Barro-Traoré F, Preney L, Traoré A, Darie H, Tapsoba P, Bassolé A, Sawadogo S, Niamba P, Grosshans E, Geniaux M
Service de dermatologie et de vénéréologie de Ouagadougou, B.P. 3016, Ouagadougou 01, Burkina Faso.
Ann Dermatol Venereol. 2008 May;135(5):380-3. doi: 10.1016/j.annder.2007.10.005. Epub 2008 Apr 18.
Leishmaniasis covers three well-individualized clinical variants, each due to individual species found in different geographic areas. Herein we report the first case of cutaneous leishmaniasis due to Leishmania major involving bone marrow in an AIDS patient in Burkina Faso.
A 38-year-old HIV-positive man presented with generalized, copper-coloured, painless, infiltrated, itching, papulonodular lesions present over the previous 10 months. Skin biopsy confirmed the diagnosis of diffuse cutaneous leishmaniasis. The bone-marrow smear showed numerous leishmania. The culture was positive and L. major was identified. The patient was being treated with antiretroviral medication and a pentavalent antimonial compound. The disease progression consisted of attacks and remissions separated by an average of three weeks.
L. major is the Leishmania species identified in Burkina Faso. It is responsible for typical cutaneous leishmaniasis but particular clinical forms have been described in immunodeficient patients, especially with diffuse cutaneous involvement. The spread of L. major infection to bone marrow could represent a public health problem in our country, where the HIV epidemic is still not under control, and particular vigilance is thus called for.
利什曼病涵盖三种临床表现截然不同的类型，每种类型由不同地理区域发现的特定利什曼原虫物种引起。在此，我们报告布基纳法索一名艾滋病患者首例由硕大利什曼原虫引起的累及骨髓的皮肤利什曼病。
一名38岁的HIV阳性男性，在过去10个月中出现全身性、铜色、无痛、浸润性、瘙痒性丘疹结节性皮损。皮肤活检确诊为弥漫性皮肤利什曼病。骨髓涂片显示大量利什曼原虫。培养结果为阳性并鉴定出硕大利什曼原虫。该患者正在接受抗逆转录病毒药物和五价锑化合物治疗。疾病进展表现为发作与缓解交替，平均间隔三周。
硕大利什曼原虫是在布基纳法索发现的利什曼原虫物种。它可引起典型的皮肤利什曼病，但在免疫缺陷患者中已描述了特殊的临床形式，尤其是弥漫性皮肤受累的情况。在我国，HIV疫情仍未得到控制，硕大利什曼原虫感染扩散至骨髓可能成为一个公共卫生问题，因此需要格外警惕。
