Die Leishmaniasis – eine parasitäre Erkrankung als Differenzialdiagnose maligner Mundschleimhauterkrankungen. Fallbericht und Literaturübersicht

Mund-, Kiefer- und Gesichtschirurgie - Tập 11 Số 3 - Trang 167-173 - 2007
Wysluch, Andreas1, Sommerer, Florian2, Ramadan, Hamid1, Loeffelbein, Denys1, Wolff, Klaus-Dietrich1, Hölzle, Frank1
1Universitätsklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie, Ruhr-Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer, Bochum, Germany
2Institut für Pathologie, Ruhr-Universität Bochum, Bochum, Germany

Tóm tắt

Zur Differenzialdiagnostik maligner Erkrankungen der Mundschleimhaut zählen auch Infektionen mit im nördlichen europäischen Raum seltenen parasitären Erregern. Durch zunehmenden Tourismus in Endemiegebieten ist auch mit einer weiteren Verbreitung von seltenen Erregern zu rechnen, die in dem hier vorliegenden Fall eine maligne Mundschleimhauterkrankung vortäuschen können und sich klinisch als Ulkus an ungewöhnlicher Lokalisation darstellen. Der hier vorgestellte Fall ist insofern eine Besonderheit, da der Patient bei bekannter chronischer Hepatitis C eine zunehmende Leberzirrhose entwickelte, die eine Lebertransplantation verlangte. Anamnestisch lag ebenfalls eine stattgehabte Leishmanien-Infektion vor, die jedoch durch ein Tropeninstitut ausbehandelt zu sein schien. Die neu entwickelten Leishmanien-Infektion stellt aufgrund der anstehenden Immunsuppression eine Kontraindikation für die Lebertransplantation dar. Unter oraler Therapie mit Miltefosin (IMPAVIDO®) konnte eine Remission erzielt werden. Die Leishmaniase gehört zu den klassischen tropenmedizinischen Infektionskrankheiten. Derzeit sind laut WHO etwa zwölf Millionen Menschen in 88 Ländern der Welt, speziell in tropischem Klima, infiziert. Wiederholt kommt es zu Infektionen im Bereich des nördlichen europäischen Raumes durch die Phleobotonus-Sandmücke. Bei der intraoralen Befunderhebung ist die Leishmaniase bei zukünftigen unklaren Effloreszenzen der Mundschleimhaut als Differenzialdiagnose zu bedenken.

Tài liệu tham khảo

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