2002-2011 年伊朗西北部内脏利什曼病流行区感染利什曼原虫引起的皮肤和黑热病后皮肤利什曼病：病例系列。
Cutaneous and post kala-azar dermal leishmaniasis caused by Leishmania infantum in endemic areas of visceral leishmaniasis, northwestern Iran 2002-2011: a case series.
机构信息
Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Pathog Glob Health. 2013 Jun;107(4):194-7. doi: 10.1179/2047773213Y.0000000097.
Abstract
Visceral leishmaniasis (VL) is endemic in Northwest and southern Iran. Reports of cutaneous leishmaniasis (CL) in Northwest areas are rare, and its etiological agents are unknown. In the current study, we report six CL and two post kala-azar dermal leishmaniasis (PKDL) cases caused by Leishmania infantum from endemic areas of VL in the Northwest. Smears were made from skin lesions of 30 suspected patients in 2002-2011, and CL was determined by microscopy or culture. Leishmania spp. were identified by nested-PCR assay. The disease was confirmed in 20 out of 30 (66%) suspected patients by parasitological examinations. L. infantum was identified in eight and Leishmania major in 12 CL cases by nested-PCR. Cutaneous leishmaniasis patients infected with L. major had the history of travel to CL endemic areas. L. infantum antibodies were detected by direct agglutination test (DAT) at titers of 1:3200 in two cases with history of VL. Results of this study indicated that L. infantum is a causative agent of CL as well as PKDL in the VL endemic areas.
摘要
内脏利什曼病（VL）在伊朗西北部和南部流行。关于西北部地区皮肤利什曼病（CL）的报告很少，其病原体尚不清楚。在本研究中，我们报告了 6 例 CL 和 2 例由利什曼原虫引起的 post kala-azar 皮肤利什曼病（PKDL）病例，这些病例来自伊朗西北部 VL 的流行地区。在 2002-2011 年期间，从 30 名疑似患者的皮肤病变中制作了涂片，并通过显微镜检查或培养来确定 CL。通过巢式 PCR 检测鉴定利什曼原虫。在 30 名疑似患者中，有 20 名（66%）通过寄生虫学检查确诊。通过巢式 PCR 鉴定，8 例 CL 感染 L. infantum，12 例 CL 感染 L. major。感染 L. major 的 CL 患者有前往 CL 流行地区的旅行史。两名有 VL 病史的患者通过直接凝集试验（DAT）检测到 L. infantum 抗体，滴度为 1:3200。本研究结果表明，L. infantum 是 VL 流行地区 CL 和 PKDL 的病原体。
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