High seroprevalence of Leishmania infantum is linked to immune activation in people with HIV: a two-stage cross-sectional study in Bahia, Brazil

Visceral leishmaniasis is an opportunistic disease in HIV-1 infected individuals, unrecognized as a determining factor for AIDS diagnosis. The growing geographical overlap of HIV-1 and Leishmania infections is an emerging challenge worldwide, as co-infection increases morbidity and mortality for both infections. Here, we determined the prevalence of people living with HIV (PWH) with a previous or ongoing infection by Leishmania infantum and investigated the virological and immunological factors associated with co-infection. We adopted a two-stage cross-sectional cohort (CSC) design (CSC-I, n = 5,346 and CSC-II, n = 317) of treatment-naïve HIV-1-infected individuals in Bahia, Brazil. In CSC-I, samples collected between 1998 and 2013 were used for serological screening for leishmaniasis by an in-house Enzyme-Linked Immunosorbent Assay (ELISA) with SLA (Soluble Leishmania infantum Antigen), resulting in a prevalence of previous or ongoing infection of 16.27%. Next, 317 PWH were prospectively recruited from July 2014 to December 2015 with the collection of sociodemographic and clinical data. Serological validation by two different immunoassays confirmed a prevalence of 15.46 and 8.20% by anti-SLA, and anti-HSP70 serology, respectively, whereas 4.73% were double-positive (DP). Stratification of these 317 individuals in DP and double-negative (DN) revealed a significant reduction of CD4+ counts and CD4+/CD8+ ratios and a tendency of increased viral load in the DP group, as compared to DN. No statistical differences in HIV-1 subtype distribution were observed between the two groups. However, we found a significant increase of CXCL10 (p = 0.0076) and a tendency of increased CXCL9 (p = 0.061) in individuals with DP serology, demonstrating intensified immune activation in this group. These findings were corroborated at the transcriptome level in independent Leishmania- and HIV-1-infected cohorts (Swiss HIV Cohort and Piaui Northeast Brazil Cohort), indicating that CXCL10 transcripts are shared by the IFN-dominated immune activation gene signatures of both pathogens and positively correlated to viral load in untreated PWH. This study demonstrated a high prevalence of PWH with L. infantum seropositivity in Bahia, Brazil, linked to IFN-mediated immune activation and a significant decrease in CD4+ levels. Our results highlight the urgent need to increase awareness and define public health strategies for the management and prevention of HIV-1 and L. infantum co-infection

Contribuição da avaliação otorrinolaringológica no diagnóstico diferencial e na detecção precoce da leishmaniose mucosa.

