Resumen:
An 82-year-old man presented with a 1-year history of swelling of his left ear, with associated difficulty hearing. He had applied topical glucocorticoids for 4 months without response. On examination, the ear was enlarged, indurated, and erythematous (Panel A), with no associated lymphadenopathy. Biopsy revealed chronic inflammatory infiltration in the dermis, with confluent epithelioid granulomas and a lymphocytic background. High magnification showed abundant intracytoplasmic amastigotes in dermal macrophages (Panel B). Leishmania infantum was identified by means of culture and polymerase-chain-reaction assay. No visceral enlargement was noted on ultrasonography of the abdomen. The patient was treated with amphotericin B, with complete resolution of the lesion after 2 months (Panel C) and recovery of hearing loss.
