苏丹皮肤利什曼病的罕见临床表现。
Uncommon clinical presentations of cutaneous leishmaniasis in Sudan.
作者信息
Elamin E M, Guerbouj S, Musa A M, Guizani I, Khalil E A G, Mukhtar M M, Elkadaro A M Y, Mohamed H S, Ibrahim M E, Abdel Hamid M M, El Azhari M, El Hassan A M
机构信息
Institute of Endemic Diseases, University of Khartoum, P.O. Box 11463, Khartoum, Sudan.
出版信息
Trans R Soc Trop Med Hyg. 2005 Nov;99(11):803-8. doi: 10.1016/j.trstmh.2005.04.009.
Cutaneous leishmaniasis in Sudan is caused by Leishmania major zymodeme LON1. Self-healing usually occurs within 1 year but occasionally its duration is prolonged and treatment is required. The clinical forms are ulcers, nodules and noduloulcerative lesions. Here we describe seven patients with uncommon lesions that were difficult to recognize as Leishmania infections. These included mycetoma-like lesions, lesions that resembled L. tropica infection and others. One HIV/AIDS patient had Kaposi's sarcoma with Leishmania parasites in the Kaposi lesions. Most of these uncommon clinical forms were difficult to treat. The diagnosis depended on a high degree of suspicion and the demonstration of parasites in smears or culture. PCR was used to characterize parasites from the patients described here. Leishmania major was found by kDNA PCR in all patients, except one, who had a leishmanioma due to L. donovani. In three patients, including one with a L. tropica like-lesion, the parasites were confirmed as L. major by gp63 PCR-RFLP.
苏丹的皮肤利什曼病由硕大利什曼原虫酶谱型LON1引起。通常在1年内自愈，但偶尔病程会延长，需要进行治疗。临床症状包括溃疡、结节和结节溃疡性病变。在此，我们描述了7例具有不常见病变的患者，这些病变难以被识别为利什曼原虫感染。其中包括足菌肿样病变、类似热带利什曼原虫感染的病变等。1例艾滋病毒/艾滋病患者患有卡波西肉瘤，在卡波西病变中有利什曼原虫寄生虫。这些不常见的临床症状大多难以治疗。诊断依赖于高度的怀疑以及在涂片或培养物中发现寄生虫。采用聚合酶链反应（PCR）对本文所述患者的寄生虫进行特征分析。除1例因杜氏利什曼原虫导致利什曼瘤的患者外，所有患者通过kDNA PCR均检测到硕大利什曼原虫。在3例患者中（包括1例有类似热带利什曼原虫病变的患者），通过gp63 PCR-RFLP证实寄生虫为硕大利什曼原虫。
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