III Infectious Diseases Unit, III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, 20157, Milan, Italy.
Department of Biomedical and Clinical Sciences, Università degli studi di Milano, Milan, Italy.
Intern Emerg Med. 2023 Nov;18(8):2293-2300. doi: 10.1007/s11739-023-03430-5. Epub 2023 Sep 28.
We aimed to estimate the diagnostic latency of patients with visceral leishmaniasis (VL). A monocentric retrospective observational study was conducted including all confirmed cases of VL diagnosed from January 2005 to March 2022. Epidemiological and clinical characteristics of patients with VL were collected. The diagnostic latency was defined as the number of days between the first contact with a health-care provider for signs and/or symptoms referable to VL and the laboratory diagnosis of leishmaniasis. Twenty-four cases of VL were included in the study, mostly male (75%) and Italians (79.2%), with a median age of 40 years [Inter Quartile Range (IQR 30-48)]. Fourteen (58.3%) VL cases were people living with HIV (PLWH) and 4 (16.6%) subjects were on immunosuppressive therapy. For VL the median diagnostic latency was 54 days (IQR 28-162). The shorter diagnostic latency was observed in PLWH [31 days (IQR 20-47)] followed by immunocompetent patients [160 days (IQR 133-247)] and those on immunosuppressive therapy [329 days (IQR 200-678)]. Twelve patients (50%) reported at least one medical encounter before the diagnosis of VL and 6 patients received a wrong therapy. Diagnostic delay in VL was significant in patients under immune suppressive treatment.
我们旨在估计内脏利什曼病（VL）患者的诊断潜伏期。进行了一项单中心回顾性观察研究，纳入了 2005 年 1 月至 2022 年 3 月期间诊断的所有确诊 VL 病例。收集了 VL 患者的流行病学和临床特征。诊断潜伏期定义为从首次出现与 VL 相关的体征和/或症状到实验室诊断利什曼病之间的天数。本研究纳入了 24 例 VL 患者，大多数为男性（75%）和意大利人（79.2%），中位年龄为 40 岁[四分位距（IQR 30-48）]。14 例（58.3%）VL 病例为艾滋病毒感染者（PLWH），4 例（16.6%）患者正在接受免疫抑制治疗。VL 的中位诊断潜伏期为 54 天（IQR 28-162）。PLWH 的诊断潜伏期较短[31 天（IQR 20-47）]，其次是免疫功能正常的患者[160 天（IQR 133-247）]和接受免疫抑制治疗的患者[329 天（IQR 200-678）]。12 名患者（50%）在诊断 VL 之前至少有一次就诊记录，6 名患者接受了错误的治疗。免疫抑制治疗患者的 VL 诊断延迟明显。
