华盛顿特区的一例附件皮肤利什曼病。

IF 2.9 Q1 OPHTHALMOLOGY
Sinan Akosman, Heeyah Song, Paul Sheils, Tamer Mansour, Keith J Wroblewski, Lamise Rajjoub
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引用次数: 0

摘要

目的:报告华盛顿特区一例罕见的非流行性利什曼原虫病例:一名 68 岁的女性前来接受常规检查,主诉其右上眼睑在过去 5 个月中出现了皮损。经检查,患者右眼内侧眦部至眉心处有一簇隆起的红斑。最初怀疑是病毒引起的,使用 Valtrex 治疗无效。随后的检查包括鼻泪管冲洗、排除自身免疫病因的血液检查、强力霉素疗程和核磁共振检查,但均无改善。当眼睑上的病变发展成持续性斑块时,进行了打孔活检,证实了利什曼病。随后,患者开始口服米替福新,疗程为 28 天,症状完全缓解:本病例强调了广泛鉴别包括非流行性疾病的重要性,尤其是在患者频繁出差的城市地区。此外,本病例中的延迟打孔活检突显了对患者进行咨询以确保及时诊断和治疗的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A case of adnexal cutaneous leishmaniasis in Washington DC.

Purpose: To report a rare non-endemic case of Leishmania aethiopica in Washington DC.

Case report: A 68-year-old female presented for a routine examination with a complaint of right upper eyelid lesions for the past 5 months. On examination, a cluster of elevated and erythematous lesions extending from the medial canthus to the brow area of the right eye were seen. Initial treatment with Valtrex based on a suspected viral etiology failed. Although a biopsy was recommended at this time, the patient declined, and subsequent workup included nasolacrimal duct irrigation, blood work to rule out autoimmune etiology, a course of doxycycline, and an MRI, which yielded no improvement. Upon progression of the lesions into persistent plaques on the eyelids, a punch biopsy was performed, confirming leishmaniasis. The patient was then started on a 28-day course of oral miltefosine which led to complete resolution of her symptoms.

Conclusion: This case underlines the importance of a broad differential including non-endemic diseases, particularly in urban areas with frequent patient travel. Furthermore, the delayed punch biopsy in this case highlights the importance of patient counseling to ensure prompt diagnosis and treatment.

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来源期刊
CiteScore
3.80
自引率
3.40%
发文量
39
审稿时长
13 weeks
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