title: [Demographic, clinical and therapeutic features of adult visceral leishmaniasis at the Rabta hospital in Tunis (tunisia) from 1983 to 2002].
abstract: The purpose of this study was to evaluate in a retrospective analysis, cases of Mediterranean visceral leishmaniasis (VL) diagnosed in adults during a 20-year period in a department of infectious diseases. Demographic data, clinical and laboratory features and therapeutic findings were considered. During the study period, 22 cases of VL were diagnosed, and 6 (27%) were associated with HIV infection. Fever and splenomegaly were observed in all cases. Anaemia was constant. The anti-leishmanial IF titer was positive among 21 patients (95%). Smears from bone marrow aspiration were positive at microscopy in 95% of cases. Zymodeme analysis was carried out in nine isolates. L. infantum zymodeme MON-1 was characterized in all cases. Seventeen patients (77%) received meglumine antimoniate (MA) (20 mg SbV/kg per day) and 5 (23%) patients amphotericin B (AB) (0.5-1 mg/kg per day) for an average period of 25 days (10-49 days). Adverse events occurred in 7 patients (32%), among them 4 received AB. Clinical cure was achieved with success in 21 patients (95%). After a successful MA treatment of the initial episode, VL relapse was observed in one HIV-positive patient. Only one HIV-positive patient died from neurological disorders. VL is rare in adults. However, its incidence is increasing everywhere in the world, because of HIV-related cases. Its prognosis depends on the precocity of diagnosis and treatment.
authors.affiliation: Service des maladies infectieuses, Hôpital La Rabta, 1007 Jebbari, Tunis, Tunisie.
authors.forename: A
authors.initials: A
authors.lastname: Toumi
authors.forename: B
authors.initials: B
authors.lastname: Kilani
authors.forename: L
authors.initials: L
authors.lastname: Ammari
authors.forename: H
authors.initials: H
authors.lastname: Tiouiri
authors.forename: F
authors.initials: F
authors.lastname: Kanoun
authors.forename: S
authors.initials: S
authors.lastname: Belhadj
authors.forename: E
authors.initials: E
authors.lastname: Chaker
authors.forename: T
authors.initials: T
authors.lastname: Ben Chaabene
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000740:Anemia / Q000453:epidemiology; D000818:Animals; D000965:Antimony / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D005334:Fever / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D018314:Leishmania infantum / Q000145:classification; D007898:Leishmaniasis, Visceral / Q000453:epidemiology*; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D013163:Splenomegaly / Q000453:epidemiology; D016896:Treatment Outcome; D014416:Tunisia / Q000453:epidemiology
chemical_list: D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000666:Amphotericin B; D000965:Antimony