Raccurt C P, Pradinaud R, Couppie P, Moreau B, Pratlong F, Dedet J P, Cotellon P, Juminer B, Sainte-Marie D
Laboratoire de biologie polyvalerite, l'université des Antilles, Cayenne.
Bull Soc Pathol Exot. 1996;89(5):341-4.
The authors report the ninth case of cutaneous Leishmaniasis without mucosal involvement due to Leishmania (Viannia) braziliensis (isoenzymatic profile related to zymodeme MON-44) diagnosed in a legionnaire who recently arrived in French Guiana. The skin lesion as a single ulcerated nodule of the dorsum of the left ringfinger was cured after two courses of four intramuscular injections of pentamidine isothionate (total posology of pentamidine-base: 16.6 mg/kg). The transmission occurred during nocturnal trekking in forest and swamps just behind the coastal belt at Degrad Saramaka (7 km South of Kourou). In French Guiana, the good level of medical care and the early treatment of the majority of the cases of Leishmaniasis may explain the rarity of mucosal lesions. Since the clinical aspect of the lesion is not sufficient to prejudge the identity of the causative species, it is necessary to perform cultivation of Leishmania for iso-enzymatic identification. The adaptation of pentamidine doses and long term follow up of patients infected by L. (V.) braziliensis could be defined more precisely.
作者报告了第九例由巴西利什曼原虫（维安尼亚利什曼原虫）（与酶谱型MON - 44相关的同工酶谱）引起的无黏膜受累的皮肤利什曼病病例，该病例发生在一名近期抵达法属圭亚那的退伍军人身上。皮肤病变为左手无名指背部的单个溃疡结节，在接受了两个疗程、每个疗程四次肌肉注射异硫氰酸喷他脒（喷他脒碱基的总剂量：16.6mg/kg）后治愈。传播发生在德格拉德萨拉马卡（库鲁以南7公里）沿海地带后方森林和沼泽地的夜间徒步旅行期间。在法属圭亚那，良好的医疗水平以及大多数利什曼病病例的早期治疗可能解释了黏膜病变的罕见性。由于病变的临床特征不足以预先判断致病物种的身份，因此有必要进行利什曼原虫培养以进行同工酶鉴定。可以更精确地确定喷他脒剂量的调整以及感染巴西利什曼原虫患者的长期随访。
