Dört Eriskin Visseral Leishmaniasis Olgusunun Degerlendirilmesi/Evaluation of Four Adult Visceral Leishmaniasis Cases
Leishmania infantum, Türkiye'nin Ege, Akdeniz ve Iç Anadolu bölgelerinde agirlikli olarak pediatrik yas gruplarinda sporadik olarak gözlenen viseral leishmaniasis'den [(VL), kala-azar] sorumlu türdür. Bu çalismanin amaci, hastanemize basvuran VL'li dört eriskin hastanin tanisi...
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| Published in: | Türkiye parazitolojii dergisi Vol. 47; no. 4; p. 275 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Galenos Yayinevi Tic. Ltd
01-12-2023
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Leishmania infantum, Türkiye'nin Ege, Akdeniz ve Iç Anadolu bölgelerinde agirlikli olarak pediatrik yas gruplarinda sporadik olarak gözlenen viseral leishmaniasis'den [(VL), kala-azar] sorumlu türdür. Bu çalismanin amaci, hastanemize basvuran VL'li dört eriskin hastanin tanisi, klinigi, laboratuvar sonuçlari ve tedavilerini degerlendirmektir. Hastalar, hematolojik malignite arastirilmasi amaciyla hastanemize yönlendirilmistir. Ãalismada, hastanemizin enfeksiyon hastaliklari kliniginde Ocak 2022-Nisan 2022 tarihleri arasinda VL teshisi konulan ve yatirilarak tedavi edilen dört hastanin (üç erkek, bir kadin; yas araligi: 30-40 yil) verileri retrospektif olarak degerlendirildi. VL tanisi, uygun klinik ve fizik muayene bulgulari, biyokimyasal ve serolojik testler (indirekt floresan antikor testi ve rK39 hizli antijen testi) ve polimeraz zincir reaksiyonu (PCR) sonuçlarina göre, ayrica kemik iligi örneklerinde parazitin amastigot formlarinin görülmesi ile konulmustur. Hastalarin hepsinde seroloji poztifligi, iki hastada ise KI pozitifligi saptandi. Hastalarin hepsinde RT-PCR sonucuna göre hastaliga neden olan türün L. infantum/L. donovani oldugu belirlendi. Hastalarda baslangiçta en sik ates, halsizlik ve karinda sislik gibi belirtiler saptandi. Hastalarin hiçbirisinde immün sistemi baskilayici bir durum yoktur. Bütün hastalarin Suriye'nin Idlip iline bagli kirsal alanda yasadigi anlasildi. Bütün hastalarda hepatosplenomegali, eritrosit sedimentasyon hizinda artis, anemi, lökopeni ve trombositopeni saptandi. Hastalarin tedavisi, lipozomal amfoterisin-B ile yapildi. Bir hasta takiplere gelmedi, diger üç hastanin takiplerinde tamamen iyilestikleri saptandi. Hastalarin hiçbirisinde nüks görülmedi. Sonuç olarak, saglik kurumlarina ates, hepatosplenomegali, eritrosit sedimentasyon hizinda artis, anemi, lökopeni ve trombositopeni sikayetleri ile basvuran hastalarda VL'nin de dikkate alinmasi gerekmektedir. Anahtar kelimeler: Viseral leishmaniasis, tani, tedavi Leishmania infantum is the species responsible for visceral leishmaniasis [(VL), kala-azar], which is observed sporadically mainly in pediatric age groups in the Aegean, Mediterranean and Central Anatolian regions of Türkiye. The aim of this study is to evaluate the diagnosis, clinic, laboratory results and treatments of four adult patients with VL who applied to our hospital. The patients were referred to our hospital to investigate hematological malignancy. In the study, the data of four patients (three men, one woman; age range: 30-40 years) who were diagnosed with VL and treated in the infectious diseases clinic of our hospital between January 2022 and April 2022 were evaluated retrospectively. The diagnosis of VL was made according to appropriate clinical and physical examination findings, biochemical and serological tests (indirect fluorescent antibody test and rK39 rapid antigen test) and polymerase chain reaction (PCR) results, as well as the presence of amastigote forms of the parasite in bone marrow samples. Serology positivity was found in all patients, and bone marrow positivity was found in two patients. According to the results of RT-PCR in all patients, it was determined that the species causing the disease was L. infantum/L. donovani. Initially, the most common symptoms were fever, fatigue, and abdominal distension. None of the patients had an immunosuppressive condition. It was understood that all the patients lived in the rural area of Syria's Idlib province. Hepatosplenomegaly, increased erythrocyte sedimentation rate, anemia, leukopenia and thrombocytopenia were found in all patients. The patients were treated with liposomal amphotericin-B (L-AMB). One patient did not come for follow-ups, the other three patients were found to have completely recovered in their follow-up. No recurrence was observed in any of the patients. In conclusion, VL should be considered in patients who apply to health institutions with complaints of fever, hepatosplenomegaly, increased erythrocyte sedimentation rate, anemia, leukopenia and thrombocytopenia. Keywords: Visceral leishmaniasis, diagnosis, treatment |
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| ISSN: | 1300-6320 |
| DOI: | 10.4274/tpd.galenos.2023.47550 |