Department of Parasitology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey.
Department of Emergency Medicine, Eşrefpaşa Municipality Hospital, Yenişehir, Gaziler Cd No: 315, 35170, Konak/İzmir, Turkey.
Acta Parasitol. 2023 Sep;68(3):699-704. doi: 10.1007/s11686-023-00695-w. Epub 2023 Jun 23.
In Turkey, the main causative agent of visceral leishmaniasis (VL) is Leishmania. infantum and the main causative agent of cutaneous leishmaniasis (CL) is Leishmania tropica. In this study, we aimed to discuss the possible mechanisms, clinical aspects, and threat of visceralizing L. tropica.
This study includes seven cases of VL caused by L. tropica.Five patients were male (71%) and four were adults (57%).
All the VL patients complained of fever and splenomegaly. Fatigue, pancytopenia, and hepatomegaly were present in six patients each (86%), while weight loss and gastrointestinal system (GIS) symptoms were present in 5 patients (71%).
In this study, we have evaluated seven cases of visceralized L. tropica (VLT) in the context of the changing leishmaniasis epidemiology in Turkey. We have evaluated the possible mechanisms of visceralization; inter- and intraspecies genetic exchange with all the old world leishmaniasis agents present in the region, stress induced by inappropriate use of drugs, and possible ongoing adaptation mechanisms of Leishmania spp. The threat posed by VLT is significant as L. tropica is the most widespread and most common cause of leishmaniasis in Turkey. We do not know the vectorial capacity of the sand flies for the transmission of VLT strains or if these strains are in circulation in Turkey. Future studies should be carried out to investigate these issues as the transition of L. tropica from a mild disease-causing agent to a mortal one poses a significant public health concern for Turkey and Europe.
在土耳其，内脏利什曼病（VL）的主要病原体是利什曼原虫。婴儿，皮肤利什曼病（CL）的主要病原体是利什曼原虫。热带。在这项研究中，我们旨在讨论内脏化 L 的可能机制。热带。
本研究包括 7 例由 L 引起的 VL。热带。5 例为男性（71%），4 例为成人（57%）。
所有 VL 患者均有发热和脾肿大。乏力、全血细胞减少和肝肿大各有 6 例（86%），体重减轻和胃肠道（GIS）症状各有 5 例（71%）。
在本研究中，我们评估了土耳其利什曼病流行病学变化背景下的 7 例内脏化 L。热带。我们评估了内脏化的可能机制；与该地区所有旧世界利什曼病病原体的种间和种内遗传交换、药物使用不当引起的应激以及利什曼原虫可能正在进行的适应机制。VLT 构成的威胁是巨大的，因为 L。热带。是土耳其最广泛和最常见的利什曼病病原体。我们不知道沙蝇传播 VLT 株的媒介能力，也不知道这些株是否在土耳其流行。应开展未来研究，以调查这些问题，因为 L 从温和的病原体向致命病原体的转变对土耳其和欧洲构成重大公共卫生关注。热带。
