CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES ›› 2022, Vol. 40 ›› Issue (2): 266-268.doi: 10.12140/j.issn.1000-7423.2022.02.022

• CASE REPORTS • Previous Articles     Next Articles

Relapse of visceral leishmaniasis in a cured case after 64 years

ZHANG Ai-ping(), LIANG Man-man, ZHU Ling-ling, SHENG Hao-yu, YANG Jiang-hua*()   

  1. Department of Infectious Diseases, Yijishan Hospital, Wannan Medical College, Wuhu 241001, China
  • Received:2021-07-30 Revised:2021-11-17 Online:2022-04-30 Published:2022-03-11
  • Contact: YANG Jiang-hua E-mail:1124247919@qq.com;yjhpath@163.com

Abstract:

A 74-year-old patient from Juxian County, Rizhao, Shandong Province was diagnosed with visceral leishmaniasis and treated with pentavalent antimony for 6 d in the local hospital of Juxian in 1957. In 1964, the patient migrated to Ma’anshan City, Anhui Province. In October 2014, He travelled back to Juxian County for two weeks before returning to Ma’anshan City. In July 2020, he migrated to Bozhou City, Anhui Province. The patient denied any history of being bitten by sandfly, living with a dog at home during this period. The patient had no contact history of visceral leishmaniasis patients or Leishmannia infected dogs. The patient presented unexplained emaciation and fatigue from July 2020, and dizziness from April 2021. The patient had a sudden high fever without obvious inducement and aggravated fatigue and dizziness in June 2021. Bone marrow smear examination revealed Leishmania parasite flagellate body. The metagenomic analysis of the bone marrow pathogenic microorganisms revealed 30 366 sequences of the Leishmania genus, including 128 sequences of Leishmania donovani. Serum rk39 immunochromatographic strip showed a positive result. Combining the epidemiological history and labortory test results, a recurrent visceral leishmaniasis diagnosis was made. The patient was discharged after treatment with pentavalent antimony (0.6 g/d, intramuscular injection, 6 g, one course of 10 days). The patient was followed up by telephone after discharge, and showed no fever but did not go to the hospital for review.

Key words: Visceral leishmaniasis, Leishmania, Recurrent infection

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