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旅行者输入性利什曼病:法国巴黎一家医院的 7 年回顾性研究。

Imported leishmaniasis in travelers: a 7-year retrospective from a Parisian hospital in France.

机构信息

Laboratoire de Parasitologie et de Mycologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), 1 Avenue Claude Vellefaux, 75475, Paris, France.

Université de Paris, Paris, France.

出版信息

BMC Infect Dis. 2021 Sep 15;21(1):953. doi: 10.1186/s12879-021-06631-5.


DOI:10.1186/s12879-021-06631-5
PMID:34525963
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8442464/
Abstract

BACKGROUND: Leishmaniases are regularly seen in non-endemic areas due to the increase of international travels. They include cutaneous leishmaniases (CL) and mucocutaneous (MC) caused by different Leishmania species, and visceral leishmaniases (VL) which present with non-specific symptoms. METHODS: We reviewed all consecutive leishmaniasis cases seen between September 2012 and May 2020. The diagnostic strategy included microscopy after May-Grünwald-Giemsa staining, a diagnostic quantitative PCR (qPCR) assay, and species identification based on sequencing of the cytochrome b gene. RESULTS: Eighty-nine patients had a definitive leishmaniasis diagnosis. Nine patients had VL with Leishmania infantum. Eighty patients had CL. Twelve patients acquired CL after trips in Latin America (7 Leishmania guyanensis, 2 Leishmania braziliensis, 2 Leishmania mexicana, and 1 Leishmania panamensis). Species could be identified in 63 of the 68 CLs mainly after travel in North Africa (59%) with Leishmania major (65%), Leishmania tropica/killicki (24%), and L. infantum (11%), or in West Sub-Saharan Africa (32%), all due to L. major. The median day between appearance of the lesions and diagnosis was 90 [range 60-127]. CONCLUSIONS: Our diagnostic strategy allows both positive diagnoses and species identifications. Travelers in West Sub-Saharan Africa and North Africa should be better aware of the risk of contracting leishmananiasis.

摘要

背景:由于国际旅行的增加,非流行地区经常出现利什曼病。它们包括由不同利什曼原虫引起的皮肤利什曼病(CL)和黏膜皮肤利什曼病(MC),以及表现为非特异性症状的内脏利什曼病(VL)。

方法:我们回顾了 2012 年 9 月至 2020 年 5 月间连续出现的所有利什曼病病例。诊断策略包括梅格-格伦瓦尔德-吉姆萨染色后的显微镜检查、诊断定量 PCR(qPCR)检测,以及基于细胞色素 b 基因测序的种属鉴定。

结果:89 例患者被明确诊断为利什曼病。9 例患者患有婴儿利什曼原虫引起的 VL。80 例患者患有 CL。12 例患者在拉丁美洲旅行后感染 CL(7 例为利什曼原虫圭亚那型,2 例为利什曼原虫巴西型,2 例为利什曼原虫墨西哥型,1 例为利什曼原虫巴拿马型)。在 68 例 CL 中,有 63 例在旅行后(59%在北非,24%在北非)可鉴定出种属,主要为利什曼原虫 major(65%)、利什曼原虫 tropica/killicki(24%)和 L. infantum(11%),或在西撒哈拉以南非洲(32%),均为 L. major。病变出现到诊断的中位天数为 90 [范围 60-127]。

结论:我们的诊断策略既能进行阳性诊断,也能进行种属鉴定。来自撒哈拉以南非洲和北非的旅行者应更好地意识到感染利什曼病的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1d8/8442464/ee1b1a2b6e10/12879_2021_6631_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1d8/8442464/ee1b1a2b6e10/12879_2021_6631_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1d8/8442464/ee1b1a2b6e10/12879_2021_6631_Fig1_HTML.jpg

相似文献

[1]
Imported leishmaniasis in travelers: a 7-year retrospective from a Parisian hospital in France.

BMC Infect Dis. 2021-9-15

[2]
[Cutaneous Leishmaniasis Cases Caused by Leishmania infantum in Şanlıurfa Province, Turkey].

Mikrobiyol Bul. 2020-10

[3]
Clinical manifestations and genetic variation of Leishmania infantum and Leishmania tropica in Southern Turkey.

Exp Parasitol. 2015-7

[4]
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Biomed Res Int. 2019-8-8

[5]
Immunodetection and molecular determination of visceral and cutaneous Leishmania infection using patients' urine.

Infect Genet Evol. 2018-5-27

[6]
Molecular identification of and isolated from cutaneous human leishmaniasis samples in central Morocco.

J Vector Borne Dis. 2020

[7]
Molecular Characterization of Leishmania Parasites in Giemsa-Stained Slides from Cases of Human Cutaneous and Visceral Leishmaniasis, Eastern Algeria.

Vector Borne Zoonotic Dis. 2017-6

[8]
Specific K39 antibody response and its persistence after treatment in patients with imported leishmaniasis.

Parasitol Res. 2016-2

[9]
[Epidemiology of Leishmania (L.) infantum, L. major and L. killicki in Tunisia: results and analysis of the identification of 226 human and canine isolates].

Bull Soc Pathol Exot. 2008-10

[10]
Enzymatic polymorphism during Leishmania/HIV co-infection: a study of 381 Leishmania strains received between 1986 and 2000 at the international cryobank in Montpellier, France.

Ann Trop Med Parasitol. 2003-10

引用本文的文献

[1]
The estimated distribution of autochthonous leishmaniasis by Leishmania infantum in Europe in 2005-2020.

PLoS Negl Trop Dis. 2023-7

[2]
A Rare Case of Imported Cutaneous Leishmaniasis Caused by in the Republic of Korea, 2021.

Trop Med Infect Dis. 2023-4-12

[3]
Non-Endemic Leishmaniases Reported Globally in Humans between 2000 and 2021-A Comprehensive Review.

Pathogens. 2022-8-16

本文引用的文献

[1]
Distribution, treatment outcome and genetic diversity of Leishmania species in military personnel from Colombia with cutaneous leishmaniasis.

BMC Infect Dis. 2020-12-9

[2]
Mastomys natalensis, Cricetomys gambianus and Taterillus sp. were found PCR positive for Leishmania major in Burkina Faso, West Africa.

Ann Parasitol. 2020

[3]
A comprehensive systematic review of leishmaniasis in patients undergoing drug-induced immunosuppression for the treatment of dermatological, rheumatological and gastroenterological diseases.

Rev Inst Med Trop Sao Paulo. 2020

[4]
Test accuracy of polymerase chain reaction methods against conventional diagnostic techniques for Cutaneous Leishmaniasis (CL) in patients with clinical or epidemiological suspicion of CL: Systematic review and meta-analysis.

PLoS Negl Trop Dis. 2020-1-21

[5]
PCR primers designed for new world Leishmania: A systematic review.

Exp Parasitol. 2019-10-9

[6]
Cutaneous and mucocutaneous leishmaniasis in travellers and migrants: a 20-year GeoSentinel Surveillance Network analysis.

J Travel Med. 2019-12-23

[7]
Clinical aspects of visceral leishmaniasis caused by L. infantum in adults. Ten years of experience of the largest outbreak in Europe: what have we learned?

Parasit Vectors. 2019-7-24

[8]
Cross-sectional screening study for Leishmania DNA and antibodies in biologic-treated patients with psoriasis living in an area endemic for leishmaniasis.

Br J Dermatol. 2019-12

[9]
Leishmania infection: Misdiagnosis as cancer and tumor-promoting potential.

Acta Trop. 2018-12-7

[10]
Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa-A systematic review.

PLoS Negl Trop Dis. 2018-10-25

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