The clinical data of 3 imported kala-azar patients
Objective To analyze the clinical data of 3 imported kala-azar patients in Yichang city of Hubei province,and provide basis for early diagnosis and treatment.Method The epidemiological and clinical data of 3 patients diagnosed with kala-azar in the Yichang Central People's Hospital from January 2014 to December 2023 were collected and analyzed.Results All the 3 patients were male and had an epidemiological history of working in the endemic areas of kala-azar;the incubation period was 2,10 and 20 months,respectively.At the onset of the disease,3 patients had chills and fever,2 patients had muscle or joint pain,2 patients had poor appetite,and 1 patient had headache,1 patient had cough and expectoration,3 patients had splenomegaly,and 2 patients underwent splenectomy and splenic biopsy,only one case had lymphadenopathy and lymph node biopsy.All 3 patients had blood cell decrease in different degree,2 patients had leukopenia and neutrophil,2 patients had anemia of different degrees,2 patients had thrombocytopenia,and 3 patients had hypoproteinemia,1 patient had marked increase of globulin,1 patient had severe decrease of fibrinogen,and 3 patients had abnormal increase of serum ferritin.All the 3 patients were positive for Leishmania species confirmed by bone marrow smear microscopy and PCR sequencing,and all of them were cured by amphotericin B treatment.Conclusion Medical staff in non-epidemic areas should consider the possibility of kala-fever,and make early diagnosis and treatment when receiving patients with recurrent fever,splenomegaly and cytopenia,especially those with a history of travel and residence north of the Yangtze River.
Kala-azarLeishmaniaHemophagocytic syndromeAmphotericin B
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