Lessa et al reported a clinical staging system for mucosal leishmaniasis. The stages are useful for characterizing the severity of the infection and to optimize therapeutic outcomes. The authors are from Universidade Federal da Bahia in Brazil.
Patient selection: mucosal leishmaniasis
Mucosal Lesions
Ulcerations
Nasal Septum
Stage
nodular
none
intact
I
present
superficial with fine granular lesions
intact
II
present
deep with granulation tissue
thickened, bloody crust
III
NA
NA
perforation of cartilaginous nasal septum with necrosis
IV
NA
NA
severe destruction with compromised nasal pyramid, altered facial structure
V
Stage I patients may be asymptomatic or have mild symptoms like non-bloody rhinorrhea.
Stage II patients may have bloody rhinorrhea or nasal obstruction.
Stage III patients may have nasal pain, bloody rhinorrhea, discharge of blood clots and/or nasal obstruction.
In theory there could be a Stage 0 without obvious mucosal nodules.
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