Gonçalves Sheila V C B, Costa Dorcas L, Cantinho-Junior João da J, Vieira-Junior José N, Ishikawa Edna A Y, Costa Rubens N, Costa-Filho Antônio C G, Araújo Ronald da C, Uliana Silvia R B, Yasunaka Jenicer K U Y, Coelho Adriano C, Costa Jackson M L, Costa Carlos H N
Clínica Dermatológica, Hospital Getúlio Vargas, Teresina 64001-200, PI, Brazil.
Centro de Agravos Tropicais Emergentes e Negligenciados, Universidade Federal do Piauí, Teresina 64000-450, PI, Brazil.
Pathogens. 2023 Jun 29;12(7):890. doi: 10.3390/pathogens12070890.
Infection with and may lead to diffuse cutaneous leishmaniasis. The cure is exceptional, especially for the strange case of this lady. Case report: The patient acquired the disease in childhood and remained with lesions for over 30 years, albeit several treatments. She worsened after a pregnancy, developing disseminated lesions. Miltefosine with amphotericin B and pentamidine resulted in remission. Lesions reappeared after one year, accompanied by intra-nasal infiltration of the disease. The nasal spraying of a single ampoule of pentavalent antimoniate resulted in the sustained disappearance of the nasal symptoms and all the cutaneous lesions. After over eight years, she remains disease-free, albeit under renal replacement therapy. The high nasal mucosal antimonial concentration may explain the long-lasting cure via new MHC class I epitope-specific CD8+ cell clones against present in the nasal mucosa.
感染[寄生虫名称1]和[寄生虫名称2]可能导致弥漫性皮肤利什曼病。治愈情况极为罕见，尤其是这位女士的特殊病例。病例报告：该患者童年时期患病，尽管经过多次治疗，皮损仍持续了30多年。怀孕后病情恶化，出现播散性皮损。米替福新联合两性霉素B和喷他脒治疗后病情缓解。一年后皮损复发，并伴有鼻内疾病浸润。单次注射五价锑剂进行鼻腔喷雾治疗后，鼻部症状和所有皮肤损害持续消失。八年多来，她一直无病，尽管接受肾脏替代治疗。鼻腔黏膜中高浓度的锑剂可能通过针对鼻腔黏膜中存在的[寄生虫名称]的新的MHC I类表位特异性CD8 +细胞克隆来解释这种持久的治愈效果。
