Spontaneous remission of fully symptomatic visceral leishmaniasis

BMC Infectious Diseases

Case Report

Nathalie Costedoat-Chalumeau¹  Mathilde Benhamou²  Gaëlle Leroux³  Zahir Amoura³  Oussama Mouri⁴  Nathalie Chartrel⁴  Pierre Buffet⁵  Marc Thellier⁵  Alain Devidas⁶ 

[1] AP-HP, Hôpital Cochin, Service de Médecine Interne. Centre de référence maladies auto-immunes et systémiques rares, Service de Médecine Interne, F-75014, Paris, France;AP-HP, Hôpital Cochin, Service de Rééducation et Réadaptation, F-75014, Paris, France;AP-HP, Hôpital Pitié-Salpêtrière, Service de Médecine Interne, F-75013, Paris, France;AP-HP, Hôpital Pitié-Salpêtrière, Service de Parasitologie, F-75013, Paris, France;AP-HP, Hôpital Pitié-Salpêtrière, Service de Parasitologie, F-75013, Paris, France;UPMC Université Paris 06, Centre Immunologie et Maladies Infectieuses, F-75005, Paris, France;Hopital Sud Francilien, Service d’Hématologie, Corbeil-Essonnes, France;

关键词: Visceral leishmaniasis;    Spontaneous remission;    Hemophagocytic lymphohistiocytosis;    Real time PCR;    Giemsa stained;    Bone marrow smear;   

DOI  :  10.1186/s12879-015-1191-6

 received in 2015-04-14, accepted in 2015-10-07,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundVisceral leishmaniasis (VL), i.e., infection with Leishmania sp. associated with high fever, weight loss, massive splenomegaly and markedly altered laboratory parameters, is generally fatal if untreated. The possibility of transient spontaneous remission of fully symptomatic visceral leishmaniasis (VL) has been mentioned but, to our knowledge) has never been documented.Case presentationWe report the first documented history of a patient with overt, confirmed VL experiencing a complete remission in the absence of any anti-leishmanial therapy. The diagnosis of VL at the time of the self-resolving episode was strongly suspected based on clinical presentation and presence of antileishmanial antibody, then unequivocally confirmed years later by the presence of an amastigote on a stored smear and the positive quantitative PCR with Leishmania-specific primers from the material scraped from this same slideConclusionThis report demonstrates that complete spontaneous remission may occur in patients with overt, fully symptomatic VL. VL should therefore be considered in cases of self-resolving or relapsing episodes of fever of unknown origin. Confirmation should be based on both serological tests and specific PCR on a blood sample.

【 授权许可】

CC BY   
© Mouri et al. 2015