Author(s) : M. ABRISHAMI, M. SOHEILIAN, A. FARAHI, Y. DOWLATI, Shaheed Beheshti University of Medical Sciences, Labbafinejad Medical Center, Ophthalmology Department and Eye Research Center, Tehran, Iran..
Summary : Purpose. To report successful treatment of a case of ocular leishmaniasis with combined stibogluconate and allupurinol.
Method. A 32-year-old physician developed a non-tender reddish chalazion like lesion in his right lower lid, associated with conjunctivitis and nodular episcleritis.
Biopsy of the lesion in his eyelid and conjunctiva disclosed a dense inflammatory response including histiocytes containing typical leishmania organisms.
Result. Therapy with stibogluconate, both intralesional and intramuscular, was initiated with some improvement. However recurrence of the lesion occurred. Systemic retreatment with combined stibogluconate and allupurinol led to complete healing of the lesion.
Conclusion. Ocular leishmaniasis is a rare and potentially blinding disorder. Combined stibogluconate and allupurinol may be an effective therapy in such cases.
Figure 1. Front view of facial aspects of patient with eyelid and
conjunctival leishmaniasis before treatment.
Figure 2. Biopsy specimen
of the eyelid lesion showing dense inflammatory infiltration of mixed composition,
with predominance of plasma cells, lymphocytes and histiocytes. Many of
the histiocytes contain typical leishmania organisms. Isolated leishmania
organisms from ruptured cells are noted in the interstitium.
Figure 3. Facial aspect of patient after
successful treatment.
Printable version
