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皮肤利什曼病的误诊与不恰当治疗:一例报告

Misdiagnosis and inappropriate treatment of cutaneous leishmaniasis: a case report.

作者信息

Sikorska Katarzyna, Gesing Marta, Olszański Romuald, Roszko-Wysokińska Anna, Szostakowska Beata, Van Damme-Ostapowicz Katarzyna

机构信息

Division of Tropical Medicine and Epidemiology, Department of Tropical Medicine and Parasitology, Institute of Maritime and Tropical Medicine, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.

Department of Infectious Diseases, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland.

出版信息

Trop Dis Travel Med Vaccines. 2022 Aug 1;8(1):18. doi: 10.1186/s40794-022-00175-5.

Abstract

BACKGROUND

Leishmaniasis is a widespread disease in tropical and subtropical countries, except for Australia and Oceania. In Poland, tourists, migrants and travellers from leishmaniasis-endemic countries may carry Leishmania.

CASE PRESENTATION

We present a case of undiagnosed cutaneous leishmaniasis in a patient who received many weeks of inadequate antibiotic treatment. Ulceration in the right submandibular region was thought to be a purulent complication after laser surgery. Six weeks before the ulcer developed, the patient had visited the jungle (Guatemala). Cutaneous leishmaniasis was finally diagnosed after nine months based on a proper history and a polymerase chain reaction (PCR) assay. Treatment with antimony derivatives was administered. After three months, the ulcer healed but left a scar.

CONCLUSION

A lack of knowledge about tropical diseases among doctors and an incomplete medical history were the reasons for many weeks of erroneous treatment of cutaneous leishmaniasis with antibiotics. This is the first reported case of cutaneous leishmaniasis misdiagnosed as a complication after an aesthetic medical procedure.

摘要

背景

利什曼病在热带和亚热带国家广泛流行,澳大利亚和大洋洲除外。在波兰,来自利什曼病流行国家的游客、移民和旅行者可能携带利什曼原虫。

病例介绍

我们报告一例未被诊断出的皮肤利什曼病病例,该患者接受了数周的不恰当抗生素治疗。右下颌下区域的溃疡被认为是激光手术后的化脓性并发症。溃疡出现六周前,患者曾去过丛林(危地马拉)。基于恰当的病史和聚合酶链反应(PCR)检测,九个月后最终诊断为皮肤利什曼病。给予锑衍生物治疗。三个月后,溃疡愈合但留下了疤痕。

结论

医生对热带疾病知识的缺乏以及不完整的病史是皮肤利什曼病被抗生素错误治疗数周的原因。这是首例被误诊为美容医疗手术后并发症的皮肤利什曼病病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b565/9341103/dea6910a6b8a/40794_2022_175_Fig1_HTML.jpg

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