PDF(Pubmed)
Abstract：
BACKGROUND: Post-kala-azar dermal leishmaniasis (PKDL) is a dermatosis that occurs 2-3 years after an apparently successful treatment of visceral leishmaniasis (VL). In rare cases, PKDL occurs concurrently with VL and is characterized by fever, splenomegaly, hepatomegaly or lymphadenopathy, and poor nutritional status and is known as Para-kala-azar dermal leishmaniasis (Para-KDL). Co-association of active VL in PKDL patients is documented in Africa, but very few case reports are found in South Asia. We present a case of Para-kala-azar Dermal Leishmaniasis (Para-KDL) in a 50-year-old male patient with a history of one primary Visceral Leishmaniasis (VL) and 2 times relapse of Visceral Leishmaniasis (VL). The patient presented with fever, skin lesions, and hepatosplenomegaly. Laboratory tests revealed LD bodies in the slit skin smear and splenic biopsy. The patient was treated with two cycles of Amphotericin B with Miltefosine in between cycles for 12 weeks to obtain full recovery.
CONCLUSIONS: This case report serves as a reminder that Para-kala-azar dermal leishmaniasis can develop as a consequence of prior visceral leishmaniasis episodes, even after apparently effective therapy. Since para-kala-azar is a source of infectious spread, endemics cannot be avoided unless it is effectively recognized and treated.
CONCLUSIONS: This case report serves as a reminder that Para-kala-azar dermal leishmaniasis can develop as a consequence of prior visceral leishmaniasis episodes, even after apparently effective therapy. Since para-kala-azar is a source of infectious spread, endemics cannot be avoided unless it is effectively recognized and treated.
摘要：
背景：黑热病后真皮利什曼病（PKDL）是在内脏利什曼病（VL）明显成功治疗2-3年后发生的皮肤病。在极少数情况下,PKDL与VL同时发生，以发热为特征，脾肿大,肝肿大或淋巴结肿大，和营养不良，被称为Para-kala-azar真皮利什曼病（Para-KDL）。在非洲有记录的PKDL患者中活跃的VL的共同关联。但是在南亚发现的病例报告很少。我们在一名50岁的男性患者中介绍了一例黑热病皮肤利什曼病（Para-KDL），该患者有一次原发性内脏利什曼病（VL）和2次内脏利什曼病（VL）复发。病人出现发烧，皮肤损伤,和肝脾肿大.实验室检查显示，狭缝皮肤涂片和脾活检中有LD体。患者在两个周期之间用两性霉素B和米替福辛治疗12周,以获得完全康复。
结论：此病例报告提醒人们，原发黑热病真皮利什曼病可由于先前的内脏利什曼病发作而发展，即使经过明显有效的治疗。由于para-kala-azar是传染病传播的来源，除非得到有效的承认和治疗，否则无法避免地方病。
结论：此病例报告提醒人们，原发黑热病真皮利什曼病可由于先前的内脏利什曼病发作而发展，即使经过明显有效的治疗。由于para-kala-azar是传染病传播的来源，除非得到有效的承认和治疗，否则无法避免地方病。
