关键词: 内脏利什曼病, 输入性病例, 宏基因组第二代测序

Abstract:

The patient, a 46-year-old male, was a farmer from Zhongning County, Zhongwei City, Ningxia. The patient worked as a Gogie berry farmer and picker in Sidaogou Village, Yumen City, Jiuquan City, Gansu Province during 2013—2021 March to October. The patient showed fever, sweating and joint pain with no obvious causes on February 18, 2022. The highest body temperature exceeded 40 ℃ and the patient was diagnosed with a“lung infection” at a local clinic. Penicillin and cephalosporin were administrated but unsuccessful. On March 6, the patient was treated at the General Hospital of Ningxia Medical University. The patient’s physical examination upon admission showed clear consciousness, a flat and soft abdomen, no palpable abdominal mass, and no palpable subcostal liver. Blood routine showed: white blood cell count was 2.61 × 10⁹/L, hemoglobin level was 122.0 g/L, platelet count was 114.0 × 10⁹/L. On March 17, abdominal ultrasound showed liver enlargement, reduced and uniform echo in the paren-chyma, and unclear vascular imaging. Spleen enlargement without obvious lesions. On March 21, blood samples were sent to Yugok Biotechnology Co. Ltd. for the second-generation sequencing of the macro genome. The results showed 420 sequences of the Leishmania genus, including 418 sequences of L. donovani. Based on the clinical symptoms and laboratory examination results, it was diagnosed as visceral leishmaniasis. Amphotericin B (5 mg) was administered intravenously for 8 consecutive days, and the condition improved. The body temperature dropped to 36.2 ℃. On day 9, she was discharged after 1 day of intravenous drip with antimony sodium gluconate (6 ml). After discharge, the patient was given an intramuscular injection of antimony sodium gluconate (6 ml/d, suspended for 2 weeks after continuous injection for 6 days, and continued for 9 days), and other symptoms were treated accordingly. After one month of discharge, there was a phone follow-up, and the body felt light and weak; two months after discharge, the telephone follow-up showed good recovery.

Key words: Vsceral leishmaniasis, Imported case, Metagenomic next generation sequencing