Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, Antwerp 2000, Belgium.
Department of Internal Medicine, University of Gondar, Post Office Box 196, Gondar, Ethiopia.
Infect Dis Clin North Am. 2019 Mar;33(1):79-99. doi: 10.1016/j.idc.2018.10.005.
Diagnostic advances in visceral leishmaniasis include the development of the rK39 and rK28 rapid diagnostic test. The direct agglutination test is also increasingly used, as well as conventional and real-time polymerase chain reaction, which also performs well on peripheral blood. The choice of treatment for visceral leishmaniasis depends on the geographic region where the infection is acquired. Liposomal amphotericin B is generally found to be safe and effective in most endemic regions of the world; antimonials still remain to be the most effective in eastern Africa despite its high toxicity. Combination therapy is increasingly explored. Immunosuppressed patients require adapted diagnostic and therapeutic strategies.
内脏利什曼病的诊断进展包括 rK39 和 rK28 快速诊断检测的发展。直接凝集试验也越来越多地被使用,以及常规和实时聚合酶链反应,在外周血中也表现良好。内脏利什曼病的治疗选择取决于感染发生的地理区域。两性霉素 B 脂质体通常被发现是安全有效的,在世界上大多数流行地区;尽管锑剂毒性很高,但在东非仍然是最有效的。联合治疗越来越受到关注。免疫抑制患者需要适应的诊断和治疗策略。