Hamilton Alexander, Kelleher Anthony, Marriott Debbie
St Vincent's Hospital, Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2009.2036. Epub 2009 Sep 1.
Visceral leishmaniasis is rare in the developed world, particularly in immunocompetent hosts. It must be considered, however, in patients who are unwell, febrile and unresponsive to conventional antibiotics with a history of travel to areas where leishmaniasis is endemic. A case of more severe clinical manifestations than have been previously reported in Australia is presented here. The recent introduction of PCR technology for the detection of Leishmania in Australia has improved the diagnosis and management of leishmaniasis. Treatment with liposomal amphotericin B proved to be very effective in this severe case of visceral leishmaniasis.
内脏利什曼病在发达国家较为罕见，尤其是在免疫功能正常的宿主中。然而，对于那些身体不适、发热且对传统抗生素无反应，并有前往利什曼病流行地区旅行史的患者，必须考虑该病。本文报告了一例临床表现比澳大利亚此前报道的更为严重的病例。澳大利亚最近引入的用于检测利什曼原虫的PCR技术改善了利什曼病的诊断和管理。在这例严重的内脏利什曼病病例中，脂质体两性霉素B治疗被证明非常有效。
