HIV 阳性和 HIV 阴性患者的口腔利什曼病：两例新病例报告的对比分析。
Oral Leishmaniasis in HIV-Positive and HIV-Negative Patients: A Comparative Analysis with Two New Case Reports.
机构信息
Federal University of Tocantins, Medicine Course, Palmas, Tocantins, Brazil.
Afya Faculty of Medical Sciences, Dentistry Course, Palmas, Tocantins, Brazil.
出版信息
Head Neck Pathol. 2024 Aug 5;18(1):69. doi: 10.1007/s12105-024-01674-x.
PURPOSE
This case report examines the clinical presentation, diagnosis, treatment, and outcomes of mucocutaneous leishmaniasis with primary oral involvement in HIV-positive and HIV-negative patients diagnosed in Brazil.
METHODS
We discuss the clinical manifestations, diagnostic methods, and therapeutic strategies, highlighting the clinical and histopathologic diagnostic features and distinct progression patterns based on HIV status. Our findings are compared with patterns observed in other countries, emphasizing the differences between the Americas and Europe, Asia, and Africa.
RESULTS
In the Americas, particularly in Brazil, mucocutaneous leishmaniasis often presents with localized oral lesions, even in the presence of systemic immunosuppression, whereas in the Europe, Asia, and Africa, oral involvement is typically associated with visceral leishmaniasis in immunocompromised patients. These differences were due to variations in the parasite species involved.
CONCLUSION
This comparison underscores the importance of regional and immunological factors in diagnosing and managing this neglected infectious disease.
目的
本病例报告探讨了在巴西确诊的 HIV 阳性和 HIV 阴性患者中，黏膜皮肤利什曼病伴原发性口腔受累的临床表现、诊断、治疗和转归。
方法
我们讨论了临床表现、诊断方法和治疗策略，重点介绍了根据 HIV 状态的临床和组织病理学诊断特征以及不同的进展模式。我们的发现与其他国家的模式进行了比较，强调了美洲与欧洲、亚洲和非洲之间的差异。
结果
在美洲，特别是在巴西，黏膜皮肤利什曼病常表现为局部口腔病变，即使存在全身免疫抑制也是如此，而在欧洲、亚洲和非洲，口腔受累通常与免疫功能低下患者的内脏利什曼病有关。这些差异归因于涉及的寄生虫物种的变异。
结论
这种比较强调了区域和免疫因素在诊断和管理这种被忽视的传染病中的重要性。
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