SHM Converge Scientific Abstract ePoster Gallery-Navigating Diagnostic Challenges: Cutaneous Leishmaniasis Masquerading as Malaria

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This case report describes a 34-year-old man who presented with fever, body pain, and inguinal lymph node swelling after recent migration and travel through several tropical regions, including Colombia and Central America. He had a resolving rash on his legs with purulent drainage and was initially suspected to have malaria because of a positive malaria rapid diagnostic test and blood smear artifacts that appeared parasitic. He was treated with artemether/lumefantrine, but his skin lesions worsened.<br /><br />Further evaluation, including a punch biopsy and RT-PCR testing, ruled out Plasmodium infection and instead identified cutaneous leishmaniasis. The report emphasizes that malaria rapid diagnostic tests can yield false-positive results due to cross-reactivity with Leishmania antigens, and that microscopy may be misleading when artifacts resemble parasites.<br /><br />Because of persistent symptoms and concern for leishmaniasis, the patient was treated with liposomal amphotericin B on days 1–5, 14, and 21, with a total dose of 21 mg/kg. His skin lesions improved significantly after therapy.<br /><br />The authors stress that cutaneous leishmaniasis can mimic other infections and be difficult to diagnose, especially in travelers from regions where malaria and leishmaniasis are both endemic. They recommend maintaining a broad differential diagnosis and using PCR-based confirmation when clinical suspicion remains high, to avoid delayed treatment and potential complications.

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Angela Centeno Gavica

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Author List Andrew Kim, Angela Centeno Gavica, Carl Urban, Christina Coyle, Glenn Turett, James Yoon, Lok W. Yung, Nishant Prasad, Sorana Segal-Maurer, Virginia Cortez Romero

Category Clinical Vignettes

Concept Cutaneous Leishmaniasis

Concept Leishmania Infection

Concept Skin ulcer

Concept Polymerase Chain Reaction

Concept Liposomal Amphotericin B

Distinguished Non-Finalist

Presenter Organization NewYork-Presbyterian Queens

Presenting Author Angela Centeno Gavica

Track Adult

Keywords

cutaneous leishmaniasis

malaria false positive

rapid diagnostic test

cross-reactivity

travel medicine

tropical infection

liposomal amphotericin B

PCR confirmation

blood smear artifacts

inguinal lymphadenopathy

Cutaneous Leishmaniasis

Leishmania Infection

Skin ulcer

Polymerase Chain Reaction

Liposomal Amphotericin B