Gaeta G B, Gradoni L, Gramiccia M, di Martino L, Pizzuti R, Pempinello R, Scotti S, Maisto A
Clinica Malattie Infettive, II Università, Napoli.
Recenti Prog Med. 1994 Jun;85(6):340-7.
Visceral leishmaniasis (VL) is a public health problem in most countries bordering the Mediterranean sea. The disease has been found in central and southern Italy, Sicily, Sardinia; some pockets are present in Liguria. Dogs are the reservoirs and the vectors are some species of sandfly (Phlebotomus species). The incubation period is usually between 2 and 8 months; children and adults may become infected; lethality may be high and depends upon a correct diagnosis and treatment. The diagnosis should be suspected on the basis of the epidemiological data and clinical picture and confirmed by the detection of specific antibodies by appropriate techniques. Leishmaniasis can be detected in splenic or bone marrow aspirates. Patients with HIV infection and VL may lack specific antibodies; parasitological diagnosis is mandatory for these patients. Antimonials are the classic therapeutic agents for VL. Recently liposomal amphotericin B (Ambisome) has been successfully used, with negligible toxicity.
内脏利什曼病（VL）是地中海沿岸大多数国家面临的一个公共卫生问题。该疾病在意大利中部和南部、西西里岛、撒丁岛均有发现；利古里亚也有一些病例。狗是储存宿主，传播媒介是某些种类的白蛉（白蛉属物种）。潜伏期通常为2至8个月；儿童和成人都可能感染；致死率可能很高，这取决于正确的诊断和治疗。应根据流行病学数据和临床表现怀疑诊断，并通过适当技术检测特异性抗体来确诊。利什曼病可在脾或骨髓穿刺物中检测到。感染HIV的患者和VL患者可能缺乏特异性抗体；这些患者必须进行寄生虫学诊断。锑剂是治疗VL的经典药物。最近，脂质体两性霉素B（安必素）已成功使用，毒性可忽略不计。
