21735735/0000007200000006/v1_202111270648/S2173573521000995/v1_202111270648/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Otorhinolaryngology</span>" "titulo" => "Lingual Mucocutaneous Leishmaniasis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "403" "paginaFinal" => "404" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Cristina Isabel Sanz Sánchez, Eduardo Rodríguez Pastor, Rafael Cabanás Vega" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Cristina Isabel" "apellidos" => "Sanz Sánchez" "email" => array:1 [ 0 => "cristinasanzsanchez03@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Rodríguez Pastor" ] 2 => array:2 [ "nombre" => "Rafael" "apellidos" => "Cabanás Vega" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Otorrinolaringología, Hospital Universitario Virgen de la Victoria, Málaga, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Leishmaniasis mucocutánea lingual" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1231 "Ancho" => 905 "Tamanyo" => 145132 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 70-year old male presented with a lingual lesion of 2 year onset with a progressive and fluctuating increase in size, that had become painful in the last 3 weeks. He lived in contact with animals and had a history of presenting with leukocytoclastic vasculitis and chronic idiopathic neutropenia. In the examination an ulcerated and painful lesion of 2.5 cm on the back of the tongue (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) was observed. At cervical level an adenopathy in the left IIA was palpated. On suspicion of a tumoral process an incisional punch biopsy was performed and computerised tomography and magnetic resonance was requested with oral cavity and cervical contrast.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Magnetic resonance (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) reported a lesion in the right half of the tongue, with irregular edges, which reached mid-line, 33 × 24 × 12 mm, and which affected the whole thickness, with enhancement of the homolateral genioglossus muscle. Computerised tomography showed both adenopathies in the right jugulo-carotid region of 20 mm and left bulbar carotid region of 23 mm (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Biopsy reported leishmaniasis, which was confirmed with positive serology test and PCR of the sample. Systemic involvement and HIV infection were ruled out and systemic treatment with liposomal amphotericin B was initiated, with good evolution and complete disappearance of the lesion after 6 months.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">This zoonosis is an endemic and emerging disease in Spain which most often affects immunocompromised individuals. It is important to bear in mind in the differential diagnosis for an oral mucosa ulcerative mucosa.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sanz Sánchez CI, Rodríguez Pastor E, Cabanás Vega R. Leishmaniasis mucocutánea lingual. 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