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[来自土耳其卡拉曼马拉什的两例内脏利什曼病病例]

[Two cases of visceral leishmaniasis from Kahramanmaraş, Turkey].

作者信息

Karaoğlan İlkay, Ekşi Fahriye, Haydaroğlu Şahin Handan, Pehlivan Mustafa, Tekin Şahin Sema, Keçik Boşnak Vuslat, Bilici Muhammed, Namıduru Mustafa, Karslıgil Tekin

机构信息

Gaziantep University Faculty of Medicine, Department of Infectious Diseases, Gaziantep, Turkey.

出版信息

Mikrobiyol Bul. 2015 Apr;49(2):295-8.

Abstract

Turkey is an endemic area for cutaneous leishmaniasis (CL) according to the data of World Health Organization. CL is more widely distributed in Sanliurfa region (located at south-eastern part of Anatolia) of Turkey, while visceral leishmaniasis (VL) is reported sporadically from all parts of Turkey, especially in pediatric cases. However VL has not been reported from our region yet. Here we report two cases of VL from Kahramanmaraş region (located at eastern part of South Anatolia), one of which was a 57-year-old immuncompromised patient and the other was a 18-year-old immunocompetent patient. The common symptoms of the patients were high fever, hepatosplenomegaly and pancytopenia. The diagnosis of both patients was made by demonstration of the amastigotes of parasite in Giemsa-stained smears prepared from bone marrow aspiration samples, and isolation of promastigotes from cultures in NNN medium. The isolates were identified as Leishmania donovani with PCR and sequencing methods. Both of the patients were treated successfully with liposomal amphotericin B, resulting in complete cure. In conclusion, cases with fever of unknown origin, hepatosplenomegaly, pancytopenia and hypergammaglobulinemia should be considered in terms of VL especially in Kahramanmaraş region.

摘要

根据世界卫生组织的数据,土耳其是皮肤利什曼病(CL)的流行地区。CL在土耳其的尚勒乌尔法地区(位于安纳托利亚东南部)分布更为广泛,而内脏利什曼病(VL)在土耳其各地均有零星报道,尤其是在儿科病例中。然而,我们所在地区尚未有VL的报道。在此,我们报告了来自卡拉曼马拉什地区(位于南安纳托利亚东部)的两例VL病例,其中一例是一名57岁的免疫功能低下患者,另一例是一名18岁的免疫功能正常患者。患者的常见症状为高热、肝脾肿大和全血细胞减少。两名患者均通过在由骨髓穿刺样本制备的吉姆萨染色涂片中发现寄生虫无鞭毛体,并在NNN培养基中从培养物中分离出前鞭毛体而确诊。通过PCR和测序方法将分离株鉴定为杜氏利什曼原虫。两名患者均接受脂质体两性霉素B治疗并成功治愈。总之,对于不明原因发热、肝脾肿大、全血细胞减少和高球蛋白血症的病例,尤其是在卡拉曼马拉什地区,应考虑VL的可能性。

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