Atypical Cutaneous Leishmaniasis with Negative Direct Smear: Two Case Reports Confirmed by Molecular Diagnosis

Background: Cutaneous leishmaniasis (CL) is a chronic parasitic disease caused by protozoa of the genus Leishmania, primarily transmitted to humans by bites of infected female sandflies. Methods: This report describes two patients from Damghan with cutaneous lesions that were initially misdiagnosed as fungal infections. The lesions were evaluated using direct smear microscopy and a kDNA-based polymerase chain reaction (PCR) assay. Results: The first patient was a ۵-year-old girl with a chronic lesion on her hand. Despite a negative direct smear, kDNA-based PCR confirmed CL. The second patient was a ۴۳-year-old man with a painful ulcerative lesion on his leg. kDNA-based PCR confirmed Leishmania major infection, and the patient improved following treatment with Glucantime. Conclusion: Atypical CL presents diverse clinical features, especially in children, which complicate diagnosis. Increased awareness and further research are crucial to improving outcomes and refining management strategies.

کلیدواژه ها:

Atypical presentations ، cutaneous leishmaniasis ، Case report ، Molecular test