Visceral Leishmaniasis during Childhood in Southern Greece

Abstract

Records were reviewed of 82 immunocompetent children (median age, 2. 5 years) from southern Greece who were diagnosed with visceral leishmaniasis from 1986 through 1998. Forty-nine (58%) patients originated from the city of Athens; of them, 46 (94%) lived by hills bordering the city. The median interval from the onset of symptoms to admission was 10 days. Fever and splenomegaly were observed in >95% of the patients. Thrombocytopenia was the most frequent hematological finding (80%). All patients were treated with meglumine antimonate; 20 (24%) of them were partially treated on an outpatient basis. Rapid clinical response was noted in all patients but one. Five patients relapsed; 3 responded to reintroduction of meglumine antimonate, 1 responded to liposomal amphotericin B, and 1 underwent splenic artery ligation. We conclude that pentavalent antimonials remain the first choice of treatment for visceral leishmaniasis in immunocompetent children in areas where resistance has not become a problem. It is possible to treat affected patients with outpatient administration of these agents, making them feasible options for therapy.

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

“…As in other case series describing VL acquired in the Mediterranean area [13,14,15], VL in Sicily involved mainly young children: the median age of our patients was 1.7 years, and 26.1% of the children were younger than 12 months. The main clinical and laboratory findings were also similar to those reported in the other Mediterranean countries [13,14,15].…”

Visceral leishmaniasis: clinical and laboratorial aspects

“…Discussão As leishmanioses são consideradas doenças tropicais ou subtropicais, mas ocorrem também em países do Mediterrâneo ou que recebem viajantes provenientes de áreas endêmicas 17,18 . No Brasil, apenas os estados do sul do país não apresentam casos autóctones, e muitos pacientes acabam se deslocando para hospitais gerais e terciários de áreas de baixa incidência e devem ser adequadamente diagnosticados e tratados.…”

Leishmaniasis in travelers: A literature review

“…Occasionally VL may manifest as acute hepatitis, cholecystitis, hemophagocytic syndrome, and GuillainBarré syndrome [19,102]. Growth retardation may be noticed in children [103]. The natural history of VL includes a mortality rate between 75 and 95%, with delayed diagnosis increasing disease complications, particularly in patients suffering from immune-suppressive diseases.…”

“…Usually exitus is caused by severe anemia, secondary infection, and hemorrhage [104e108]. Laboratory findings include normocytic normochromic anemia, neutropenia, thrombocytopenia, hypoalbuminemia, hypergammaglobulinemia, and increased transaminases [103]. HIV-infected patients usually have higher parasite loads and atypical symptoms (e.g.…”

“…Experience with antimonials for almost 70 years indicates efficacy rates of >90e95% and low fatality and relapse rates [107,135,170,171]. One advantage is their low cost; the main disadvantages include intramuscular route of administration, prolonged (20 mg/kg once for day for 21e30 days) schedules, and transient but occasionally life-threatening side effects, such as increased serum hepatic transaminases, pancreatitis, and cardiac arrhythmias [103].…”