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在一名免疫功能正常患者的喉部组织中检测到婴儿利什曼原虫动基体DNA。

Detection of Leishmania infantum kinetoplast DNA in laryngeal tissue from an immunocompetent patient.

作者信息

Guddo Francesca, Gallo Elena, Cillari Enrico, La Rocca Anton Maria, Moceo Piero, Leslie Kevin, Colby Thomas, Rizzo Aroldo G

机构信息

Unità Operativa di Anatomia ed Istologia Patologica, Ospedale V. Cervello, Palermo 90148, Italy.

出版信息

Hum Pathol. 2005 Oct;36(10):1140-2. doi: 10.1016/j.humpath.2005.07.006. Epub 2005 Sep 6.

Abstract

Mucosal leishmaniasis of the upper respiratory tract is usually associated with the visceral form or is found in immunosuppressed individuals. This report presents a case of isolated mucosal leishmaniasis in an immunocompetent patient, whose diagnosis mainly rested on histology and positive polymerase chain reaction result for Leishmania donovani in the laryngeal tissue. A 59-year-old man, who never lived outside Italy, showed a subglottic mucosal polypoid-like lesion. The typical morphological picture and positive polymerase chain reaction result for L donovani by DNA extracted from laryngeal biopsy specimens allowed the diagnosis of mucosal leishmaniasis. Specific amphotericin B therapy was started, resulting in clinical and endoscopic improvement. Increased knowledge about the histological and molecular tissue analysis of Leishmania enhances the diagnostic testing for mucosal leishmaniasis, as primary mucosal leishmaniasis may occur in both immunosuppresed and immunocompetent patients who travel to or reside in areas endemic for Leishmania.

摘要

上呼吸道黏膜利什曼病通常与内脏型利什曼病相关,或见于免疫抑制个体。本报告介绍了一例免疫功能正常患者的孤立性黏膜利什曼病病例,其诊断主要基于组织学检查以及喉组织中杜氏利什曼原虫聚合酶链反应结果呈阳性。一名59岁从未离开过意大利的男性,出现了声门下黏膜息肉样病变。从喉活检标本中提取的DNA对杜氏利什曼原虫进行典型形态学观察及聚合酶链反应结果呈阳性,从而确诊为黏膜利什曼病。开始使用特异性两性霉素B治疗,临床及内镜检查结果均有改善。随着对利什曼原虫组织学和分子组织分析的认识增加,黏膜利什曼病的诊断检测得到了加强,因为原发性黏膜利什曼病可能发生在前往或居住在利什曼病流行地区的免疫抑制和免疫功能正常的患者中。

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