Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- permanência prévia em área endêmica
- imunossupressão
- febre prolongada
- perda de peso
- lesões cutâneas ulcerativas
- presença de fatores de risco
- vários nódulos cutâneos não ulcerativos
- inflamação destrutiva da mucosa
- esplenomegalia
- escurecimento da pele
Outros fatores diagnósticos
- fadiga
- tosse
- cefaleia
- enfraquecimento
- linfonodos aumentados
- hepatomegalia
- tratamento antileishmaniose prévio
- epistaxe
- dor abdominal
Fatores de risco
- alta exposição a picadas de flebotomíneo
- pobreza
- proximidade com um paciente com uma história de infecção
- proprietário de animais domésticos
- imunossupressão
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- Hemograma completo
- testes da função hepática e ureia/creatinina
- gonadotrofina coriônica humana (hCG) sérica
Investigações a serem consideradas
- exame microscópico do espécime relevante
- cultura de sangue (camada leucoplaquetária) ou tecido
- reação em cadeia da polimerase
- sorologia
- intradermorreação para leishmaniose (teste cutâneo de Montenegro)
- teste para sorologia de HIV
Algoritmo de tratamento
leishmaniose cutânea (LC)
leishmaniose mucosa (LM)
leishmaniose visceral (LV)
leishmaniose dérmica pós-calazar (LDPC)
recidiva
Colaboradores
Autores
Naomi E. Aronson, MD
Professor of Medicine
Director, Infectious Diseases Division
Uniformed Services University of the Health Sciences
Bethesda
MD
Declarações
NEA receives federal grants to study leishmaniasis, has given lectures on the topic of leishmaniasis at national and international meetings, was part of a committee that developed the US guidelines on the diagnosis and treatment of leishmaniasis, and has a patent on biomarkers for leishmaniasis. NEA has received honoraria from the Welcome Trust and the Leventis Foundation, University of Cyprus for programme and grant reviews. NEA's institution USU has received royalties for her writing and editorial work for Elsevier and UpToDate. Additionally USU has received funding for leishmaniasis grants that NEA applied for from Defense Health Agency, and an intent to fund from National Institutes of Health. NEA serves unpaid as a member of the NIH, CDC, HIVMA opportunistic infections/geographic infections section guideline writing committee. NEA has been invited to speak at IDWeek, Am Soc Trop Med Hygiene, WorldLeish 7, Center for Newcomer Health, University of Oklahoma, University of Iowa, National Institutes of Allergy and Infectious Diseases, and DC tropical rounds on topic leishmaniasis. NEA has assisted CDC with developing published FAQs regarding leishmaniasis in operation allied welcome (Afghanistan refugees). NEA is an author of a number of references cited in this topic. The views expressed in this topic are those of the authors and do not reflect the official policy of the Department of Army/Navy/Air Force, the Department of Defense, or the US Government.
Nathanial K. Copeland, MD, MTM&H
Assistant Professor of Medicine
Uniformed Services University of the Health Sciences
Bethesda
MD
Declarações
NKC is an author of a number of references cited in this topic. The views expressed in this topic are those of the authors and do not reflect the official policy of the Department of Army/Navy/Air Force, the Department of Defense, or the US Government.
Agradecimentos
Professor Naomi E. Aronson and Dr Nathanial K. Copeland would like to gratefully acknowledge Professor Richard Reithinger and Professor François Chappuis, previous contributors to this topic.
Declarações
RR and FC are authors of a number of references cited in this topic.
Revisores
Roberto Arenas, MD
Chief of the Mycology Section
Dr. Manuel Gea Gonzalez General Hospital
Mexico
Declarações
RA is the author of an article cited in this topic.
Diagnósticos diferenciais
- Esplenomegalia malárica hiper-reativa (HMS)
- Infecção malárica
- Esquistossomose
Mais Diagnósticos diferenciaisDiretrizes
- Guideline for the treatment of visceral leishmaniasis in HIV co-infected patients in East Africa and South-East Asia
- Guideline for the treatment of leishmaniasis in the Americas
Mais Diretrizes
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