Female patient, 29 age, married, lives in Ha Long. Admitted of hospital 16/03/2001. Reason for admitted hospital: prolonged fever symtoms: splenomegaly, hepatomegaly, enlargement of the lymph glands, anemia, purpura. Investigation: thrombocytopenia, hypohemoglobin, hyperglobulin, HIV positive. Hypermacrophages were indentidied by microsscopy in the bone marrow smear: parasites in macrophages look like Amastigote of Leishmania parasites in the atlas (the morphology of human blood cells- abbott laboratories). Born marrow cultured in NNN medium: identidied promastigote. Diagnosis: visceral Leishmaniaxsis. It was confirmed by Karolinska hospital of Sweden, China, Singapore, Australia. This is first case indentified in Vietnam
Leishmaniasis, Visceral ; Leishmania donovani

A female patient 29 years old, married, lived in Halong was admitted to hospital in 16/03/2001. Reason for admitting hospital: prolonged fever. Symptoms: splenomegaly, hepatomegaly, enlargement of the lymph glands, amenia and purpura. Investigation: Thrombocytepenia, hypomemoglobin, hyperglobulin, HIV positive. Hypermacrophages were identified by microscopy in the born marrow smear: parasites in macrophages look like Amastigote of Leishmania parasites in the Atlas (The morphology of human blood cells- Abbott laboratories). Born marrow cultured in N.N.N medium: identified Promastigotes. Diagnosis: Visceral Leishmaniasis. It was confirmed by Karolinska hospital of Sweden, China, and Singapore. This is first case identified in Vietnam
Leishmaniasis, Visceral ; Leishmania donovani

Female ; Humans ; Infant ; Leishmaniasis, Visceral

No abstract available.
Female ; Humans ; Leishmaniasis, Visceral* ; Lupus Erythematosus, Systemic*

Adult ; Diagnosis, Differential ; Female ; Humans ; Leishmaniasis, Visceral ; diagnosis

OBJECTIVES: Leishmania parasites are the causative agents of leishmaniasis. The Visceral leishmaniasis (VL) form of the disease is fatal if not treated in most cases. This study examined the epidemiological aspects of VL in two southwest counties of Iran. METHODS: This was a retrospective study of hospitalized patients with a laboratory confirmation of VL from Larestan and Ghiro-Karzin Counties. RESULTS: For Larestan county, a decline in the incidence of VL has been observed from 2004 to 2015. Significantly more males (n = 14) than females (n = 6) were infected with VL in this county (p < 0.05), >95% of cases in children under 5 years of age. In Ghiro-Karzin county, the results were similar to a decline in VL infection from 2004 to 2015, and slightly more males (n = 14) than females (n = 11). Similarly, the majority of the patients infected with VL were children under 5 years old (88%). CONCLUSION: The results from this study indicate that although the incidence of VL infection has reduced over time, VL was more prevalent in boys under 5 years old, suggesting that more attention to controlling the parasite and its vector are required.
Child ; Epidemiology ; Female ; Humans ; Incidence ; Iran* ; Leishmania ; Leishmaniasis ; Leishmaniasis, Visceral* ; Male ; Parasites ; Retrospective Studies

A patient with fever, chills, and pancytopenia as major clinical manifestations was presented. To investigate the cause, the patient's peripheral blood was collected for pathogen screening using metagenomic next - generation sequencing (mNGS). The DNA sequence of Leishmania donovani was detected, and Leishmania amastigotes were found in bone marrow smears using microscopy. The case was therefore definitively diagnosed as visceral leishmaniasis, and was cured and discharged from hospital following treatment with liposomal amphotericin B for 14 days. This is the first imported case of visceral leishmaniasis since the founding of Shenzhen City in 1979.
Humans ; Fever ; High-Throughput Nucleotide Sequencing ; Leishmania donovani/genetics* ; Leishmaniasis, Visceral/drug therapy*

OBJECTIVEThe clinical features of four cases of visceral leishmaniasis (VL)-associated hemophagocytic lymphohistiocytosis (VL-HLH) were retrospectively analyzed for the purpose of helping the diagnosis of secondary HLH.

