Abstract: Objective　To perform an epidemiological investigation on a case of visceral leishmaniasis reported from Shule County, Kashi Prefecture, Xinjiang Uygur Autonomous Region in 2021, so as to provide insights into differential diagnosis of visceral leishmaniasis during the COVID⁃19 pandemic. Methods　The epidemiological history of this case was collected, and the case was diagnosed for Leishmania infection with the immunochromatographic (rK39) strip test, bone marrow smear microscopy and PCR assay. Results　The patient had typical clinical symptoms of leishmaniasis, including irregular fever, hepatosplenomegaly, low serum albumin and elevated globulin. Bone marrow smear microscopy identified L. donovani amastigotes, and both rK39 strip test and PCR assay were positive, while the case was tested negative for SARS⁃CoV⁃2. COVID⁃19 was therefore excluded and visceral leishmaniasis was diagnosed. Standard full⁃dose treatment with sodium stibogluconate was given, and no Leishmania was found on blood smears during the reexamination. No recurrence was found during the followup after discharge for hospital. Conclusions　During the COVID⁃19 pandemic, it is recommended to increase the perception of differential diagnosis of visceral leishmaniasis among first⁃contact doctors, and reinforce the capability of differential diagnosis and health education of visceral leishmaniasis among medical and healthcare institutions at all levels, to prevent missed diagnosis and misdiagnosis of visceral leishmaniasis.

Key words: Visceral leishmaniasis, COVID?19, Differential diagnosis

摘要： 目的　对2021年新疆维吾尔自治区喀什地区疏勒县报告的1例内脏利什曼病病例进行调查，为新型冠状病毒肺炎疫情流行期间内脏利什曼病鉴别诊断提供参考依据。方法　收集患者流行病学史，采用rk39快速诊断试剂、骨髓涂片镜检和分子生物学技术进行检测。结果　患者主要表现为不规则发热、肝脾肿大、血清白蛋白降低及球蛋白升高等利什曼病典型临床症状，骨髓涂片镜检查出利什曼原虫无鞭毛体，rk39快速诊断试剂和PCR方法检测均为阳性，严重急性呼吸综合征冠状病毒2型（SARS⁃CoV⁃2）核酸检测为阴性，排除新型冠状病毒感染，鉴定为内脏利什曼病。给予葡萄糖酸锑钠足疗程治疗后复查，血片中未见利什曼原虫。出院后随访未复发。结论　新型冠状病毒肺炎流行期间，要提升首诊医生内脏利什曼病鉴别诊断意识，加强各级医疗卫生机构内脏利什曼病鉴别诊断能力和宣传教育，防止漏诊、误诊。

关键词: 内脏利什曼病, 新型冠状病毒肺炎, 鉴别诊断