Case Report: Cutaneous Leishmaniasis-A Hidden Disease in Côte d'Ivoire.

Almamy Diabaté,Ryo Fukaura,Chiaki Terashima-Murase,Bamba Vagamon,Rie R Yotsu
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Abstract

Cutaneous leishmaniasis (CL) is classified as one of the skin-related neglected tropical diseases by the WHO. There have been limited reports of CL in Côte d'Ivoire, with fewer than 20 cases reported from Côte d'Ivoire in the literature since 1967, when it was first identified. Here, we report a case of CL originating in Côte d'Ivoire that we diagnosed during our active case finding activity in the Zounan Hounien District. The patient, a 15-year-old male, presented with multiple noninflammatory skin lesions on the face and trunk that had progressed from nodular to ulcerated lesions over the previous 3 months. Concurrent symptoms included fever, chest pain, cough, and malaise. Investigations for infectious diseases such as HIV and tuberculosis returned negative results. Histopathological analysis of a skin biopsy specimen from the nasal base demonstrated the presence of Leishman-Donovan bodies, confirming a diagnosis of CL. Although treatment with intralesional meglumine antimoniate (Glucantime) injections was intended, the drug could not be administered because the patient unfortunately died shortly after our consultation visit. Because of the rarity of CL in Côte d'Ivoire, awareness remains low, resulting in delayed diagnosis and treatment. Urgent strategies to improve awareness of CL among clinicians practicing in Côte d'Ivoire is required, first to appropriately diagnose and treat CL and second to generate epidemiological data of adequate quality.
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病例报告:皮肤利什曼病--科特迪瓦的隐性疾病。
皮肤利什曼病(CL)被世界卫生组织列为与皮肤有关的被忽视热带病之一。自1967年首次发现皮肤利什曼病以来,有关科特迪瓦皮肤利什曼病的报道十分有限,文献中报道的病例不到20例。在此,我们报告了一例源于科特迪瓦的CL病例,该病例是我们在祖南胡年区积极开展病例发现活动期间确诊的。患者是一名 15 岁的男性,面部和躯干出现多处非炎症性皮损,在过去 3 个月中,皮损从结节发展为溃疡。并发症状包括发烧、胸痛、咳嗽和乏力。艾滋病毒和肺结核等传染病的检查结果均为阴性。鼻底皮肤活检标本的组织病理学分析表明存在莱什曼-多诺万体,确诊为 CL。虽然本打算采用局部注射巨鲁明抗锑酸盐(Glucantime)的方法进行治疗,但由于患者在我们就诊后不久不幸去世,因此无法使用该药物。由于CL在科特迪瓦非常罕见,因此人们对它的认识仍然很低,导致诊断和治疗延误。我们需要采取紧急策略,提高科特迪瓦临床医生对CL的认识,首先是为了对CL进行适当的诊断和治疗,其次是为了获得高质量的流行病学数据。
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