Zobba Rosanna, Evangelisti Maria Antonietta, Manunta Maria Lucia, Alberti Alberto
Dipartimento di Medicina Veterinaria, Università di Sassari, via Vienna 2, 07100 Sassari, Italy.
Vet Ital. 2017 Dec 29;53(4):321-326. doi: 10.12834/VetIt.307.1193.4.
In this study we describe a case of neurological leishmaniasis in a dog, reported in an endemic area, with signs of multifocal intracranial lesions involving the vestibular system and the cerebellum. Serum biochemistry revealed a decrease of albumin-globulin ratio caused by an increase of alfa2-, beta-, and gamma- globulin, while antibody titers were highly positive for Leishmania spp. Magnetic resonance images of the brain were consistent with a granulomatous in ammation/infection. Cerebrospinal fluid revealed a marked mononuclear pleocytosis and was positive to the Pandy Test, as well as to a Leishmania spp. -speci c polymerase chain reaction (PCR) assay. Sequencing of the PCR products revealed the highest similarity with several strains belonging to the Leishmania infantum / Leishmania chagasi group. Clinical response to treatment for systemic leishmaniasis was supportive of diagnosis. This report focuses on an atypical form of canine leishmaniasis and suggests that in endemic geographic areas leishmaniasis has to be considered for di erential diagnosis in neurological manifestations. Also, cerebrospinal liquor should always be tested when neurological symptoms are present in order to di erentiate neurological leishmaniasis from unrelated neurological signs in Leishmania positive patients.
在本研究中,我们描述了一例在流行地区报告的犬神经型利什曼病病例,该病例具有累及前庭系统和小脑的多灶性颅内病变体征。血清生化检查显示,由于α2-球蛋白、β-球蛋白和γ-球蛋白增加,白蛋白-球蛋白比值降低,而利什曼原虫属抗体滴度呈高度阳性。脑部磁共振成像与肉芽肿性炎症/感染相符。脑脊液显示明显的单核细胞增多,潘氏试验呈阳性,利什曼原虫属特异性聚合酶链反应(PCR)检测也呈阳性。PCR产物测序显示与婴儿利什曼原虫/恰加斯利什曼原虫组的多个菌株相似度最高。对系统性利什曼病治疗的临床反应支持诊断。本报告重点关注犬利什曼病的一种非典型形式,并表明在流行地理区域,对于神经学表现进行鉴别诊断时必须考虑利什曼病。此外,当利什曼原虫阳性患者出现神经症状时,应始终检测脑脊液,以便将神经型利什曼病与无关的神经体征区分开来。