Track

Abstract

Cutaneous leishmaniasis (CL) is typically endemic to regions outside the United States but increasing reports from the southern and southwestern United States suggest emerging local transmission. A 7-year-old boy from rural Arizona presented to wound care clinic with a chronic, non-healing ulcer on the knee. Despite multiple courses of antibiotics and topical antifungals, the lesion continued to progress. Eventually, tissue sampling was performed and confirmed Leishmania mexicana infection. Histopathological examination with Hematoxylin and Eosin revealed a chronic granulomatous inflammatory infiltrate extending throughout the dermis and into the subcutaneous fat. CD1A immunostaining highlighted abundant Leishmania organisms. This case highlights the importance of considering CL in non-endemic regions and obtaining a thorough history; it also underscores the diagnostic utility of an early tissue biopsy in pediatric patients with unexplained non-healing wounds, to ensure timely and accurate diagnosis and appropriate treatment initiation.