Stolf H O, Marques S A, Marques M E, Yoshida E L, Dillon N L
Departamento de Dermatologia da Faculdade de Medicina de Botucatu, UNESP, Brasil.
Rev Inst Med Trop Sao Paulo. 1993 Sep-Oct;35(5):437-42.
An outbreak of cutaneous leishmaniasis in a small rural settlement, located in the Southern of São Paulo State-Brazil was observed. This region has basic agricultural activities, and has no forests. Two hundred and thirty one persons were evaluated, and the following aspects were observed. 1) 67 individuals (29%) had skin lesions, confirmed by histopathologic study and the Montenegro skin test; 2) of these cases, 40 (59.7%) were males; 3) The youngest patients were 2 years (5 cases), and the oldest, 86 (1 case); 4) the following types of cutaneous lesions, were observed: a) 54 cases (80.6%) had ulcers, 13 (19.4%) had nodules, 4 (5.9%) had verrucose lesions, and 3 (4.4%) had typical scars. In all the cases, the parasite identified was Leishmania (Viannia) braziliensis. The vector captured in the region was Lutzomyia intermedia, a strong anthropophilic sandfly very frequently observed in São Paulo. This study shows that apart from the well-known outbreak observed in the forest environments, leishmaniasis can be transmitted within or around dwellings.
在巴西圣保罗州南部的一个小型乡村定居点观察到皮肤利什曼病的一次暴发。该地区主要从事农业活动,没有森林。对231人进行了评估,并观察到以下情况:1)67人(29%)有皮肤病变,经组织病理学研究和蒙氏皮肤试验确诊;2)在这些病例中,40人(59.7%)为男性;3)最年轻的患者为2岁(5例),最年长的为86岁(1例);4)观察到以下几种皮肤病变类型:a)54例(80.6%)有溃疡,13例(19.4%)有结节,4例(5.9%)有疣状病变,3例(4.4%)有典型瘢痕。在所有病例中,鉴定出的寄生虫为巴西利什曼原虫(维氏亚属)。在该地区捕获的病媒为中间罗蛉,这是一种在圣保罗非常常见的强嗜人血白蛉。这项研究表明,除了在森林环境中观察到的众所周知的暴发外,利什曼病也可在住宅内或周围传播。