Mucosal leishmaniasis: Quantitative nasal cytology as a marker of disease activity and indicator of healing

Mucosal leishmaniasis (ML) follow-up is based on subjective parameters. Usi ng simplified quantitative cytology of nasal lavages (QNCs). we studied 20 ML patients, 10 patients with cutaneous leishmaniasis (CL), and 10 healthy subjects. Patients with ML were treated with antimony and followed up with otolaryngological examination plus QNCs for 6 months. At the first evaluati on, the median total number of,cells in ML patients (1,540,000) was greater than that in CL patients (215,000) or that in healthy subjects (250,000). Neutrophils were predominant in ML patients, in contrast to both sets of co ntrols? in whom epithelial cells were more frequent. During treatment, we f ound a significant reduction in total nasal cell counts in ML patients who were cured, and encountered a switch in predominant cell type. The cytology of 2 patients who did not respond to antimony remained the same. It is the refore possible to detect nasal inflammation in ML patients through QNCs, w hich may indicate extension of mucosal involvement, providing an objective parameter to monitor therapy.