LEISHMANIA: ARTAN HASTA SAYISINA DİKKAT! SALGIN OLABİLİR Mİ?

Year 2022, , 38 - 42, 30.04.2022

Gamze Şanlıdağ Oğuzhan Acet Hüseyin Aytaç Erdem Meltem Işıkgöz Taşbakan , Ayşe Deniz Gökengin Oğuz Reşat Sipahi , Hüsnü Pullukçu

https://doi.org/10.54962/ankemderg.1109808

Abstract

Leishmania spp., dişi tatarcıklar (Phlebotomus) ile insanlara bulaşan zorunlu hücre içi parazitleridir. Kutanöz layşmanyazis (KL) ve visseral layşmanyazis (VL) olmak üzere iki ana klinik formu bulunmaktadır. Dünya Sağlık Örgütü (DSÖ) tarafından ihmal edilen tropikal hastalıklardan biri olan layşmanyazisin her iki formu da ülkemizde endemiktir. Ancak ülkemizdeki son vaka sayıları bilinmemektedir. Vakaların sporadik olarak görüldüğü bir bölgede bulunan kliniğimizde Ocak-Mart 2021 tarihleri arasında üç visseral layşmanyazis, iki kutanöz layşmanyazis tanısı konmuştur. Bildirimi yapılan vaka sayıları ile karşılaştırıldığında artan vaka sayıları dikkat çekmiştir. Vakaların bir kısmı dış merkezde tetkik edilmiş olup layşmanyazis açısından tetkik edilmedikleri görülmüştür. Bu yazıda amaç; ülkemizin layşmanyazis açısından endemik bir bölge olduğunu vurgulamak ve nedeni bilinmeyen ateş olgularında ve uzun süreli lezyonlarda layşmanyazis ayırıcı tanısının da düşünülmesi gerektiğini vurgulamaktadır.

Keywords

HIV, Leishmania, kutanöz layşmanyazis, visseral layşmanyazis

Leishmania: Attention to the Increasing Number of Patients! Can It Be an Epidemic?

Abstract

Leishmania spp. are obligate intracellular parasites transmitted to humans by female sand flies (Phlebotomus). There are two main clinical forms: cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL). Both forms of leishmaniasis, one of the tropical diseases neglected by the World Health Organization (WHO), are endemic in our country. However, the latest case numbers in our country are not known. In our clinic located in a non-endemic region, three visceral leishmaniasis and two cutaneous leishmaniasis were diagnosed between January and March 2021. When compared to the number of reported cases, the increasing number of cases drew attention. Some of the cases were examined in an external center and it was seen that they were not examined in terms of leishmaniasis. The purpose of this article; emphasizes that our country is an endemic region in terms of leishmaniasis and the differential diagnosis of leishmaniasis should be considered in cases of unknown fever and long-term lesions.

