National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria.
Pathog Glob Health. 2013 Jul;107(5):260-6. doi: 10.1179/2047773213Y.0000000101.
Visceral leishmaniasis (VL), caused by the parasite Leishmania infantum, which was once largely confined to Southern Europe is now being diagnosed throughout Northern Europe, including Great Britain. In an effort to help EU clinicians improve their diagnosis and management of VL, this paper defines clinical features typical of the disease as it presents in Bulgaria, where VL is endemic.
The list of clinical symptoms presented here was gleaned from the medical records (patient histories, epidemiological survey cards, laboratory data) of 59 Bulgarian patients with VL. This study also includes microscopic, serological, and molecular laboratory techniques.
Described and analyzed are the clinical features, diagnostic techniques, and therapeutic regimens of 59 cases--part of the total number of VL case histories (P = 120, 116 Bulgarian and 4 not Bulgarian) collected in Bulgaria over the past 24 years (1988-2011). Although all of the studied 59 cases presented with classical symptoms of VL, only in three occasions, the initial diagnosis was correct.
Left untreated, zooanthroponotic VL leads to debilitating chronic disease and even death. Yet, because VL is hard to recognize and relatively new to Northern Europe, misdiagnosis is common and treatment too often inappropriate and delayed.
内脏利什曼病（VL）由寄生虫利什曼原虫引起，过去主要局限于南欧，但现在在北欧（包括英国）也有诊断报告。为帮助欧盟临床医生提高对 VL 的诊断和管理水平，本文根据保加利亚的地方性流行情况，定义了该病的典型临床特征。
本文列出的临床症状是从 59 例保加利亚 VL 患者的病历（病史、流行病学调查卡、实验室数据）中收集的。本研究还包括显微镜检查、血清学和分子实验室技术。
对 59 例病例的临床特征、诊断技术和治疗方案进行了描述和分析，这些病例是过去 24 年（1988-2011 年）在保加利亚收集的 VL 病例总数（P = 120，116 例保加利亚病例和 4 例非保加利亚病例）的一部分。尽管所有研究的 59 例病例均表现出经典的 VL 症状，但仅有 3 例的初始诊断是正确的。
未经治疗的动物源 VL 会导致衰弱的慢性疾病，甚至死亡。然而，由于 VL 难以识别，且在北欧相对较新，因此误诊很常见，治疗往往不恰当且延迟。
