河南省1例输入性皮肤利什曼病的诊断与分析  

Diagnosis and analysis of an imported case of cutaneous leishmaniasis in Henan Province

作　　者：李素华[1] 高丽君[1] 张雅兰[1] 周瑞敏[1] 杨成运[1] 钱丹[1] 刘颖[1] 赵玉玲[1] 鲁德领[1] 张红卫[1] 许汴利[1] LI Su-hua;GAO Li-jun;ZHANG Ya-lan;LIU Ying;ZHAO Yu-ling;LU ZHOU Rui-min;YANG Cheng-yun;QIAN Dan;De-ling;ZHANG Hong-wei;XU Bian-li(Henan Center for Disease Control and Prevention,Zhengzhou 450016,China)

机构地区：[1]河南省疾病预防控制中心,郑州450016

出　　处：《中国寄生虫学与寄生虫病杂志》2018年第4期339-342,共4页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：2017年度河南省医学科技攻关计划项目(No.201702274);2016年度河南省科技攻关项目(No.162102310035);河南省卫生计生科技创新型人才"51282"工程~~

摘　　要：患者,男,2017年6月到乌兹别克斯坦务工,7月2日发现左胸臂部有2个小红疹,回国后于10月15日前后发现红疹变大,有少量脓液。用利什曼病快速检测试纸条检测患者血清利什曼原虫抗体结果为阴性。取皮损处组织镜检未查见利什曼原虫无鞭毛体。取皮损处组织置NNN培养基培养,培养至第8天镜检查见大量前鞭毛体。提取前鞭毛体DNA,用利什曼原虫属特异性引物K13A/K13B和L5.8S/LITSR分别扩增出120和350 bp的片段,片段序列与硕大利什曼原虫相应序列(Gen Bank登录号:EU370906.1和FN677342.1)的同源性分别为90%和98%。确诊患者为输入性皮肤利什曼病,病原体为硕大利什曼原虫。患者经过葡萄糖酸锑钠注射液治疗2个疗程(总剂量7.2 g,每个疗程6 d,两个疗程间隔1周),病情得到控制,现已康复。The male patient who went to Uzbekistan in June 2017 and found two small red rashes on the left thoracic arm on July 2 returned to China in October. The rashes became larger with a small amount of pus. A rapid strip test for leishmaniasis showed that the patient serum was negative for anti-Leishmania antibody. Microscopic examination of the lesioned tissue revealed no Leishmania amastigotes. The lesioned tissue was cultured in NNN medium and a large number of promastigotes were found in culture on day 8. The promastigote DNA was extracted and underwent PCR amplification using Leishmania-specific primers K13A/K13B and L5.8 S/LITSR, producing fragments of 120 and 350 bp. The two products were 90% and 98% homologous to the corresponding sequences of L.major（Gen Bank accession number： EU370906.1 and FN677342.1）. The patient was diagnosed as imported cutaneous leishmaniasis and the pathogen was identified to be L. major. The disease was controlled after 2 treatment courses with sodium stibogluconate at a total dosage of 7.2 g（ 6 days for each course, with a 1-week interval between them）. The patient had recovered by the end of the study.

关 键 词：皮肤利什曼病 前鞭毛体 硕大利什曼原虫 诊断 

分 类 号：R531.62[医药卫生—内科学]