Ponce C, Ponce E, Morrison A, Cruz A, Kreutzer R, McMahon-Pratt D, Neva F
Central Laboratory, Ministry of Health, Honduras.
Lancet. 1991 Jan 12;337(8733):67-70. doi: 10.1016/0140-6736(91)90734-7.
During surveillance for endemic visceral leishmaniasis on an island off the Pacific coast of Honduras, an unusual form of cutaneous leishmaniasis was encountered. By clinical and laboratory criteria, 17 cases were identified over 5 months; children aged 4 to 15 years were primarily affected. Lesions were generally few in number, small, always papular, and non-ulcerative, even when present for several years. Patients with skin lesions seemed otherwise healthy and were well nourished. Montenegro skin tests with Leishmania mexicana and L major antigens were positive in 10 of 17 patients tested, and lesions from 9 patients were positive by culture. Since the summer of 1988, cases of atypical cutaneous leishmaniasis continue to occur on the island (8) as well as on the mainland of southern Honduras (23). A total of 9 parasite isolates from skin lesions, 4 from bone marrow of patients with kala-azar, and 2 from sandflies were identified as L donovani chagasi and were indistinguishable from one another by isoenzyme analysis.
在洪都拉斯太平洋沿岸一座岛屿上对内脏利什曼病进行地方病监测期间，发现了一种不寻常的皮肤利什曼病形式。根据临床和实验室标准，在5个月内确认了17例病例；主要受影响的是4至15岁的儿童。病变数量通常较少，较小，始终为丘疹状，且无溃疡，即使存在数年也是如此。有皮肤病变的患者在其他方面似乎健康且营养良好。对17例受测患者中的10例进行墨西哥利什曼原虫和大利什曼原虫抗原的蒙氏皮肤试验呈阳性，9例患者的病变通过培养呈阳性。自1988年夏季以来，该岛屿（8例）以及洪都拉斯南部大陆（23例）持续出现非典型皮肤利什曼病病例。从皮肤病变中分离出9株寄生虫，从黑热病患者的骨髓中分离出4株，从白蛉中分离出2株，均被鉴定为杜氏利什曼原虫恰加斯亚种，通过同工酶分析无法区分彼此。
