[巴西利什曼原虫：1例对脂质体两性霉素B有反应的儿科输入性病例报告]

[Leishmania braziliensis: report of a pediatric imported case with response to liposomal amphotericin B].

作者信息

Campos-Muñoz L, Quesada-Cortés A, Martín-Díaz M A, Rubio-Flores C, de Lucas-Laguna R

机构信息

Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España.

出版信息

Actas Dermosifiliogr. 2007 Jan-Feb;98(1):42-4.

PMID:17374332

Abstract

Leishmania braziliensis is the main etiologic agent of leishmaniasis in South America. A 9-year-old boy consulted for the presence of round, ulcerative lesions with raised borders that were painful and have appeared after a travel to Bolivia and Brazil. The culture for parasites showed leishmanias and the PCR was positive for L. braziliensis. The patient underwent treatment with itraconazol but due to the persistence of lesions he received liposomal amphotericin B with complete resolution of the lesions. In all lesions by L. braziliensis the treatment must be systemic due to the risk of mucosal dissemination. Liposomal amphotericin B is a convenient alternative to pentavalent antimonials given its efficacy and good tolerance.

摘要

巴西利什曼原虫是南美洲利什曼病的主要病原体。一名9岁男孩因出现圆形、边界隆起的溃疡性病变前来就诊，这些病变疼痛，且在去过玻利维亚和巴西后出现。寄生虫培养显示有利什曼原虫，聚合酶链反应检测巴西利什曼原虫呈阳性。该患者接受了伊曲康唑治疗，但由于病变持续存在，他接受了脂质体两性霉素B治疗，病变完全消退。对于所有由巴西利什曼原虫引起的病变，由于存在黏膜播散的风险，治疗必须采用全身性治疗。脂质体两性霉素B因其疗效和良好的耐受性，是五价锑剂的便捷替代药物。