Milián M A, Bagán J V, Jiménez Y, Pérez A, Scully C
Valencia University, Spain.
Oral Dis. 2002 Jan;8(1):59-61. doi: 10.1034/j.1601-0825.2002.1c666.x.
Leishmaniasis is a parasitic disease caused by a protozoon (Leishmania), with different clinical forms that are endemic in certain countries. The association of this disease in patients who are seropositive to human immunodeficiency virus (HIV) has recently been described. Leishmaniasis can develop in any stage of HIV infection, although the clinical manifestations - and hence the diagnosis - tend to coincide with the periods of maximum immune depression. We present the case of a HIV-positive, ex-intravenous drug abuser (in stage B2 of the CDC, 1992) with concomitant hepatitis C infection who presented with palatinal pain and bleeding for the past 2 months. Exploration revealed a vegetating tumoration of the hard palate. Hematoxylin-eosin and Giemsa staining of the biopsy confirmed the diagnosis of leishmaniasis. The definitive diagnosis was mucocutaneous leishmaniasis (MCL), for a bone marrow aspirate proved negative, and no further lesions could be established. The patient was treated with meglumine antimoniate (Glucantime), followed by improvement of the lesions.
利什曼病是一种由原生动物（利什曼原虫）引起的寄生虫病，有不同的临床形式，在某些国家呈地方流行。最近已描述了这种疾病在人类免疫缺陷病毒（HIV）血清学阳性患者中的关联情况。利什曼病可在HIV感染的任何阶段发生，尽管临床表现——以及因此的诊断——往往与免疫抑制最严重的时期相符。我们报告一例HIV阳性的前静脉吸毒者（处于疾病控制中心1992年B2期），同时合并丙型肝炎感染，在过去2个月出现腭部疼痛和出血。检查发现硬腭有赘生性肿物。活检的苏木精-伊红和吉姆萨染色确诊为利什曼病。最终诊断为黏膜皮肤利什曼病（MCL），因为骨髓穿刺检查结果为阴性，且未发现其他病变。患者接受葡甲胺锑酸盐（葡糖胺锑）治疗，随后病变有所改善。
