Foreign Title :
Leishmaniosi con Localizzazione nelle Cavità Mucose (Nuova Forma Clinica).
Bulletin de la Société de Pathologie Exotique
In this memoir the author describes in detail his observations upon three cases of the Brazilian leishnianiasis, which is peculiar in that it produces lesions not only of the skin on the exposed parts of the body, but also of the mucous membranes of the nose, mouth, pharynx and larynx. Its features were well described in an earlier paper by the author and also by CARINI (Kala Azar Bulletin No. 2, pp. 104-105), and later by EsCOMEL under the name of La Espundia and by LAVERANN and NATTAN-LARRIER (Kala Azar Bulletin No. 3, pp. 167 and 168).
The author points out that the lesions on the skin resemble closely those of oriental sore, whereas the nasal, buccal, and pharyngeal lesions take the form of vegetations of framboesial type. An important feature of the disease, emphasised by the author, is the occurrence of irregular fever in periods of several days duration. It is usually attributed to malaria, but is resistant to quinine, and other evidences of a malarial affection are wanting. The lymphatic glands in the neck are enlarged and have been shown to contain leishmania. The blood shows a leucocytosis (12-16 thousand) with an increase in the large mononuclears. Leishmania have not been found in the peripheral blood except in that taken from the neighbourhood of the lesions. As regards treatment, nothing reduces the lesions in the mouth and nose; the author has tried radium exposures, X-rays, and injections of 606. Radium exposures are however, very efficacious in the case of the cutaneous lesions, which are quickly healed.
The leishmania which have been found by the author in the Various lesions differ in no way from those of oriental sore. In pharyngeal growths, however, there occur some curious elongated forms, some of which are provided with flagella and thus resemble the forms seen in artificial culture. The parasites have been cultivated in the usual way on NNN medium; the cultures did not differ from those of oriental sore obtained by NICOLLE. Experimentally the author has been successful in inoculating the virus from man into two monkeys (Mico estrella); with other animals he was unsuccessful. The injection of cultures in large quantity both intraperitoneally and subcutaneously into various animals (dog, rabbit, guineapig, rat, bat, cat, pigeon, bird, frog) was without result except in the case of one rat killed after a month which showed peculiar red granules in the spleen and liver like nuclei of leishmania. A monkey (M. estrella) inoculated in the frontal region with culture developed a small papule after forty days; no leishmania were found and it disappeared in fifteen days.
The author has not been able to solve the problem of transmission.
C. M. W.
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Societe de Pathologie Exotique
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