经骨髓细胞形态学检查确诊内脏利什曼病一例

    王哲徐倩付建珠赵亚玲张昕孙立娜田明杰

    【摘要】内脏利什曼病又名黑热病，是通过中华白蛉叮咬而传播的慢性地方性传染病，属人畜共患疾病，目前临床上已较少见，极易误诊。其临床表现主要为不规则发热，肝、脾、淋巴结肿大以及贫血等。该文报道1例以不规则发热、肝与脾肿大及全血细胞减少为主要表现的内脏利什曼病患儿，于其骨髓涂片中发现利什曼原虫的无鞭毛体，遂确诊，给予葡萄糖酸锑钠治疗后，患儿病情好转，肝、脾明显缩小，血常规及骨髓象恢复正常。因此，骨髓细胞形态学检查对于诊断内脏利什曼病极为重要。

    【关键词】内脏利什曼病；脾肿大；骨髓；利什曼原虫

    收稿日期：(2015-05-14)

    DOI：10.3969/g.issn.0253-9802.2015.10.016

    One case of visceral leishmaniasis diagnosed by bone marrow cell morphological examinationWangZhe,XuQian,FuJianzhu,ZhaoYaling,ZhangXin,SunLina,TianMingjie.ClinicalLaboratory,theFirstHospitalofBaoding,Baoding071000,China

    Correspondingauthor,TianMingjie,E-mail:2530135881@qq.com

    Abstract【】Visceral leishmaniasis, also known as Kala-azar, is a chronic endemic infectious disease caused by phlebotomus chinensis, which can infect both human and animals. At present, it is rarely reported in clinical practice and likely to be misdiagnosed. This disease is clinically manifested with irregular fever, hepatosplenomegaly, lymphadenopathy and anemia, etc. In this paper, we reported one suspected case of Kala-azar presenting with fever, hepatosplenomegaly and pancytopenia. The diagnosis was confirmed by identifying Leishmania donovani amastigotes through bone marrow smears. After treated with sodium stiboglucinate, the child was improved. The size of liver and spleen was significantly reduced and routine blood and bone marrow examinations revealed normal outcomes. Consequently, bone marrow cell morphological examination is of significance in the diagnosis of visceral leishmaniasis. ......