Pediatric Visceral Leishmaniasis in Western Sicily, Italy: A Retrospective Analysis of 111 Cases

Abstract

The clinical and epidemiological characteristics of 111 consecutive cases of visceral leishmaniasis identified from 1980 to 2000 in a Sicilian pediatric hospital were analyzed retrospectively. The mean age of the patients was 1.7 years. All children were HIV negative, but 15% were severely malnourished. Fever and splenomegaly were present in all cases and hepatomegaly in 101 (90.1%) cases. Thrombocytopenia and anemia were both observed in 78 (70.2%) cases and leukopenia in 47 (42.3%) cases. A bone marrow aspirate was obtained in all cases; Leishmania amastigotes were detected in 89 (80.2%) cases. Initial treatment consisted of meglumine antimoniate in 99 (89.2%) patients and amphotericin B in 12 (10.8%) patients. Only two children treated with meglumine antimoniate relapsed. The findings highlight the differences between the cases of visceral leishmaniasis observed in the Mediterranean basin and those observed in other regions. The use of the term "Mediterranean visceral leishmaniasis", rather than the term "kalaazar", is proposed for cases observed in the Mediterranean area.

Comparison of New Diagnostic Tools for Management of Pediatric Mediterranean Visceral Leishmaniasis

“…The mean age, sex ratio, and clinical features of the present patients are similar to those described in other studies on pediatric Mediterranean VL (9,25).…”

Significance of persistence of antibodies against Leishmania infantum in sicilian patients affected by acute visceral leishmaniasis

“…VL patients were treated with a complete course of meglumine antimoniate (MA, 20 mg/kg daily, by intramuscular injection, for 4 weeks) [9,14] or liposomal amphotericin B (1-3 mg/kg daily, for 5 days, with a final dose at 11th day, with no incremental dosage, infused slowly over 2 h). Patients were considered cured and discharged when fever subsided, and there was weight gain and absence of L. infantum bodies in the bone marrow aspirates and/or biopsy.…”

Foco emergente de leishmaniose visceral em Mato Grosso do Sul

“…Na maioria dos casos, o diagnóstico foi feito com 11 a 20 dias de doença, compatível com revisão realizada em Palermo, Itália 6 , porém, mais precocemente que em outros estudos realizados no Brasil e em Malta, que relatam o tempo médio de 40 a 60 dias 15 31 32 35 .…”