Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Am J Trop Med Hyg. 2010 Jan;82(1):4-8. doi: 10.4269/ajtmh.2010.09-0434.
We report a case of visceral leishmaniasis in a human immunodeficiency virus (HIV)-infected 37-year-old Thai fisherman who presented with nephritonephrotic syndrome, fever, anemia, and thrombocytopenia. Bone marrow biopsy revealed many amastigotes within macrophages. Kidney biopsy showed membranoproliferative glomerulonephritis. Polymerase chain reaction (PCR) and nucleotide sequence analysis of the internal transcribed spacer 1 of the small subunit ribosomal RNA gene in blood and kidney biopsy specimens showed Leishmania species previously described in a Thai patient with visceral leishmaniasis. Only four autochthonous cases of leishmaniasis have been reported in Thailand since 1996. To the best of our knowledge, this is the first report of autochthonous visceral leishmaniasis in an HIV-infected Thai. With an increasing number of patients with autochthonous leishmaniasis in association with the presence of potential vector, it remains to be determined whether this vector-borne disease will become an emerging infectious disease in Thailand.
我们报告了一例内脏利什曼病（HIV）感染的 37 岁泰国渔民，他表现为肾病综合征、发热、贫血和血小板减少。骨髓活检显示巨噬细胞内有许多无鞭毛体。肾活检显示膜增生性肾小球肾炎。血液和肾活检标本小亚单位核糖体 RNA 基因内转录间隔区 1 的聚合酶链反应（PCR）和核苷酸序列分析显示，此前在一名患有内脏利什曼病的泰国患者中发现了利什曼物种。自 1996 年以来，泰国仅报告了四起地方性利什曼病病例。据我们所知，这是首例在 HIV 感染的泰国人身上发生的地方性内脏利什曼病。随着越来越多的与潜在媒介相关的本地利什曼病患者，这种媒介传播的疾病是否会成为泰国的一种新发传染病仍有待确定。
