Abstract

Abderrazzak Atir*, Ryad El Otmani, Malak Daoudi, Amina Benouda, Hamid Benziane

ABSTRACT

Background: Cutaneous leishmaniasis is a vector-borne protozoal infection with a broad clinical spectrum and may resemble bacterial, inflammatory, fungal, or neoplastic skin disease. Travel history can support diagnostic suspicion, but the site of acquisition should not be assigned solely from travel chronology when parasite speciation is unavailable. Case presentation: A 14-year-old Moroccan adolescent presented with a persistent facial lesion on the right cheek that had developed after travel to Qatar. The lesion had been present for approximately eight months and had not improved despite self-medication with antibiotics. Examination showed a well-demarcated, indurated, painless nodular plaque approximately 21 mm in diameter, surrounded by a pruritic erythematous halo. Direct microscopy of lesional material stained with May-Grünwald-Giemsa demonstrated intracellular amastigote forms morphologically consistent with Leishmania spp. within macrophages, establishing the diagnosis of cutaneous leishmaniasis. The patient received intralesional meglumine antimoniate twice weekly for one month, followed by progressive clinical improvement. Conclusion: Cutaneous leishmaniasis should be considered in any chronic non-healing skin lesion, particularly after failure of empirical antibacterial therapy and in the presence of relevant travel or exposure history. Direct microscopy remains a useful first-line parasitological method, while species identification by molecular testing should be pursued when available to strengthen epidemiological interpretation and guide management in selected cases.