Sener B, Ergüven S, Günalp A
Hacettepe University School of Medicine, Department of Clinical Microbiology, Ankara, Turkey.
Cent Eur J Public Health. 1999 Feb;7(1):8-9.
Leishmaniasis is an endemic, sporadic infection in many parts of the world. Turkey is geographically unique in linking Asia and Europe. Of special interest is leishmaniasis, as various forms of this disease have long been reported in the surrounding regions. Visceral and cutaneous leishmaniasis are endemic in the western and southeastern parts of Turkey, respectively. Here, we report a cutaneous and a visceral leishmaniasis case, to draw attention to the increase in the incidence of leishmaniasis in Turkey. In the patient with cutaneous leishmaniasis, the ulcerative lesion on the cheek had persisted for two months before admittance to the hospital. Direct smears prepared from this lesion were negative for leishmania amastigotes whereas the promastigote forms were maintained in NNN (Novy-MacNeal-Nicolle) medium. The second patient was hospitalized with a prediagnosis of haematological malignancy, but the smears prepared from the bone marrow aspirates revealed leishmania amastigotes and promastigotes were seen on the smears from NNN cultures. These two reports mark the importance of inoculation of the specimens to NNN medium for the recovery of the promastigote forms. Cutaneous and visceral leishmaniasis have become endemic in considerable number of foci in Turkey, possibly due to the cessation of vector control programmes and increase in the agricultural and irrigation areas. These two reports also point out the increased prevalence of leishmaniasis in Turkey after 1980's.
利什曼病在世界许多地区呈地方性、散发性感染。土耳其在连接亚洲和欧洲方面具有独特的地理位置。特别值得关注的是利什曼病，因为在其周边地区长期以来一直报告有这种疾病的各种形式。内脏利什曼病和皮肤利什曼病分别在土耳其西部和东南部呈地方性流行。在此，我们报告一例皮肤利什曼病和一例内脏利什曼病病例，以引起对土耳其利什曼病发病率上升的关注。在皮肤利什曼病患者中，脸颊上的溃疡性病变在入院前已持续两个月。从该病变制备的直接涂片未发现利什曼无鞭毛体，而前鞭毛体形式在NNN（诺维 - 麦克尼尔 - 尼科尔）培养基中得以维持。第二名患者因血液系统恶性肿瘤的初步诊断而住院，但从骨髓抽吸物制备的涂片显示有利什曼无鞭毛体，并且在NNN培养物的涂片上可见前鞭毛体。这两份报告表明将标本接种到NNN培养基中以恢复前鞭毛体形式的重要性。皮肤利什曼病和内脏利什曼病在土耳其的相当数量的疫源地已成为地方性疾病，这可能是由于病媒控制计划的停止以及农业和灌溉面积的增加。这两份报告还指出了20世纪80年代后土耳其利什曼病患病率的上升。
