小结
定义
病史和体格检查
关键诊断因素
- presença de fatores de risco
- permanência prévia em área endêmica
- imunossupressão
- febre prolongada
- perda de peso
- lesões cutâneas ulcerativas
- vários nódulos cutâneos não ulcerativos
- inflamação destrutiva da mucosa
- esplenomegalia
- escurecimento da pele
其他诊断因素
- fadiga
- tosse
- cefaleia
- enfraquecimento
- linfonodos aumentados
- hepatomegalia
- tratamento antileishmaniose prévio
- epistaxe
- dor abdominal
危险因素
- alta exposição a picadas de flebotomíneo
- pobreza
- proximidade com um paciente com uma história de infecção
- proprietário de animais domésticos
- imunossupressão
诊断性检查
首要检查
- Hemograma completo
- testes da função hepática e ureia/creatinina
- gonadotrofina coriônica humana (hCG) sérica
需考虑的检查
- 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
治疗流程
leishmaniose cutânea (LC)
leishmaniose mucosa (LM)
leishmaniose visceral (LV)
leishmaniose dérmica pós-calazar (LDPC)
recidiva
撰稿人
作者
Naomi E. Aronson, MD
Professor of Medicine
Director, Infectious Diseases Division
Uniformed Services University of the Health Sciences
Bethesda
MD
利益声明
NEA receives federal grants to study leishmaniasis (received by NEA's institution USU), has given lectures on the topic of leishmaniasis at national and international meetings, and has a patent on biomarkers for leishmaniasis. NEA's institution USU has received royalties for her writing and editorial work for UpToDate. NEA is an unpaid member for the NIH/CDC/HIVMA guidelines group (the guideline is cited in this topic), and has chaired the IDSA/ASTMH guidelines (also cited in this topic). 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
利益声明
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.
鸣谢
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.
利益声明
RR and FC are authors of a number of references cited in this topic.
同行评议者
Roberto Arenas, MD
Chief of the Mycology Section
Dr. Manuel Gea Gonzalez General Hospital
Mexico
利益声明
RA is the author of an article cited in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Aronson N, Herwaldt BL, Libman M, et al. Diagnosis and treatment of leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis. 2016 Dec 15;63(12):1539-57.全文 摘要
National Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association, and Infectious Diseases Society of America. Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: Leishmaniasis. 2024 [internet publication].全文
Aronson NE, Joya CA. Cutaneous leishmaniasis: updates in diagnosis and management. Infect Dis Clin North Am. 2019 Mar;33(1):101-17. 摘要
Chakravarty J, Sundar S. Current and emerging medications for the treatment of leishmaniasis. Expert Opin Pharmacother. 2019 Jul;20(10):1251-65. 摘要
Pan American Health Organization. Guideline for the treatment of Leishmaniasis in the Americas. Second edition. Sep 2022 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Esplenomegalia malárica hiper-reativa (HMS)
- Infecção malárica
- Esquistossomose
More DifferentialsGuidelines
- CDC Yellow Book: health information for international travel - leishmaniasis
- CDC Yellow Book: health information for international travel - leishmaniasis
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