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首页> 外文期刊>Infection >Focal spleen lesions in visceral leishmaniasis, a neglected manifestation of a neglected disease: report of three cases and systematic review of literature
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Focal spleen lesions in visceral leishmaniasis, a neglected manifestation of a neglected disease: report of three cases and systematic review of literature

机译：内脏Leishmaniaisis的局灶性脾脏病变，被忽视的疾病表现出来的忽视表现：关于文学的三种病例和系统审查报告

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BackgroundThe Mediterranean area is endemic for the zoonotic form of visceral leishmaniasis (VL) caused by Leishmania infantum, a species which has been recently associated with unexpected epidemiological and clinical features.MethodWe report the result of a systematic review of the literature on VL unusually presenting with spleen focal lesions, including three previously unpublished cases.ResultsA total of 28 cases of VL with multiple spleen focal lesions were retrieved. Twenty-six (93%) were acquired in the Mediterranean area, where L. infantum is endemic. Thirteen cases were diagnosed in children, and the remaining 15 cases in middle-aged adults, of whom 9 were immunosuppressed. Four patients (14%) underwent diagnostic splenectomy, while the diagnosis was confirmed by less invasive techniques in the remaining patients. The most common radiological patterns were: multiple subcentimetric or centimetric spleen lesions (size <= 1cm in 14 of 19 cases, 74%), hypoechoic at ultrasonography (25 of 26 cases, 99%) and hypodense at CT scan (9 of 10 cases, 90%). PET-CT (available for four patients) showed an intense FDG spleen uptake. MRI and contrast-enhanced ultrasonography, available for two and one cases each, showed complex patterns.ConclusionsVL must be added to the list of possible differential diagnosis of spleen focal lesions and health care provider awareness about this condition will avoid unnecessary invasive diagnostic procedures.
机译：背景，地中海地区是由Leishmania Infantum引起的内脏LeishManiaisis（VL）的人群，最近与意外流行病学和临床特征有关的物种。普通撰写了对vl的系统审查的结果，同意脾脏焦点病变，包括三个以前未发表的病例。检测到具有多个脾脏焦点病变的28例VL的总共28例。在地中海地区获得了二十六（93％），其中L. Infantum是地方性的。在儿童诊断出13例病例，其余15例中年成年人的病例，其中9例被免疫抑制。四名患者（14％）接受诊断脾脏切除术，而剩余患者中的侵入性技术则确认诊断。最常见的放射性图案是：多重细胞或厘秒脾脏病变（14例14例，74％），超声检查中的低压象（26例，99％）和CT扫描中的脱索（9例9例） ，90％）。 PET-CT（可用于四名患者）显示出强烈的FDG脾脏摄取。 MRI和对比度增强的超声检查，每次和一个病例可用，显示复杂的图案.ConclusionsVL必须添加到可能的差异诊断列表中，脾脏病群病变和医疗保健提供者意识到这种情况将避免不必要的侵入性诊断程序。

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