Evidence map›Paper›PMID 42543410›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Mucosal leishmaniasis of the nasal septum: diagnostic pitfalls and management considerations.

S Orozco-Núñez, A García-Lliberós, V Abril, L Delvasto, M J Gómez-Gómez, E Zapater-Latorre

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

S Orozco-NúñezRhinology and Skull Base Section, Department of Otorhinolaryngology and Head and Neck Surgery, University General Hospital of Valencia, Av. Tres Cruces, Valencia, 46014, Spain.
A García-LliberósRhinology and Skull Base Section, Department of Otorhinolaryngology and Head and Neck Surgery, University General Hospital of Valencia, Av. Tres Cruces, Valencia, 46014, Spain. ainhoagarcialliberos@gmail.com.ORCID http://orcid.org/0000-0002-6813-7850
V AbrilDepartment of Infectious Diseases, University General Hospital of Valencia, Valencia, Spain.
L DelvastoDepartment of Otorhinolaryngology and Head and Neck Surgery, Hospital of Manises, Valencia, Spain.
M J Gómez-GómezRhinology and Skull Base Section, Department of Otorhinolaryngology and Head and Neck Surgery, University General Hospital of Valencia, Av. Tres Cruces, Valencia, 46014, Spain.
E Zapater-LatorreRhinology and Skull Base Section, Department of Otorhinolaryngology and Head and Neck Surgery, University General Hospital of Valencia, Av. Tres Cruces, Valencia, 46014, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveLeishmaniasis is a chronic parasitic disease caused by a protozoan of the order Kinetoplastida, transmitted through the bite of infected sandflies. Its mucosal form with sinonasal involvement is exceptional but clinically relevant, potentially causing granulomatous lesions, nasal obstruction, and epistaxis, mimicking inflammatory or malignant disease. In the Old World (Europe, Asia, Africa), it is usually associated with Leishmania infantum, whereas in the New World (America) L. braziliensis predominates, generally following a previous or concomitant cutaneous lesion. Early diagnosis and treatment are crucial due to the risk of local and systemic progression. The aim of this study is to highlight the diagnostic pitfalls and management considerations of mucosal leishmaniasis confined to the nasal septum in a European clinical setting by presenting a case series. MATERIAL AND

methodsThree cases diagnosed between 2018 and 2023 were retrospectively reviewed. All were male patients (aged 37, 43, and 76 years) with mucosal leishmaniasis involving exclusively the nasal septum, without previous or concomitant cutaneous lesions and no history of travel to endemic areas. Diagnosis was confirmed by lesion biopsy and Giemsa staining, demonstrating the presence of intracellular amastigotes. All patients received treatment with liposomal amphotericin B.

resultsAll three patients achieved complete clinical resolution. Reversible adverse effects were documented: two cases of acute renal failure and one case of sinus bradycardia, successfully managed with temporary treatment suspension and intensive hydration. Patient number 2, immunosuppressed due to Crohn's disease, experienced recurrence several years later, initially treated with fluconazole and, due to persistent lesions, with a second course of liposomal amphotericin B.

conclusionIsolated septal mucosal leishmaniasis is a rare and potentially underdiagnosed entity, particularly in the absence of cutaneous lesions, requiring a high index of clinical suspicion and histopathological confirmation. Liposomal amphotericin B is effective and safe under close monitoring. Immunosuppression may increase the risk of recurrence, justifying prolonged follow-up and multidisciplinary management.

Indexed as

Histopathological diagnosisLiposomal amphotericin BMucocutaneous leishmaniasisMucosal leishmaniasisNasal granulomatous lesionNasal septum

Identifiers

PMID42543410

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