Eholié S P, Tanon A K, Folquet-Amorissani M, Doukouré B, Adoubryn K D, Yattara A, Bissagnéné E
Service des maladies infectieuses et tropicales, BP V 3, CHU Treichville, Abidjan, Côte d'Ivoire.
Bull Soc Pathol Exot. 2008 Feb;101(1):60-1.
The objective of this work is to report three cases of visceral leishmaniasis in non-HIV infected native patients in Côte d'Ivoire. The three observations concerned adults aged of 31 and 65 and a five years old child without particular medical or surgery histories. Factors associated with visceral leishmaniasis regarding the younger and the older adults were respectively young age, chronic lymphoid leukaemia and Burkitt lymphoma. Clinical features in the three cases were chronic fever a myeloproliferative syndrome with wasting syndrome and pancytopenia. The diagnosis was confirmed by the existence of Leishmania in bone marrow, ganglionic juice and splenic samples. The species of Leishmania was not identified. Specific treatment was based on intravenous amphotericin B (Fungizone) relayed by Glucantim in one case because of side effects; however the treatment has been unsuccessful. These three new cases show that visceral leishmaniasis is a reality in Côte d'Ivoire therefore an epidemiological survey is requested in order to identify Leishmania species, reservoirs and vectors.
这项工作的目的是报告科特迪瓦非艾滋病毒感染的本地患者中三例内脏利什曼病病例。这三例病例涉及31岁和65岁的成年人以及一名5岁儿童,他们均无特殊的病史或手术史。与年轻和年长成人内脏利什曼病相关的因素分别为年轻、慢性淋巴细胞白血病和伯基特淋巴瘤。这三例病例的临床特征为长期发热、伴有消瘦综合征和全血细胞减少的骨髓增殖综合征。通过在骨髓、淋巴结液和脾脏样本中发现利什曼原虫确诊。未鉴定出利什曼原虫的种类。因出现副作用,其中一例的特异性治疗基于静脉注射两性霉素B(氟康唑)后改用葡醛内酯;然而治疗未成功。这三例新病例表明,内脏利什曼病在科特迪瓦确实存在,因此需要进行流行病学调查,以确定利什曼原虫的种类、宿主和传播媒介。