病例报告:一例由秘鲁利什曼原虫(Viannia)引起的孢子状皮肤利什曼病。

Dai Akine,Teppei Sasahara,Yuka Hirota,Hirotomo Kato
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摘要

利什曼病是由利什曼属的一种细胞内原生动物引起的。其临床表现包括皮肤型、粘膜型和内脏型。孢子丝状皮肤利什曼病(SCL)是一种非典型、罕见的皮肤利什曼病(CL),主要在旧大陆报告。本病例报告描述了一名日本男子在秘鲁感染秘鲁利什曼病(Viannia)后出现的皮肤利什曼病。他的病变发生在双脚,左脚的病变为单纯的 CL,可自行消退。然而,右脚的病变并没有自行痊愈,而是沿着淋巴结向中心发展,最终形成了 SCL。双脚都检测到了母细胞,经基因鉴定为 L. (V.) peruviana。经静脉注射脂质体两性霉素 B 治疗后,病变逐渐消退。在此,我们报告了首例由 L. (V.) peruviana 引起的 SCL 病例。
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Case Report: A Case of Sporotrichoid Cutaneous Leishmaniasis Caused by Leishmania (Viannia) peruviana.
Leishmaniasis is caused by an obligate intracellular protozoa of the genus Leishmania. Its clinical manifestations include cutaneous, mucocutaneous, and visceral forms. Sporotrichoid cutaneous leishmaniasis (SCL) is an atypical and rare form of cutaneous leishmaniasis (CL) reported mainly in the Old World. This case report describes SCL in a Japanese man infected with Leishmania (Viannia) peruviana in Peru. His lesions occurred on both feet, with the left foot lesion being a simple CL that resolved spontaneously. However, the lesion on the right foot did not cure by itself; instead, it progressed centrally along the lymph nodes, eventually forming an SCL. Amastigotes were detected in both feet and genetically identified as L. (V.) peruviana. The lesions gradually resolved after treatment with intravenous liposomal amphotericin B. Here, we report the first case of SCL caused by L. (V.) peruviana.
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