Submitted by Repositório Arca ([email protected]) on 2019-07-17T17:07:26Z No. of bitstreams: 1 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2019-07-30T16:12:46Z (GMT) No. of bitstreams: 2 Viviane Sampaio Boaventura de Oliveira Contribuição...2005.pdf: 3152851 bytes, checksum: 97d24c59da48231a35f8f7181241d3b8 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Made available in DSpace on 2019-07-30T16:12:46Z (GMT). No. of bitstreams: 2 Viviane Sampaio Boaventura de Oliveira Contribuição...2005.pdf: 3152851 bytes, checksum: 97d24c59da48231a35f8f7181241d3b8 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2005CAPESUniversidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil.Apresentamos dois trabalhos onde investigamos a leishmaniose mucosa (LM) quanto ao diagnóstico precoce e à diferenciação com outras patologias nasais. No primeiro artigo avaliou-se a mucosa nasal de pacientes com leishmaniose cutânea (LC) primária em atividade, buscando diagnóstico precoce de lesão metastática. Por 18 meses foi realizado exame otorrinolaringológico de rotina nos pacientes com diagnóstico de LC primária no ambulatório do Centro de Referências para Doenças Endêmicas Pirajá da Silva (CERDEPS/PIEJ) - no município de Jequié-Bahia. Além da investigação clínica foram realizadas sorologia, reação intradermica de Montenegro (IDRM), biópsia com estudo anatomo-patológico, imunohistoquímica (IMH) e isolamento dos parasitas. Foram encontrados seis casos de doença mucosa e cutânea concomitantes em pacientes com LC primária em atividade. Desses, em cinco a doença estava restrita à mucosa nasal. A maioria apresentava linfadenopatia e IDRM positiva. Cinco casos foram confirmados pela histopatologia com imunohistoquímica ou pela cultura com isolamento do parasita em hamster. A avaliação da produção de citocinas sérica e in vitro, após estimulação de células mononucleares do sangue periférico com antígeno de Leishmania, mostrou não haver diferença estatisticamente significante entre os pacientes com LC e LM concomitantes e aqueles com LC localizada. A identificação de lesão mucosa em pacientes com LC primária certificou a importância da avaliação clínica rotineira da mucosa nasal. No segundo artigo, investigamos a elevada notificação de LM no estado do Acre no ano de 2002. Avaliando 44 pacientes encaminhados com suspeita de LM, verificamos que a leishmaniose foi confundida com diversas doenças da mucosa nasal, utilizando-se como critérios diagnósticos apenas a história clínica e a IDRM. Pelo exame otorrinolaringológico foi possível afastar a suspeita de LM ativa ou cicatrizada em 31 pacientes. Foram realizadas oito biópsias de lesão mucosa. Seis casos de LM foram confirmados pela anatomia patológica com IMH e dez pelo PCR (polimerase chain reaction), cuja sensibilidade foi de 100 por cento. Os erros diagnósticos levaram ao tratamento inadequado com glucantime de pacientes sem LM e o retardo do diagnóstico de outras patologias nasais além do tratamento incorreto de formas clínicas mais graves da LM. Os trabalhos evidenciaram a importância da participação de um otorrinolaringologista na avaliação clínica rotineira de pacientes com leishmaniose na área endêmica.This dissertation deals with the role of the otorhinolaryngological (ENT) examination in the diagnosis of human mucosal leishmaniasis (ML) and is presented as two manuscripts. The first report deals with the early detection of ML in patients with cutaneous leishmaniasis (CL). Our hypothesis was that mucosal lesions establish early in the course of CL. For a period of 18 months, 220 patients with suspected clinically active primary CL who seek medical care at the Centro de Referência para Doenças Regionais Pirajá da Silva (CERDEPS/PIEJ) were enrolled in the study. Patients were submitted to routine ENT examination, Leishmania serology, Montenegro skin test, evaluation of anti-leishmania in vitro cell-mediated immune response, determination of serum cytokine levels, histopathologic and immunohistochemistry exam and parasite isolation. All 220 cases had their CL diagnosis confirmed and six of them also had mucosal lesions, confirming the existence of concomitant LC and LM. Leishmania was isolated in five out of the six cases. Five patients with concomitant lesions had nasal- restricted mucosal lesions. Cell-mediated immune responses and serum cytokine levels did not differ between patients with concomitant LC and LM from those with CL. The rate of concomitant LC and LM is similar to the rate of ML in this endemic area, reinforcing the need of a careful ENT examination during the initial diagnosis of CL patients as an early detection of mucosal involvement may help reducing disfiguring mucosal lesions later on. The second report deals with practical difficulties in the diagnosis of ML in an endemic area. An extremely elevated rate of ML diagnosis had been reported from Acre in 2002 where diagnosis had been based on history and a positive result on MST. Our hypothesis was that other pathologies with nasal involvement was being misdiagnosed as ML, as a positive MST resulted could be due to previous CL. A careful ENT examination with nasal and laryngeal endoscopy was performed in 44 patients suspected ML patients, and 31 of them proved to have other diseases with nasal involvement. ML was confirmed in all of the other 13 cases by serology, histopathology and immunohistochemistry and/or PCR. The manuscript stresses the importance of a careful ENT examination, when possible combined with methods of in situ Leishmania detection, in the diagnosis of ML in the endemic areas

