Delgado Olinda, Silva Sylvia, Coraspe Virginia, Rivas Maria A, Rodriguez-Morales Alfonso J, Navarro Pedro, Franco-Paredes Carlos
Division of Immunoparasitology, Tropical Medicine Institute, Universidad Central de Venezuela, Caracas 101, Venezuela.
Travel Med Infect Dis. 2008 Nov;6(6):376-9. doi: 10.1016/j.tmaid.2008.06.012. Epub 2008 Sep 5.
Imported leishmaniasis could be defined as any case acquired outside of a defined area in which the diagnosis of leishmaniasis is made. This definition has been used for the diagnosis of disease in a patient who arrives from an endemic area and displays symptoms or seeks medical attention in a nonendemic zone. However, this phenomenon can also occur between two endemic zones.
We evaluated the epidemiologic features of imported cases of cutaneous leishmaniasis imported from Colombia into Northcentral Venezuela from 2001 to 2006. A total of 29 patients with the clinical diagnosis of cutaneous leishmaniasis arriving from Colombia were evaluated at our referral center. Different diagnostic methods were used to confirm the diagnosis (the Montenegro skin test; an indirect immunofluorescence test and smear of cutaneous lesion). Clinical and epidemiological features of cutaneous leishmaniasis among these patients were evaluated.
We identified that most identified patients were male with a mean age of 35 years (age range was 7-64); all cases were from northern departments of Colombia. These patients presented a mean clinical evolution of 3 months. Most patients presented with one cutaneous lesion (17%), which were located mostly in extremities (20%). Of the 29 patients, in 16 (55%) cutaneous leishmaniasis was confirmed by different diagnostic techniques. In 2 patients the diagnosis was made by smear. In the rest, 14 (100%) patients were positive by the Montenegro skin test and 11 (79%) were positive by the indirect immunofluorescence test (79% were positive simultaneously by both tests).
The identification of imported cutaneous leishmaniasis in our setting becomes important, given the differences in the epidemiology of the disease and the clinical severity of leishmaniasis between both zones (ecological characteristics, circulating Leishmania spp., and population characteristics) and the risk of the mucocutaneous forms of the disease.
输入性利什曼病可定义为在确诊利什曼病的特定区域之外获得的任何病例。该定义已用于对来自流行地区并在非流行区出现症状或就医的患者进行疾病诊断。然而，这种现象也可能发生在两个流行区之间。
我们评估了2001年至2006年从哥伦比亚输入委内瑞拉中北部的皮肤利什曼病输入病例的流行病学特征。共有29例来自哥伦比亚且临床诊断为皮肤利什曼病的患者在我们的转诊中心接受了评估。采用了不同的诊断方法来确诊（蒙氏皮肤试验；间接免疫荧光试验和皮肤病变涂片）。对这些患者中皮肤利什曼病的临床和流行病学特征进行了评估。
我们发现，大多数确诊患者为男性，平均年龄35岁（年龄范围为7 - 64岁）；所有病例均来自哥伦比亚北部省份。这些患者的平均临床病程为3个月。大多数患者有一处皮肤病变（17%），主要位于四肢（20%）。在29例患者中，16例（55%）通过不同诊断技术确诊为皮肤利什曼病。2例患者通过涂片确诊。其余患者中，14例（100%）蒙氏皮肤试验呈阳性，11例（79%）间接免疫荧光试验呈阳性（79%的患者两种试验同时呈阳性）。
鉴于两个地区（生态特征、流行的利什曼原虫种类和人群特征）疾病流行病学和利什曼病临床严重程度的差异以及疾病黏膜皮肤型的风险，在我们的研究环境中识别输入性皮肤利什曼病变得很重要。
