孢子丝菌样利什曼病：巴西里约热内卢州的一项横断面临床、流行病学和实验室研究
Sporotrichoid leishmaniasis: a cross-sectional clinical, epidemiological and laboratory study in Rio de Janeiro State, Brazil.
作者信息
Carvalho Livia Martins Veloso de, Pimentel Maria Inês Fernandes, Conceição-Silva Fátima, Vasconcellos Érica de Camargo Ferreira E, Valete-Rosalino Cláudia Maria, Lyra Marcelo Rosandiski, Salgueiro Mariza de Matos, Saheki Maurício Naoto, Madeira Maria de Fátima, Mouta-Confort Eliame, Antonio Liliane de Fátima, Silva Aline Fagundes da, Quintella Leonardo Pereira, Bedoya-Pacheco Sandro Javier, Schubach Armando de Oliveira
机构信息
Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Rio de Janeiro, Brazil.
Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.
出版信息
Rev Inst Med Trop Sao Paulo. 2017 Jun 1;59:e33. doi: 10.1590/S1678-9946201759033.
BACKGROUND
Atypical presentations of cutaneous leishmaniasis include sporotrichoid leishmaniasis (SL), which is clinically described as a primary ulcer combined with lymphangitis and nodules and/or ulcerated lesions along its pathway.
AIMS
To assess the differences between patients with sporotrichoid leishmaniasis and typical cutaneous leishmaniasis (CL).
METHODS
From January 2004 to December 2010, 23 cases of SL (4.7%) were detected among 494 CL patients diagnosed at a reference center for the disease in Rio de Janeiro State, Brazil. These 23 cases were compared with the remaining 471 patients presenting CL.
RESULTS
SL predominated in female patients (60.9%, p = 0.024), with older age (p = 0.032) and with lesions in upper limbs (52.2%, p = 0.028). CL affected more men (64.5%), at younger age, and with a higher number of lesions exclusively in lower limbs (34.8%).
CONCLUSIONS
Differences in clinical and epidemiological presentation were found between SL patients as compared to CL ones, in a region with a known predominance of Leishmania (Viannia) braziliensis. The results are similar to the features of most of the sporotrichosis patients as described in literature, making the differential diagnosis between ATL and sporotrichosis more important in overlapping areas for both diseases, like in Rio de Janeiro State.
背景
皮肤利什曼病的非典型表现包括孢子丝菌样利什曼病（SL），其临床特征为原发性溃疡合并淋巴管炎以及沿淋巴管走行出现的结节和/或溃疡性病变。
目的
评估孢子丝菌样利什曼病患者与典型皮肤利什曼病（CL）患者之间的差异。
方法
2004年1月至2010年12月期间，在巴西里约热内卢州一家该疾病参考中心诊断的494例CL患者中，检测出23例SL（4.7%）。将这23例患者与其余471例CL患者进行比较。
结果
SL在女性患者中占主导（60.9%，p = 0.024），患者年龄较大（p = 0.032），且上肢有病变（52.2%，p = 0.028）。CL在男性患者中更为常见（64.5%），患者年龄较小，且仅下肢有病变的数量较多（34.8%）。
结论
在巴西利什曼原虫（维安尼亚亚种）已知占主导的地区，SL患者与CL患者在临床和流行病学表现上存在差异。这些结果与文献中描述的大多数孢子丝菌病患者的特征相似，这使得在两种疾病重叠的地区，如里约热内卢州，鉴别诊断非洲锥虫病与孢子丝菌病更为重要。
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