Keywords

cutaneous leishmaniasis, HIV, Leishmania, visceral leishmaniasis

References

• Amela C, López-Gay D, Alberdi JC, Castilla J. Injecting drug use as risk factor for visceral leishmaniasis in AIDS patients. Eur J Epidemiol. 1996 Feb;12(1):91-2. https://doi.org/10.1007/BF00144435.
• 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). Am J Trop Med Hyg. 2017;96(1):24-45. https://doi.org/ 10.1093/cid/ciw742.
• Aslan G, Yapıcı G. Pandemi döneminde ihmal edilen enfeksiyonlar. Turk Mikrobiyol Cemiy Derg. 2021;51(3):214-24. https://doi.org/ 10.5222/TMCD.2021.43660
• Centers for Disease Control and Prevention. Revised Surveillance Case Definition for HIV Infection. MMWR. 2014 63(RR03);1-(erişim tarihi: 30.03.2021)
• De la Rosa R, Pineda JA, Delgado J, et al. Incidence of and risk factors for symptomatic visceral Leishmaniasis among Human Immunodeficiency Virus Type 1-infected patients from spain in the era of highly active antiretroviral therapy. J Clin Microbiol. 2002;40(3):762. https://doi.org/ 10.1128/JCM.40.3.762-767.2002
• Gradoni L, Scalone A, Gramiccia M, Troiani M. Epidemiological surveillance of leishmaniasis in HIV-1-infected individuals in Italy. AIDS. 1996;10(7):785-91. https://doi.org/ 10.1097/00002030-199606001-00014
• Graepp Fontoura I, Soeiro Barbosa D, De Andrade Paes AM, et al. Epidemiological, clinical and laboratory aspects of human visceral leishmaniasis (HVL) associated with human immunodeficiency virus (HIV) coinfection: a systematic review. Parasitology. 2018;145(14):1801-18. https://doi.org/ 10.1017/S003118201800080X
• Gürel MS, Yeşilova Y, Olgen MK, Ozbel Y. Cutaneous leishmaniasis in Turkey. Turkiye parazitolojii Derg. 2012;36(2):121-9. https://doi.org/ 10.5152/tpd.2012.29
• Kobets T, Grekov I, Lipoldova M. Leishmaniasis: prevention, parasite detection and treatment. Curr Med Chem. 2012;19(10):1443-74. https://doi.org/ 10.2174/092986712799828300
• Kutlubay Z, Özkoca D. Kutanöz Layşmanyazis Tedavisi. Türkiye Klin Dermatoloji - Özel Konular. 2021;14(2):6-12.
• Leishmaniasis. World Health Organization, https://www.who.int/data/gho/data/themes/topics/indicator-groups/indicator-group-details/GHO/leishmaniasis, (erişim tarihi: 04.12.2021)
• Leishmaniasis. World Health Organization, https://www.who.int/news-room/fact-sheets/detail/leishmaniasis, (erişim tarihi: 04.12.2021)
• Mauro V, Lorenzo M, Paolo C, Sergio H. Treatall COVID 19-positive patients, but do not forget those negative with chronic diseases. Intern Emerg Med. 2020; 15(5):787-90. https://doi.org/ 10.1007/s11739-020-02395-z
• Maxfield L, Crane JS. Leishmaniasis. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. (erişim tarihi 18.07.2021)
• Medrano FJ, Hernandez-Quero J, Jimenez E, et al. Visceral leishmaniasis in HIV-1-infected individuals: a common opportunistic infection in Spain? AIDS. 1992;6(12):1499-503. https://doi.org/ 10.1097/00002030-199212000-00013
• Neglected tropical diseases. World Health Organization, https://www.who.int/health-topics/neglected-tropical-diseases#tab=tab_1 (erişim tarihi:5 Aralık 2021)
• Ok ÜZ, Balcioǧlu IC, Taylan Özkan A, Özensoy S, Özbel Y. Leishmaniasis in Turkey. Acta Trop. 2002;84(1):43-8. https://doi.org/ 10.1016/s0001-706x(02)00134-1
• Ozkan AT, Yalçinkaya T, Kiliç S, Babür C, Schallig HD. HIV/AIDS hastalarında Leishmania infantum seropozitifliğinin araştırılması [Investigation of Leishmania infantum seropositivity in HIV/AIDS patients]. Mikrobiyol Bul. 2008 Jan;42(1):113-7.
• Petersdorf RG, Beeson PB. Fever of unexplained origin: report on 100 cases. Medicine (Baltimore) [Internet]. 1961;40(1):1-30. https://doi.org/ 10.1097/00005792-196102000-00001
• Pineda JA, Gallardo JA, Macías J, et al. Prevalence of and factors associated with visceral leishmaniasis in human immunodeficiency virus type 1-infected patients in southern Spain. J Clin Microbiol. 1998;36(9):2419-22. https://doi.org/ 10.1128/JCM.36.9.2419-2422.1998
• Pullukçu H,Turgay N, Işıkgöz Taşbakan M, Akyol D, Sipahi OR, Yamazhan T, Töz SÖ. Fever of Unknown Origin and Visceral Leishmaniasis: a Series of 20 Adult Patients. FLORA. 2018;23(2):92-4. https://doi.org/10.5578/flora.66819
• Ural S, Kaptan F, Sezak N, et al. Evaluation of clinical and laboratory findings of adult visceral leishmaniasis cases. Mikrobiyol Bul. 2015;49(4):586-93. https://doi.org/ 10.5578/mb.9780