Fenske S, Stellbrink H J, Albrecht H, Greten H
Medizinische Kernklinik und Poliklinik, Universitätskrankenhaus Eppendorf, Hamburg.
Klin Wochenschr. 1991 Oct 31;69(17):793-6. doi: 10.1007/BF01744270.
We report the case of 43-year-old homosexual patient with HIV infection and a history of travel to the Far East in whom visceral leishmaniasis was the first infectious complication. Symptoms were fever, malaise, weight loss, hepatosplenomegaly, generalized lymphadenopathy, and oral thrush. Laboratory abnormalities included a slight elevation of liver enzymes, impairment of liver function tests, leukocytopenia, anemia, hypergammaglobulinemia, and markedly depressed CD4(+)-cell counts. Despite initially successful treatment with pentavalent antimony, a relapse of leishmaniasis occurred after 7 months. Eradication of the infection was not achieved. Treatment was continued as a palliative chronic suppressive treatment with fortnightly pentamidine infusions. The clinical course was complicated by legionella pneumonia and the development of rapidly progressing Kaposi's sarcoma. The case is presented in detail, and the influence of HIV infection on the course of leishmaniasis is discussed.
我们报告了一例43岁的同性恋HIV感染患者，该患者有前往远东地区旅行的经历，内脏利什曼病是其首个感染并发症。症状包括发热、不适、体重减轻、肝脾肿大、全身淋巴结肿大和口腔念珠菌病。实验室检查异常包括肝酶轻度升高、肝功能试验受损、白细胞减少、贫血、高球蛋白血症以及CD4(+)细胞计数显著降低。尽管最初使用五价锑治疗成功，但7个月后利什曼病复发，感染未被根除。随后继续采用姑息性慢性抑制治疗，每两周输注喷他脒。临床过程因军团菌肺炎和快速进展的卡波西肉瘤而复杂化。本文详细介绍了该病例，并讨论了HIV感染对利什曼病病程的影响。
