Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, Antwerp, Belgium.
Infect Dis Clin North Am. 2012 Jun;26(2):309-22. doi: 10.1016/j.idc.2012.03.005. Epub 2012 Apr 24.
Visceral leishmaniasis (VL) is a vector-borne parasitic disease targeting tissue macrophages. It is among the most neglected infectious diseases. Classical manifestations of VL include chronic fever, hepatosplenomegaly, and pancytopenia. Most cases can be detected through serologic and molecular testing. Although therapy has historically relied on antimonials, newer therapeutic options include conventional or liposomal amphotericin B, paromomycin and miltefosine. Coinfection with human immunodeficiency virus (HIV) is increasingly reported and comes with additional diagnostic and therapeutic challenges. This article provides an up-to-date clinical review of VL focusing on clinical presentation, diagnosis, management, and issues related to HIV coinfection.
内脏利什曼病(VL)是一种靶向组织巨噬细胞的寄生虫病,属于最被忽视的传染病之一。VL 的典型表现包括慢性发热、肝脾肿大和全血细胞减少。大多数病例可以通过血清学和分子检测来发现。尽管历史上的治疗方法依赖于锑剂,但新的治疗选择包括传统或脂质体两性霉素 B、巴龙霉素和米替福新。与人类免疫缺陷病毒(HIV)的合并感染越来越多地被报道,同时也带来了额外的诊断和治疗挑战。本文提供了 VL 的最新临床综述,重点关注临床表现、诊断、管理以及与 HIV 合并感染相关的问题。