PDF(Pubmed)
Abstract：
This case report presents a difficult-to-diagnose case of American tegumentary leishmaniasis (ATL) caused by Leishmania (Viannia) guyanensis in a 24-year-old Hispanic male with a travel history to the Panama jungle, an endemic region for tropical infectious diseases. The patient initially presented with persistent skin lesions that progressed to abscesses with ulceration. Despite negative initial diagnostic tests, including microbiological investigations and histopathological examination, a comprehensive diagnostic workup and subsequent polymerase chain reaction (PCR) confirmed the presence of Leishmania parasites. This case underscores the need to consider tropical infectious diseases despite initial negative tests. Accurate species identification is vital for proper drug treatment, with miltefosine as an emerging option. Early, precise diagnosis and tailored management are essential for successful treatment. This report emphasizes the significance of conducting a comprehensive diagnostic workup, including PCR, in individuals with a history of travel to endemic regions, to accurately diagnose and effectively manage complex infectious diseases.
摘要：
该病例报告介绍了一名24岁的西班牙裔男性，由利什曼原虫（Viannia）guyanensis引起的美国人包皮利什曼病（ATL），有前往巴拿马丛林的旅行史，热带传染病的流行地区。患者最初表现为持续性皮肤病变，进展为脓肿并伴有溃疡。尽管最初的诊断测试呈阴性，包括微生物调查和组织病理学检查，全面的诊断检查和随后的聚合酶链反应（PCR）证实了利什曼原虫寄生虫的存在。这种情况强调了尽管最初的阴性测试，仍需要考虑热带传染病。准确的物种识别对于正确的药物治疗至关重要，米替福辛作为一种新兴的选择。早期，精确的诊断和量身定制的管理是成功治疗的关键.这份报告强调了进行全面诊断检查的重要性,包括PCR,在有去过流行地区旅行历史的人中，准确诊断和有效管理复杂的传染病。
