最近审阅: 1 十一月 2020
最近更新: 28 五月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 以往有在流行区内居住史
  • 免疫抑制
  • 持续性发热
  • 体重减轻
  • 溃疡性皮肤病变
  • 存在的危险因素
  • 多处产生非溃疡性皮肤结节
  • 破坏性黏膜炎症
  • 脾肿大
  • 皮肤色素沉着

其他诊断因素

  • 疲劳
  • 咳嗽
  • 头痛
  • 消瘦
  • 淋巴结肿大
  • 肝肿大
  • 既往抗利什曼原虫治疗
  • 鼻衄
  • 腹痛

危险因素

  • 高度暴露于白蛉叮咬
  • 贫穷
  • 近距离接触有感染史的患者
  • 家畜饲养者
  • 免疫抑制

诊断性检查

首要检查

  • 全血细胞计数 (FBC)
  • 肝功能试验和尿素/肌酐
  • 血清人绒毛膜促性腺激素(hCG)
更多 首要检查

需考虑的检查

  • 相关标本的显微镜检查
  • 血液或组织培养
  • 聚合酶链反应 (PCR)
  • 血清学
  • 利什曼素皮肤试验(蒙氏皮肤试验)
  • 血清 HIV 检测
更多 需考虑的检查

治疗流程

撰稿人

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, 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 receives royalties from Elsevier for editing Hunter’s textbook of Tropical Medicine and Emerging Infectious Diseases, and from UpToDate for writing on cutaneous leishmaniasis. 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.

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.

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.

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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.

Medical Epidemiologist

Centers for Disease Control and Prevention

Atlanta

GA

利益声明

CB is an author of a number of references cited in this topic. 

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