Background: In Israel, most cutaneous leishmaniasis (CL) is caused by Leishmania major. Recently a new focus of CL caused by Leishmania tropica has been described in Tiberias and the surrounding area of northern Israe...Background: In Israel, most cutaneous leishmaniasis (CL) is caused by Leishmania major. Recently a new focus of CL caused by Leishmania tropica has been described in Tiberias and the surrounding area of northern Israel. Objective: The aim of this study was to evaluate clinical (size, number, location, and type of lesion) and laboratory (culture and polymerase chain reaction [PCR] analysis) parameters at diagnosis, response to treatment, and outcome of patients with CL due to L tropica. Methods: Between September 2002 and March 2004, patients with direct smear- confirmed CL were evaluated; clinical records were reviewed and a telephone survey was performed. Results: Forty nine patients, 34 (69% ) male and 15 (31% ) female, were studied. Mean age was 31.1 years (median 26 years, range 1- 70); 76% of patients live in Tiberias and the surrounding area. The mean number of lesions was 2.6 (median 2, range 1- 10). Lesions were commonly located on the face (61% ) and upper limbs (57% ). PCR analysis was performed in 27 patients and was positive for L tropica in 26. Fifty percent of patients studied received multiple therapeutic regimens because of incomplete response or treatment failure. Topical paromomycin was used in 44 patients (90% ), with a complete response reported in only 17 (39% ); of the 9 patients treated with intralesional sodium stibogluconate, a complete response was reported in 6 (67% ); of the 5 patients treated with intravenous sodium stibogluconate, 4 (80% ) were cured. Limitations: The relatively small number of patients studied combined with the fact that some were assessed retrospectively limit our conclusions. In addition, 50% of the patients studied received multiple therapeutic regimens because of failure of, or incomplete responses to, their initial therapy, thereby making comparisons difficult. Conclusions: The cure rate in those completing a course of antimony therapy, either 10 or more days of intravenous therapy or therapy administered intralesionally,was 75% (95% confidence interval [CI], 5展开更多
我院内科从1961至1964年6月底3年零6月的时期内,用酒石酸锑钾治疗16例血吸虫病合併心脏血管系疾病的患者。其临床诊断主要依据病史,体检,心电图描记和 X 线检查等的综合分析。治疗的指征为粪便或乙状结肠镜检查发现血吸虫卵阳性。除1例...我院内科从1961至1964年6月底3年零6月的时期内,用酒石酸锑钾治疗16例血吸虫病合併心脏血管系疾病的患者。其临床诊断主要依据病史,体检,心电图描记和 X 线检查等的综合分析。治疗的指征为粪便或乙状结肠镜检查发现血吸虫卵阳性。除1例有Ⅰ度充血性心力衰竭征象,先用毒毛旋花素K 控制心力衰竭外,其余病例均无明显的充血性心力衰竭征象或自觉症状者。展开更多
文摘Background: In Israel, most cutaneous leishmaniasis (CL) is caused by Leishmania major. Recently a new focus of CL caused by Leishmania tropica has been described in Tiberias and the surrounding area of northern Israel. Objective: The aim of this study was to evaluate clinical (size, number, location, and type of lesion) and laboratory (culture and polymerase chain reaction [PCR] analysis) parameters at diagnosis, response to treatment, and outcome of patients with CL due to L tropica. Methods: Between September 2002 and March 2004, patients with direct smear- confirmed CL were evaluated; clinical records were reviewed and a telephone survey was performed. Results: Forty nine patients, 34 (69% ) male and 15 (31% ) female, were studied. Mean age was 31.1 years (median 26 years, range 1- 70); 76% of patients live in Tiberias and the surrounding area. The mean number of lesions was 2.6 (median 2, range 1- 10). Lesions were commonly located on the face (61% ) and upper limbs (57% ). PCR analysis was performed in 27 patients and was positive for L tropica in 26. Fifty percent of patients studied received multiple therapeutic regimens because of incomplete response or treatment failure. Topical paromomycin was used in 44 patients (90% ), with a complete response reported in only 17 (39% ); of the 9 patients treated with intralesional sodium stibogluconate, a complete response was reported in 6 (67% ); of the 5 patients treated with intravenous sodium stibogluconate, 4 (80% ) were cured. Limitations: The relatively small number of patients studied combined with the fact that some were assessed retrospectively limit our conclusions. In addition, 50% of the patients studied received multiple therapeutic regimens because of failure of, or incomplete responses to, their initial therapy, thereby making comparisons difficult. Conclusions: The cure rate in those completing a course of antimony therapy, either 10 or more days of intravenous therapy or therapy administered intralesionally,was 75% (95% confidence interval [CI], 5
文摘我院内科从1961至1964年6月底3年零6月的时期内,用酒石酸锑钾治疗16例血吸虫病合併心脏血管系疾病的患者。其临床诊断主要依据病史,体检,心电图描记和 X 线检查等的综合分析。治疗的指征为粪便或乙状结肠镜检查发现血吸虫卵阳性。除1例有Ⅰ度充血性心力衰竭征象,先用毒毛旋花素K 控制心力衰竭外,其余病例均无明显的充血性心力衰竭征象或自觉症状者。
