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Leishmaniose

  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 23 Sep 2025
最后更新： 12 Aug 2025

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
完整详情

其他诊断因素

  • fadiga
  • tosse
  • cefaleia
  • enfraquecimento
  • linfonodos aumentados
  • hepatomegalia
  • tratamento antileishmaniose prévio
  • epistaxe
  • dor abdominal
完整详情

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
完整详情

诊断性检查

首要检查

  • Hemograma completo
  • testes da função hepática e ureia/creatinina
  • gonadotrofina coriônica humana (hCG) sérica
完整详情

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
完整详情

治疗流程

急症处理

leishmaniose cutânea (LC)

leishmaniose mucosa (LM)

leishmaniose visceral (LV)

持续性治疗

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
  • Leishmaniose images

  • Differentials

    • Esplenomegalia malárica hiper-reativa (HMS)
    • Infecção malárica
    • Esquistossomose
    More Differentials

  • Guidelines

    • CDC Yellow Book: health information for international travel - leishmaniasis
    • CDC Yellow Book: health information for international travel - leishmaniasis
    More Guidelines
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