Navin T R, Arana F E, de Mérida A M, Arana B A, Castillo A L, Silvers D N
Division of Parasitic Diseases, Centers for Disease Control, Atlanta, Georgia.
Am J Trop Med Hyg. 1990 Jan;42(1):36-42. doi: 10.4269/ajtmh.1990.42.36.
A comparison was made of methods used to diagnose suspected cutaneous leishmaniasis in Guatemala. The most sensitive method was a combination of thin smears made from superficial scrapings of the ulcers and inoculation of culture medium with either aspirates or scrapings. The diagnosis was confirmed in 252 (70%) of 362 patients. Ability to cultivate Leishmania was correlated with the concentration of amastigotes seen on thin smears. Leishmania were cultured in 42 (27%) of 153 patients with no amastigotes found in 400 oil-immersion fields and in 174 (83%) of 209 patients with at least 1 amastigote. No difference in diagnostic outcome was found when we compared smears or cultures taken from the center or the border of the ulcer or from an incision made tangential from the ulcer. We found no difference when we compared smears obtained with scalpels, capillary tubes, or dental broaches. The use of scrub brushes soaked in iodine neither decreased the rate of culturing parasites nor decreased contamination rates.
对危地马拉用于诊断疑似皮肤利什曼病的方法进行了比较。最敏感的方法是将溃疡表面刮取物制成薄涂片，并将吸出物或刮取物接种到培养基中。362例患者中有252例（70%）确诊。培养利什曼原虫的能力与薄涂片上所见无鞭毛体的浓度相关。153例患者中，42例（27%）培养出利什曼原虫，400个油镜视野中未发现无鞭毛体；209例患者中，174例（83%）培养出利什曼原虫，至少有1个无鞭毛体。比较从溃疡中心或边缘或从溃疡切向切口处获取的涂片或培养物时，诊断结果无差异。比较用手术刀、毛细管或牙钻获取的涂片时，我们未发现差异。使用浸泡在碘中的擦洗刷既未降低寄生虫培养率，也未降低污染率。
