Visceral Leishmaniasis in Children in Southern Turkey: Evaluation of Clinical and Laboratory Findings and Liposomal Amphotericin B Treatment

Özet

Aim: Visceral leishmaniasis (VL) is a systemic infection that spreads hematogenously and affects the reticuloendothelial system by theinfection of macrophages. VL occurs commonly in children, and only rarely in adults. VL should be considered in patients with prolonged highfever, hepatosplenomegaly, pancytopenia, weight loss, pallor and hypergammaglobulinemia.Materials and Methods: In this study, a total of 18 pediatric patients -9 (50%) males and 9 (50%) females- treated for VL at our clinic fromJanuary 2004 to July 2014 were analyzed retrospectively. Average time from symptom onset to hospital admission was 64±21 days (range:30-100 days). The mean age of patients was 88±40 months (range: 36-182 months).Results: The most common symptom at presentation was fever (88.9%). Other common symptoms were fatigue, chills, weight lossand anorexia. Physical examination revealed splenomegaly and hepatomegaly in all patients. Anemia (92.4%), leukopenia (78.7%) andthrombocytopenia (76.2%) were the most prominent laboratory abnormalities and 82.2% of the patients were pancytopenic on admission.Bone marrow smear was positive for leishmania in 100% of the patients. All patients received treatment with liposomal amphotericin B.Conclusion: In certain regions, increased humidity rates associated with construction of dams and irrigation canals may lead to changes inthe ecological balance and thus cause an increase in the population of disease-spreading vectors. Additionally, recent migration from themiddle-eastern region to western parts of the world due to regional civil wars may have contributed to the observed increase in the incidenceof various diseases such as VL.