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输血传播的利什曼病:一例病例报告及文献综述

Transfusion transmitted leishmaniasis: a case report and review of literature.

作者信息

Dey A, Singh S

机构信息

Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi - 110 029, India.

出版信息

Indian J Med Microbiol. 2006 Jul;24(3):165-70.

Abstract

Leishmaniasis is caused by the infection of haemoparasite Leishmania . The disease is a major public health problem in at least 88 countries, including India. Various species of Leishmania are involved in causing this disease. In India, Leishmania donovani species causes visceral leishmaniasis or kala-azar. The parasite is mainly transmitted from infected to uninfected person through the bites of female sandfly. Rarely the parasite can transmit through placenta from mother to child, through sexual intercourse, as laboratory acquired and through blood transfusion. This paper reports a unique case of transfusion-transmitted fatal kala-azar in an Indian infant who acquired this infection within few days of his birth after receiving blood from his maternal uncle, who was asymptomatic at the time of blood donation but died due to severe kala-azar within three months. The baby started having fever and developed hepatosplenomegaly within one month of blood transfusion and in spite of repeated anti-leishmanial treatment with sodium antimony gluconate the child died at the age of 7 months. This paper details the clinico-pathological findings of this child and also reviews the literature on this aspect and its impact on transfusion medicine.

摘要

利什曼病由血液寄生虫利什曼原虫感染引起。该疾病是包括印度在内的至少88个国家的主要公共卫生问题。多种利什曼原虫参与引发此疾病。在印度,杜氏利什曼原虫导致内脏利什曼病或黑热病。该寄生虫主要通过雌性白蛉叮咬从感染者传播至未感染者。极少数情况下,寄生虫可通过胎盘从母亲传给孩子、通过性行为、实验室感染及输血传播。本文报告了一例印度婴儿因输血感染致命黑热病的独特病例,该婴儿在出生后几天接受其舅舅的血液后感染此病,其舅舅献血时无症状,但在三个月内死于严重黑热病。婴儿在输血后一个月开始发烧并出现肝脾肿大,尽管多次用葡萄糖酸锑钠进行抗利什曼原虫治疗,该儿童仍在7个月大时死亡。本文详述了该患儿的临床病理发现,并回顾了这方面的文献及其对输血医学的影响。

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