Delayed diagnosis among patients with cutaneous and mucocutaneous leishmaniasis

The diagnostic latency was defined as the number of days elapsed between the first contact with a health care provider for signs and/or symptoms referable to CL and MCL and the laboratory diagnosis of leishmaniasis. A wrong treatment for leishmaniasis before the diagnosis was defined as a treatment not recommended for the disease in accordance with the current Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH) [2]. Characteristics CL n = 21 MCL n = 5 Male gender, n (%) 12 (57.1) 4 Age, median (IQR) and range 51 (42–64) 55–76 Italian nationality, n (%) 18 (85.7) 4 Probable autochthonous infection, n (%) 15 (71.4) 4 Regions of residence in Italy, n (%) Liguria 1 (6.7) 2 Tuscany 3 (20) 0 Calabria 2 (13.3) 1 Sicily 5 (33.3) 0 Sardinia and Tuscany 1 (6.7) 1 Sicily and Liguria 2 (13.3) 0 Lombardy 1 (6.7) 0 People living with HIV, n (%) 1 (4.7) 0 Patients with iatrogenic immunosuppression, n (%) 1 (4.7) 3 Multiple lesions, n (%) 10 (47) 1 Lesions localization, n (%) Head/face 7 (33.3) 4 Superior limbs 10 (47.7) 0 Inferior limbs 7 (33.3) 0 Trunk 2 (9.5) 0 Other 0 (0) 1a Characteristics of the lesion, n (%) Erythematosus 12 (57.1) 0 Papular 2 (9.5) 0 Nodular 8 (38.1) 2 Ulcerous 9 (48.2) 2 Crusted 4 (19) 0 Other 0 (0) 2b Diagnostic analysis performed, n (%) Serology positive 6/17 (35.3) 4/5 Culture positive 2/8 (25) 0/0 PCR on cutaneous sample 10/12 (83.3) 4/4 Histology positive 16/16 (100) 5/5 Days of diagnostic latency, median (IQR) and range 189 (84–300) 151–648 Leishmania species L. major 1 (4.8) 0 L. panamensis 1 (4.8) 0 L. infantum 14 (66.6) 4 L. aethiopica/tropica 1 (4.8) 0 Unknown 4 (19) 1 Table 1 Epidemiological, clinical and laboratory features of patients with cutaneous and mucocutaneous leishmaniasis.