Just G, Simader R, Helm E B, Stille W, Falk S, Stutte H J, Hübner K
Zentrum der Inneren Medizin, Universität Frankfurt/Main.
Dtsch Med Wochenschr. 1988 Dec 9;113(49):1920-2. doi: 10.1055/s-2008-1067913.
A 32-year-old homosexual with AIDS, who until 1985 was a frequent traveller to South America and mediterranean countries, had recurrent bouts of fever, splenomegaly, arthralgias as well as granulocytopenia and anaemia. Liver and bone-marrow punctures were performed to exclude malignant lymphoma and (or) a mycobacterial infection. Both biopsies revealed Leishmania donovani. During administration of sodium stibogluconate (Pentostam) the fever disappeared for a time and there was clinical improvement, but further treatment was limited because of thrombocytopenia. In patients with AIDS who have splenomegaly with nonspecific fever, visceral leishmaniasis must be considered in the differential diagnosis even outside of endemic regions.
一名32岁的艾滋病同性恋患者，1985年以前经常前往南美洲和地中海国家，反复出现发热、脾肿大、关节痛以及粒细胞减少和贫血症状。进行了肝脏和骨髓穿刺以排除恶性淋巴瘤和（或）分枝杆菌感染。两次活检均发现杜氏利什曼原虫。在使用葡萄糖酸锑钠（喷他脒）治疗期间，发热一度消失，临床症状有所改善，但由于血小板减少，进一步治疗受到限制。对于患有脾肿大并伴有非特异性发热的艾滋病患者，即使在非流行地区，鉴别诊断时也必须考虑内脏利什曼病。