METHODClinical data of three childhood cases of VL-HLH documented in our hospital and one case diagnosed in the Capital Institute of Pediatrics was reviewed retrospectively, with particular emphasis on peculiar clinical manifestations and on clues to the diagnosis of this relatively rare disease entity.

RESULTThree children were from endemic areas of VL, and the other one had lived in endemic area for one year, which was revealed by detailed history-taking. Clinically, VL-HLH is characterized by persistent fever, hepatosplenomegaly and pancytopenia, which is similar to those of HLH, and is one of the important reasons of delayed diagnosis or misdiagnosis. Based on the HLH-2004 protocol, all the four cases met the diagnostic criteria of HLH. In addition, bone marrow aspirate and immunologic detection of VL-specific antibody via rk39 dipstick test during the early disease course of VL-HLH yielded negative results. Two cases who received HLH-targeted therapy responded reasonably well, with rapid temperature normalization and spleen retraction. Nevertheless, Hb remained lower than normal, which we believed to be related to persistent red cell destruction by the invading parasite Leishmania donovani.

CONCLUSIONVL, a parasitic disease caused by Leishmania donovani, which is currently endemic just in 6 provinces in China, shares similar clinical picture of HLH and is an easily ignored underlying cause of secondary HLH. We suggest that VL should be in the list of differential diagnosis for any patients with HLH who lives in or has a definite travel history to endemic areas. Repeated bone marrow studies are highly warranted to make a definite diagnosis of VL, because bone marrow aspirate or rk39 dipstick test during early disease course might yield negative results. Although VL-HLH responds quite well to HLH-tailored chemotherapy, specific therapy against VL must be given to prevent disease recurrence, and HLH-targeted chemotherapy might be discontinued to prevent chemotherapy-related toxicities.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Leishmania donovani ; Leishmaniasis, Visceral ; complications ; diagnosis ; Lymphohistiocytosis, Hemophagocytic ; diagnosis ; etiology ; parasitology ; Male

OBJECTIVETo confirm the existence of point mutations in the SSU rDNA variable regions of 5 Leishmania donovani (L.d.) isolates from different epidemic foci in China.

METHODSSpecific SSU rDNA fragments from nuclear DNA of 7 Leishmania species/isolates were amplified by PCR and then cloned into pGEM(R)-T Easy Vectors. After that, the specific fragments were sequenced by an automated DNA sequencer.

RESULTSSequence analysis showed that the amplified DNA fragments of 7 Leishmania species/isolates were all 392 bp in length. All 5 point mutations were located in two unique sequence blocks (UQ-I and UQ-II), and no insertions or deletions were found. The identities of comparison of Leishmania in GeneBank were more than 98%.

CONCLUSIONFive point mutations exist in the SSU rDNA variable region of 5 L.d. isolates from different epidemic foci of visceral leishmaniasis (VL) in China. Sequence differences of the SSU rDNA variable region exist among L.d. isolates from different foci.

Animals ; DNA, Protozoan ; chemistry ; DNA, Ribosomal ; chemistry ; Humans ; Leishmania donovani ; genetics ; Leishmaniasis, Visceral ; parasitology ; Point Mutation ; Polymerase Chain Reaction

Leishmaniasis (Kala-azar) from different endemic regions of China expresses different clinic and epidemiological features, and traditionally is classified as hilly, plain and desert types/foci. We concentrated our review on whether the pathogens from those foci were different at molecular level, if so, whether there are were molecular markers readily identifiable by molecular technologies. This was a review of a 20-year search for such markers by using kinetoplastic DNA (kDNA), nDNA hybridization, PCR-SSCP, RAPD and sequence analysis of SSU rDNA variable regions and LACK gene. The results showed that heterogeneities at molecular level exist in Leishmania isolated from different foci of China, which could be used as markers for different types of Leishmaniasis in China.
China ; DNA Fingerprinting ; DNA, Protozoan ; analysis ; genetics ; Genotype ; Humans ; Leishmania donovani ; classification ; genetics ; isolation & purification ; Leishmaniasis, Visceral ; classification ; parasitology ; Mutation