Visceral leishmaniasis during childhood in southern Greece.
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.
Maltezou
H C
HC
Second Department of Pediatrics, P. & A. Kyriakou Children's Hospital, University of Athens, Greece.
Siafas
C
C
Mavrikou
M
M
Spyridis
P
P
Stavrinadis
C
C
Karpathios
T
T
Kafetzis
D A
DA
D000293:Adolescent; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000139:chemically induced; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007223:Infant; D018314:Leishmania infantum; D007898:Leishmaniasis, Visceral / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D008536:Meglumine / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies
D008536:Meglumine