Cutaneous leishmaniasis in an indigenous infant with Down’s syndrome: A case report

Abstract

Rationale: Leishmaniasis, caused by the protozoan Leishmania and transmitted by sandflies, is endemic to the tropical and subtropical areas of Brazil. It is one of the neglected tropical diseases in the world. Patient concerns: A 20-month-old indigenous infant with severe malnutrition and Down’s syndrome presented with a facial ulcer for 5 months. Diagnosis: Giemsa staining of scraped ulcer tissues indicated the presence of the amastigote form of Leishmania sp., and positive Montenegro’s intradermal test helped in diagnosing the condition as cutaneous leishmaniasis. Interventions: The child was hospitalized and received intravenous treatment for cutaneous leishmaniasis (1 mg/kg/day of amphotericin B). Outcomes: The condition was cured with amphotericin B (1 mg/kg/day for 14 d). Lessons: Because of infanticide practices in indigenous cultures, indigenous infants with Down’s syndrome rarely survive. Thus, no similar case has been reported in the literature.

Keywords

• cutaneous leishmaniasis
• indigenous
• down’s syndrome
• immune deficiencies