Human Mucocutaneous Leishmaniasis in Três Braços, Bahia - Brazil. an Area of Leishmania Braziliensis Braziliensis Transmission. Iii. Mucosal Disease Presentation and Initial Evolution

In an analysis o f57patients mucosaldisease was com m onestin m ales(77% ) in the third decade o flife although the age range was wide and even two children were affected A li but nine patients (16% ) had signs ofcutaneous leishmaniasis but in only 8(14% ) was this lesion active. The nose was affected in 100% o f 19patients with multiple lesions and 92% o f 38 patients with single lesions. The pharynx, palate, larynx and upper lip were affected in this order. 42% o f patients with multiple lesions had laryngeal disease and in two patients this site existed as a lone lesion. N o age difference could be discemed as to whether lesions were single or multiple. Duration o f mucosal disease was very variable fro m less than 4 months to 264 months. Only 7% developed m ucosal disease more than ten years after the cutaneous lesion. Usually patients responded to adequate antim onial treatment but there were exceptions, when amphotericin B had to be used Threepatients who refused to collaborate regarding treatment d ied Only 18% o f patients in whom measurements were made had positive fluorescent antibodies two years after treatment.