Servicio de Otorrinolaringología, Hospital de Requena, Requena, Valencia, España.
Servicio de Otorrinolaringología, Hospital de Requena, Requena, Valencia, España.
Acta Otorrinolaringol Esp (Engl Ed). 2021 Jan-Feb;72(1):3-10. doi: 10.1016/j.otorri.2019.11.006. Epub 2020 May 10.
Leishmaniasis comprises a group of diseases caused by protozoan parasites of the genus Leishmania that are transmitted by the bite of infected phlebotomine mosquitoes from animal reservoirs. Three different clinical forms are generated: cutaneous, mucocutaneous and visceral. We present the findings in the head and neck of this disease observed in our health area.
A review of the last 26 years in our hospital, noting the clinical, diagnostic and therapeutic characteristics of the cases detected.
Thirteen cases were identified, 7 cutaneous, 4 mucocutaneous and 2 visceral or kala-azar. The mean age was 53.7±10.8 years. Immunodeficiency was identified in 61% of the cases. The incidence of the disease was 1.5:100,000 inhabitants/year, with a prevalence of 2%. Of those infected, 69% had involvement of the ear-nose-throat area. In 12 cases the diagnosis was established by biopsy of the lesions. The time from clinical debut to diagnosis ranged from 3 to 10 months. Antimony compounds were used as treatment in 11 patients and amphotericin B in 3, alone or combined with the former. One cutaneous form resolved with excision of the lesion. Ninety-two percent healed clinically and parasitologically.
Leishmaniasis in Spain frequently entails cutaneous and mucocutaneous involvement, often of the skin of the head, face and neck or upper-airway mucosa. Its clinical presentation varies greatly, and it should be suspected if there is no response to conventional therapies and in conditions of immunodeficiency.
利什曼病是一组由利什曼原虫属的原生动物寄生虫引起的疾病，通过感染的白蛉从动物储库叮咬传播。产生三种不同的临床形式：皮肤、黏膜皮肤和内脏。我们在本卫生区观察到这种疾病在头颈部的发现。
回顾了我们医院过去 26 年的病例，记录了所发现病例的临床、诊断和治疗特征。
共确定了 13 例病例，7 例皮肤型，4 例黏膜皮肤型，2 例内脏型或黑热病。平均年龄为 53.7±10.8 岁。61%的病例存在免疫缺陷。该疾病的发病率为 1.5:100,000 居民/年，患病率为 2%。感染者中，69%的人耳部、鼻部和喉部受累。12 例病例通过病变活检确立诊断。从临床发病到诊断的时间范围为 3 至 10 个月。11 例患者使用锑化合物治疗，3 例患者使用两性霉素 B 治疗，单独或联合使用上述药物。1 例皮肤型病例通过切除病变治愈。92%的患者临床和寄生虫学治愈。
西班牙的利什曼病常涉及皮肤和黏膜皮肤，常累及头、面和颈部皮肤或上呼吸道黏膜。其临床表现差异很大，如果对常规治疗没有反应且存在免疫缺陷时，应怀疑该病。
