Widespread atypical cutaneous Leishmaniasis caused by Leishmania (L.) chagasi in Nicaragua
Widespread atypical cutaneous Leishmaniasis caused by Leishmania (L.) chagasi in Nicaragua
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DOI：
10.4269/ajtmh.1999.61.380
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发表时间：
1999-09-01
影响因子：
3.3
通讯作者：
Harris, E
中科院分区：
文献类型：
--
作者：
Belli, A;García, D;Harris, E
美洲内脏利什曼病（VL）的病原体恰加斯利什曼原虫，最近在中美洲与非典型皮肤利什曼病（ACL）;然而，关于这种疾病的全面信息很少。分析了尼加拉瓜252例ACL病例和44例VL病例的临床、流行病学和寄生虫学特征。内脏利什曼病主要与5岁以下的营养不良儿童有关，而ACL主要见于5岁以上的儿童和年轻人。遗传相似的寄生虫与这两种疾病的表现有关。沙蝇除伊氏潜蝇外，还有鲁蝇。longipalpis可能参与了L. chagasi人类。我们的研究结果表明，ACL比以前认为的更普遍，影响了当地人口的10%。同一种寄生虫似乎同时引起ACL和潜在致命的内脏疾病，这一事实表明，希望免疫反应在决定L。恰加斯病感染广泛存在的L. Chagasi进行了讨论。
Leishmania chagasi, the causative agent of visceral leishmaniasis (VL) in the Americas, has recently been associated with atypical cutaneous leishmaniasis (ACL) in Central America; however, little comprehensive information about this disease is available. Clinical, epidemiologic, and parasitologic characteristics of 252 ACL cases and 44 VL cases in Nicaragua were analyzed. Visceral leishmaniasis is primarily associated with malnourished children less than five years of age, whereas ACL is found predominantly in children greater than five years of age and young adults. Genetically similar parasites are associated with both disease manifestations. The sand fly Lutzomyia evansi, in addition to Lu. longipalpis, may be involved in transmission of L. chagasi to humans. Our results indicate that ACL is more prevalent than previously thought, affecting up to 10% of a local population. The fact that the same parasite appears to cause both ACL and the potentially fatal visceral disease suggests that the hope immune response is critical in determining the outcome of L. chagasi infection. The public health implications of the widespread presence of L. chagasi are discussed.