Question
The appearance of this Tunisian woman's ear is most consistent with which one of the following infectious diseases?
- Leprosy
- Leishmaniasis
- Syphilis
- Tuberculosis
- Yaws
Correct Answer : Leishmaniasis
Explanation :
Cutaneous leishmaniasis is endemic in Tunisia, particularly in the central and northern parts of the country. Lupoid leishmaniasis is an uncommon form of chronic cutaneous leishmaniasis associated with Leishmania tropica. A polymerase-chain-reaction assay performed on a biopsy specimen from this patient was positive for leishmania
Promastigotes in the sandfly change into amastigotes upon inoculation into a host. Macrophages phagocytose the amastigotes. The leishmania replicate within the macrophages, resulting in granuloma formation.
Activated T-cells are present, resulting in a positive leishmanin test, but despite this parasite replication continues.
Typically the infection is cleared after months of inflammation.