Métodos diagnósticos da Leishmaniose Tegumentar: fatos, falácias e perspectivas

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-05-13T13:06:49Z No. of bitstreams: 1 Andrade BB Métodos diagnósticos....pdf: 96960 bytes, checksum: a21ff4ad1e542a2997db85622122bda7 (MD5)Made available in DSpace on 2014-05-13T13:06:49Z (GMT). No. of bitstreams: 1 Andrade BB Métodos diagnósticos....pdf: 96960 bytes, checksum: a21ff4ad1e542a2997db85622122bda7 (MD5) Previous issue date: 2005Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil / Instituto de Investigação em Imunologia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil / Instituto de Investigação em Imunologia. Salvador, BA, BrasilPesquisas clínicas e laboratoriais recentes têm atentado para os aspectos individuais, entomológicos e epidemiológicos das diferentes manifestações clínicas da leishmaniose tegumentar. Nas áreas endêmicas, o diagnóstico ideal deve ser realizado na fase inicial da apresentação clínica, para evitar as complicações da doença cônica. A escassez de suporte financeiro, estrutura laboratorial e pessoal especializado representam obstáculos importantes para esta realidade. Investigações diagnósticas tradicionais para casos individuais incluem a pesquisa de uma história sugestiva e características clínicas, a identificação de amastigotas através da histologia ou microscopia direta e testes sorológicos. O diagnóstico através da reação de polimerase em cadeia (PCR) parece representar uma técnica inovadora, tornando possível a rápida identificação de espécies e subespécies. A proposta desta revisão é discutir algumas das mais importantes questões do diagnóstico clínico e laboratorial da leishmaniose tegumentar. A sensibilidade e especificidade dos velhos e novos testes para identificar o parasita, produtos antigênicos, a resposta imunológica do hospedeiro e o diagnóstico molecular por PCR são considerados.Recent clinical and laboratory research has addressed the individual, entomological, and epidemiological aspects of different clinical manifestations of tegumentary leishmaniasis. In endemic areas, diagnosis should ideally be made during the initial phase of the clinical presentation of the disease to preclude complications of chronic disease. The scarcity of financial support, laboratory installations and qualified personnel represent important obstacles to achieving this goal. Traditional diagnostic tools for individual cases include the search for suggestive clinical history and features, the identification of amastigotes by histology or direct microscopy, and serologic tests. Polymerase chain reaction (PCR) seems to represent an innovative diagnostic technique, enabling the fast identification of Leishmania species and subspecies. The purpose of this review is to discuss some of the more important issues related to the clinical and laboratory diagnosis of tegumentary leishmaniasis. The sensitivity and specificity of both old and novel tests used to identify the parasite, antigenic products, the host immune response, and the molecular diagnosis by PCR are all discussed in this paper

Analysis of theoretical knowledge and the practice of science among Brazilian otorhinolaryngologists

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-02-21T13:59:45Z No. of bitstreams: 1 Mendonça V R R Analysis of theoretical....pdf: 368621 bytes, checksum: ceefb350df3734ef6175b309e60bfc83 (MD5)Made available in DSpace on 2014-02-21T13:59:45Z (GMT). No. of bitstreams: 1 Mendonça V R R Analysis of theoretical....pdf: 368621 bytes, checksum: ceefb350df3734ef6175b309e60bfc83 (MD5) Previous issue date: 2013PHD StudentHospital Santa Izabel. Santa Casa de Misericórdia da Bahia. Salvador, BA, BrasilHospital Santa Izabel. Santa Casa de Misericórdia da Bahia. Salvador, BA, BrasilNational Institutes of Health. National Institute of Allergy and Infectious Diseases. Laboratory of Parasitic Diseases. Clinical Research Fellow.Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Federal University of Bahia. School of Medicine. Department of Pathology. Salvador, BA, BrasilHospital Santa Izabel. Salvador, BA, Brasil / Federal University of Bahia. School of Medicine. Department of Pathology. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilPhysicians from all medical specialties are required to understand the principles of science and to interpret medical literature. Yet, the levels of theoretical and practical knowledge held by Brazilian otorhinolaryngologists has not been evaluated to date. OBJECTIVE: To assess the background and level of scientific knowledge of Brazilian otorhinolaryngologists. METHOD: Participants of two national ENT meetings were invited to answer a questionnaire to assess scientific practice and knowledge. RESULTS AND CONCLUSION: This study included 73 medical doctors (52% otorhinolaryngologists and 38% residents) aged between 18 and 65 years. About two-thirds have been involved in some form of scientific activity during undergraduate education and/or reported to have written at least one scientific paper. Physicians who took part in research projects felt better prepared to interpret scientific papers and carry out research projects (p = 0.0103 and p = 0.0240, respectively). Respondents who claimed to have participated in research or to have written papers had higher scores on theoretical scientific concepts (p = 0.0101 and p = 0.0103, respectively). However, the overall rate of right answers on questions regarding scientific knowledge was 46.1%. Therefore, a deficiency was observed in the scientific education of Brazilian otorhinolaryngologists. Such deficiency may be mitigated through participation in research

