Khorvash Farzin, Naeini Alireza Emami, Behjati Mohaddeseh, Abdi Fatemeh
Associate Professor, Infectious Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2011 Nov;16(11):1507-10.
We report a case of visceral leishmaniasis (VL) in a patient from Shush in Iran with cutaneous lesions, negative for Leishman-Donovan bodies, enlarged spleen filled by leishmania protozoa and negative immunological test. The patient was a 26-year-old male, who attended hospital with fever and two deep purulent lesions on the distal part of his left leg. On physical examination, the patient had splenomegaly. Laboratory results were as follows: pancytopenia, positive C-reactive protein (CRP), elevated erythrocyte sedimentation rate (ESR) and lactate dehydrogenase (LDH) levels .The necessary treatment was administrated to the patient. Biopsy of lesion for Leishman-Donovan body was negative. In addition, indirect fluorescent antibody (IFA) screening for leishmaniasis was negative. Diagnostic splenectomy was performed which pathological exploration showed a bulk of leishmania protozoa in patient's spleen. Twenty days later, this patient expired.
我们报告了一例来自伊朗舒什的内脏利什曼病（VL）患者，该患者有皮肤病变，利什曼-多诺万小体检测呈阴性，脾脏肿大且充满利什曼原虫，免疫检测呈阴性。患者为一名26岁男性，因发热和左腿远端两处深部脓性病变入院。体格检查时，患者有脾肿大。实验室检查结果如下：全血细胞减少、C反应蛋白（CRP）阳性、红细胞沉降率（ESR）和乳酸脱氢酶（LDH）水平升高。对患者进行了必要的治疗。对病变进行利什曼-多诺万小体活检呈阴性。此外，利什曼病间接荧光抗体（IFA）筛查呈阴性。进行了诊断性脾切除术，病理检查显示患者脾脏中有大量利什曼原虫。二十天后，该患者死亡。
