骨髓穿刺诊断黑热病3例及临床病理分析

目的报道黑热病累及骨髓3例,探讨黑热病的组织学特点、诊断、鉴别诊断。方法对3例黑热病患者的骨髓穿刺标本行HE、PAS、免疫组化染色,结合临床表现进行光镜分析,并进行文献复习。结果利什曼原虫的确诊主要依靠病原学检查。结论黑热病目前的患病率相对较低,如果患者来自疫区,有高热反复不退的症状需考虑黑热病的可能性,需要注意与组织胞浆菌和马尔尼菲青霉菌进行鉴别,本病预后较好,大部分可治愈。

A clinicopathologic study on kala azar：report of 3 cases diagnosed by bone marrow smear eXamination

Objective To explore the clinical histological features,diagnosis and differential diagnosis of kala azar. Methods The bone marrow smears of patients with kala azar were examined by light microscopy after HE staining,and related literatures had been reviewed. Results The final diagnosis of kala azar depended upon：the finding of pathogenic protozoa,the amastigotes of Leishmania. Conclusion The incidence rate of kala azar in China is low,it should be considered when patients with long term fever coming from endemic area. It′s hard to make differenti-al diagnosis with histoplasmosis and infection with Penicillium marneffei. The prognosis of this disease is good,most of patients can be cured by chemotherapy.