Cutaneous leishmaniasis in Uganda: report of the first case at Mulago National Referral and Teaching Hospital

Abstract

The transmission of Leishmania in central Uganda is little known despite that equine leishmaniasis was reported on the mainland in 1926. A case is reported of cutaneous leishmaniasis in an immunocompromised patient, possibly acquired on the Ssesse Islands in Lake Victoria or on the mainland or even introduced from a neighbouring country. The patient’s facial and limb skin lesions were suspected to be Kaposi’s sarcoma or cutaneous mycobacterial disease and diagnosis was made on histological examination. The possibility of parasite visceralisation could not be excluded, but there was evidence of multi-organ disturbance. Treatment options though limited yielded clinical and histological improvement with Amphotericin B. Parasite isolation was not possible and polymerase chain reaction analysis of unstained formalin-fixed paraffin-embedded skin sections identified Leishmania major as the causative organism.