Faculdade de Medicina de Marília, Disciplina de Parasitologia, Marília, São Paulo, Brazil.
Faculdade de Medicina de Marília, Hospital das Clínicas, Departamento de Atenção à Saúde em Hemoterapia, Laboratório de Parasitologia, Marília, São Paulo, Brazil.
Rev Inst Med Trop Sao Paulo. 2022 Mar 11;64:e21. doi: 10.1590/S1678-9946202264021. eCollection 2022.
Visceral leishmaniasis (VL) is an opportunistic disease in immunosuppressed individuals, who may present severe clinical conditions, such as the ones described in this patient. She lived in an endemic region for VL, and was possibly infected with L. (L.) infantum chagasi through the bite of a contaminated sand fly. This initial infection has triggered a pemphigus vulgaris condition by immunogenic proteins present in the mosquito's saliva. The immunosuppression caused by the use of high doses of corticosteroids to control the disease promoted a severe VL condition, with hepatosplenomegaly, thrombocytopenia and hemorrhages, requiring hospitalization and the onset of a subsequent SARS-CoV-2 infection. Due to the intensity of clinical manifestations related to VL, aggravated by COVID-19, she died two days after admission to the Clinical Hospital of Marilia Medical School (HC-Famema).
内脏利什曼病（VL）是一种机会性疾病，发生于免疫抑制个体，其可能表现出严重的临床病症，如该患者所描述的那样。她居住在 VL 流行地区，可能通过受污染的沙蝇叮咬而感染了 L.（L.） infantum chagasi。这种初始感染通过蚊子唾液中的免疫原性蛋白引发了寻常性天疱疮。大剂量皮质类固醇用于控制疾病导致的免疫抑制促进了严重 VL 病症的发生，出现肝脾肿大、血小板减少和出血，需要住院治疗，随后发生了 SARS-CoV-2 感染。由于与 VL 相关的临床表现强度，以及 COVID-19 的加重，她在入住马里利亚医学学校临床医院（HC-Famema）两天后死亡。
