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Case Records of the Massachusetts General Hospital
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Volume 352:609-615 February 10, 2005 Number 6
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Case 4-2005 — A 35-Year-Old Man with Nasal Congestion, Swelling, and Pain
Peter F. Weller, M.D., Marlene L. Durand, M.D., and Ben Z. Pilch, M.D.

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Presentation of Case

A 35-year-old man presented to the emergency department of this hospital because of nasal congestion, swelling, and pain in his right nostril.

He had been in his usual state of health until six months previously, when he noticed an ulcer inside his right nostril. Two months before the evaluation, the ulcer began to enlarge, and pain and swelling developed, associated with crusting and mild pruritus. The patient did not have fever, sweats, cough, weight loss, or exposure to tuberculosis. He had had malaria in the past. He did not smoke or drink alcohol. He was a native of Brazil; he . . . [Full Text of this Article]

Differential Diagnosis

Mucosal Leishmaniasis

Paracoccidioidomycosis

Diagnostic Testing

Clinical Diagnosis

Dr. Peter F. Weller's Diagnosis

Pathological Discussion

Discussion of Management

Anatomical Diagnosis


Source Information

From the Division of Infectious Diseases and the Division of Allergy and Inflammation, Beth Israel Deaconess Medical Center (P.F.W.); the Infectious Disease Unit, Massachusetts General Hospital, and the Infectious Disease Service, Massachusetts Eye and Ear Infirmary (M.L.D.); the Department of Pathology, Massachusetts General Hospital (B.Z.P.); and the Departments of Medicine (P.F.W., M.L.D.) and Pathology (B.Z.P.), Harvard Medical School — all in Boston.


Related Letters:

Case 4-2005: Sodium Stibogluconate for Cutaneous Leishmaniasis
Hartzell J. D., Aronson N.
Extract | Full Text | PDF  
N Engl J Med 2005; 352:1929, May 5, 2005. Correspondence

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