RE-EMERGENCE OF VISCERAL LEISHMANIASIS:
IMPORTANT DIAGNOSTIC FEATURES
Gunay U, Meral A, Sevinir B
Department of Pediatric Hematology and Oncology, Uludag Univ.
Faculty of Medicine, Görükle-Bursa, Turkey
Objective: Mediterranean Visceral Leihmaniasis (VL) has often be confused with
other diseases with more or less similar clinical presentations. In recent
years, it has been reported that VL has reemerged in different parts of
Turkey, possibly due to the end of vector control programs, and the increase
in the agricultural and irrigation areas.
Methods: Therefore, we re-evaluated the most striking features of the 23
children treated for V in the pediatric ward of Uludag University Hospital,
Bursa.
Results: Fever, abdominal distention, weakness, poor appetite and weight loss
were the common complains. Symptoms had lasted from 7 days to 8 months
(mean:2.12±2.22months)
before presenting the hospital. Of the clinical signs on admission, anemia
and hepatosplenomegaly were the most frequent. All children had low
hemoglobin values. Fourteen out of 23 (60%) had leucopenia as 16 out of 23
(70%) children had trombocytopenia. Pancytopenia occurred in half of the
cases. Blood smear and bone marrow aspirate findings of two children were
mimicking acute myelocytic leukemia. Another striking feature was reversed
albumin-globulin ratio on admission. The diagnosis was confirmed by bone
marrow aspiration in all children except in one of whom Leishmania Donovani
bodies were determined in spleen biopsy sample.
Conclusion: All of the patients were treated with meglumine anti60monate
(glucantime) except one treated with liposomal amphotericin B. The response
to therapy was successful in all children and none was lost due to VL.