Osorio L E, Castillo C M, Ochoa M T
Centro Internacional de Entrenamiento e Investigaciones Médicas, Cali, Columbia.
Am J Trop Med Hyg. 1998 Jul;59(1):49-52. doi: 10.4269/ajtmh.1998.59.49.
The Leishmaniases are a group of diseases whose clinical presentation is in part determined by the infecting species. Until recently, mucosal leishmaniasis was attributed exclusively to Leishmania (Viannia) braziliensis; however, the capacity of other species of the subgenus Viannia to invade mucosal tissue has been documented. This report examines the clinical characteristics of 23 parasitologically diagnosed patients with mucosal leishmaniasis due to L. (V.) panamensis from the Pacific Coast of Colombia seen at CIDEIM between 1985 and 1996. Most of the mucosal lesions 74% (17 of 23) were mild, with a short time of evolution (median = 2.5 months) and were present concomitantly with an active cutaneous lesion in 61% (14 of 23) of the cases. The simultaneous presentation of mucosal and active cutaneous lesions contrast with classical descriptions of mucosal leishmaniasis caused by L. (V.) braziliensis, and highlights the importance of early diagnosis of mucosal disease by the examination of mucosa in all cases of cutaneous leishmaniasis.
利什曼病是一组疾病,其临床表现部分由感染的物种决定。直到最近,黏膜利什曼病一直被认为仅由巴西利什曼原虫(Viannia亚属)引起;然而,已有文献证明Viannia亚属的其他物种也有侵入黏膜组织的能力。本报告研究了1985年至1996年期间在CIDEIM就诊的23例经寄生虫学诊断为巴拿马利什曼原虫(Viannia亚属)引起的黏膜利什曼病患者的临床特征。大多数黏膜病变74%(23例中的17例)较轻,病程较短(中位数=2.5个月),61%(23例中的14例)的病例同时伴有活动性皮肤病变。黏膜和活动性皮肤病变同时出现的情况与巴西利什曼原虫(Viannia亚属)引起的黏膜利什曼病的经典描述形成对比,并突出了在所有皮肤利什曼病病例中通过检查黏膜进行黏膜疾病早期诊断的重要性。