Short Report: The Value of the Otorhinolaryngologic Exam in Correct Mucocutaneous Leishmaniasis Diagnosis

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2016-07-05T18:12:35Z No. of bitstreams: 1 Boaventura VS The value of the....pdf: 422333 bytes, checksum: 795045068d98af8a24763b1f9225a432 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2016-07-05T18:27:12Z (GMT) No. of bitstreams: 1 Boaventura VS The value of the....pdf: 422333 bytes, checksum: 795045068d98af8a24763b1f9225a432 (MD5)Made available in DSpace on 2016-07-05T18:27:12Z (GMT). No. of bitstreams: 1 Boaventura VS The value of the....pdf: 422333 bytes, checksum: 795045068d98af8a24763b1f9225a432 (MD5) Previous issue date: 2009Made available in DSpace on 2016-07-07T19:04:19Z (GMT). No. of bitstreams: 3 Boaventura VS The value of the....pdf.txt: 14873 bytes, checksum: 9c7b2055d43ab877aa03d147c9b19a46 (MD5) Boaventura VS The value of the....pdf: 422333 bytes, checksum: 795045068d98af8a24763b1f9225a432 (MD5) license.txt: 2991 bytes, checksum: 5a560609d32a3863062d77ff32785d58 (MD5) Previous issue date: 2009Fundação Gonçalo Moniz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Hospitalar do Acre. Fundhacre. Rio Branco, BrasilFundação Gonçalo Moniz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Gonçalo Moniz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Gonçalo Moniz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Gonçalo Moniz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil / Instituto de Investigação em Imunologia. Salvador, BA, BrasilFundação Gonçalo Moniz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, BrasilAn increase in mucocutaneous leishmaniasis (ML) cases in northern (Brazil) motivated this study. In 44 ML patients with clinical diagnosis, only 13 parasitologically confirmed cases exhibited mucosal lesion suggestive of ML. Other conditions involving nasal manifestations are frequently confounded with ML. Therefore, otorhinolaryngologic examination is important in the clinical management of ML

The Value of the otorhinolaryngologic exam in correct mucocutaneous leishmaniasis diagnosis

Submitted by Martha Silveira Berbert ([email protected]) on 2011-04-25T18:53:48Z No. of bitstreams: 1 The Value of the Otorhinolaryngologic Exam.pdf: 422333 bytes, checksum: 795045068d98af8a24763b1f9225a432 (MD5)Made available in DSpace on 2011-04-25T18:53:48Z (GMT). No. of bitstreams: 1 The Value of the Otorhinolaryngologic Exam.pdf: 422333 bytes, checksum: 795045068d98af8a24763b1f9225a432 (MD5) Previous issue date: 2009Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Hospitalar do Acre. Rio Branco, AC, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilAn increase in mucocutaneous leishmaniasis (ML) cases in northern (Brazil) motivated this study. In 44 ML patients with clinical diagnosis, only 13 parasitologically confirmed cases exhibited mucosal lesion suggestive of ML. Other conditions involving nasal manifestations are frequently confounded with ML. Therefore, otorhinolaryngologic examination is important in the clinical management of M

Towards a more precise serological diagnosis of human tegumentary leishmaniasis using Leishmania recombinant proteins

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-02-18T17:26:09Z No. of bitstreams: 1 Souza A P Towards a More....pdf: 2199911 bytes, checksum: 8ed1ae72e2ffbdbee4e84caf43d409c5 (MD5)Made available in DSpace on 2014-02-18T17:26:09Z (GMT). No. of bitstreams: 1 Souza A P Towards a More....pdf: 2199911 bytes, checksum: 8ed1ae72e2ffbdbee4e84caf43d409c5 (MD5) Previous issue date: 2013Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilUniversidad Autónoma de Madrid. Departamento de Biología Molecular. Centro de Biología Molecular Severo Ochoa. Madrid, SpainFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT). Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT). Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT). Salvador, BA, BrasilBACKGROUND: Exposure to Leishmania induces a humoral immune response that can be used as a marker of parasite exposure. METHODOLOGY/PRINCIPAL FINDINGS: Herein, ELISA was used to screen sera from patients with Tegumentary Leishmaniasis (TL) against different L. infantum-chagasi-derived recombinant proteins (rHSP70, rH2A, rH2B, rH3, rH4 and rKMP11). Among the recombinant proteins, rHSP70 and rH2A showed the best reactivity against human sera obtained from endemic areas of TL. Receiver-Operator Characteristics (ROC) curve analysis was used to identify the effectiveness of these proteins for serodiagnosis of TL. ROC curves confirmed the superior performance of rHSP70 and rH2A, in comparison to the other tested recombinant proteins. Additionally, we evaluated the specificity of the response to rHSP70 and rH2A by testing sera obtained from patients with Chagas' disease, Tuberculosis, Leprosy or Systemic Lupus Erythematosus. In this case, rHSP70 displayed an increased ability to discriminate diseases, in comparison to SLA. CONCLUSION: Our results raise possibility of using rHSP70 for the serodiagnosis of TL

Integrated Analysis Reveals That miR-193b, miR-671, and TREM-1 Correlate With a Good Response to Treatment of Human Localized Cutaneous Leishmaniasis Caused by Leishmania braziliensis

Localized cutaneous leishmaniasis (LCL) is a chronic disease characterized by ulcerated skin lesion(s) and uncontrolled inflammation. The mechanisms underlying the pathogenesis of LCL are not completely understood, and little is known about posttranscriptional regulation during LCL. MicroRNAs (miRNAs) are non-coding small RNAs that regulate gene expression and can be implicated in the pathogenesis of LCL. We investigated the involvement of miRNAs and their targets genes in human LCL using publicly available transcriptome data sets followed by ex vivo validation. Initial analysis highlighted that miRNA expression is altered during LCL, as patients clustered separately from controls. Joint analysis identified eight high confidence miRNAs that had altered expression (−1.5 ≤ fold change ≥ 1.5; p < 0.05) between cutaneous ulcers and uninfected skin. We found that the expression of miR-193b and miR-671 are greatly associated with their target genes, CD40 and TNFR, indicating the important role of these miRNAs in the expression of genes related to the inflammatory response observed in LCL. In addition, network analysis revealed that miR-193b, miR-671, and TREM1 correlate only in patients who show faster wound healing (up to 59 days) and not in patients who require longer cure times (more than 60 days). Given that these miRNAs are associated with control of inflammation and healing time, our findings reveal that they might influence the pathogenesis and prognosis of LCL

Short Report: concomitant early mucosal and cutaneous leishmaniasis in Brazil

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-06-27T16:21:28Z No. of bitstreams: 1 Boaventura, V Concomitant early....pdf: 74899 bytes, checksum: 38e7beab15a145822a919addd53e5801 (MD5)Made available in DSpace on 2014-06-27T16:21:28Z (GMT). No. of bitstreams: 1 Boaventura, V Concomitant early....pdf: 74899 bytes, checksum: 38e7beab15a145822a919addd53e5801 (MD5) Previous issue date: 2006Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilMucosal leishmaniasis (ML) is often clinically silent until reaching a highly advanced state. In this prospective study, 6 of 220 patients with early cutaneous leishmaniasis were diagnosed with mucosal involvement by otorhinolaryngological examination (a rate similar to the reported rate of late ML). Detection of early ML may represent an important strategy in preventing severe mucosal destruction in human leishmaniasis