title: [Visceral leishmaniasis in immunocompetent adults. About six cases].
abstract: OBJECTIVE
  Studying the epidemiological variations of visceral leishmaniasis in Tunisia and proving the importance of parasitological investigations to raise the diagnosis.
  
  
  METHODS
  Six patients hospitalised during the period between January 1998 and January 2009 at Fattouma Bourguiba Teaching Hospital in Monastir, five men and an only one woman, aged from 26 to 70 years old, originating from the central and eastern regions of the country. Epidemiological, clinical, biological and therapeutic data were obtained from the patient's medical files.
  
  
  RESULTS
  The major clinical symptoms were fever, weakness and spleen enlargement. Biological data revealed the presence of anaemia in every case and leucopoenia associated or not associated with thrombopenia in four cases. The diagnosis of visceral leishmaniasis was confirmed by the identification of the parasite in the blood or in the bone marrow. All patients were treated with two courses of antimoniate of meglumine separated by a 6-week interval. The outcome was positive and the patients were cured.
  
  
  CONCLUSIONS
  Visceral leishmaniasis is increasing among adults in Tunisia. Moreover, it is spreading outside its epidemiological area in the north to reach the central and southern regions. It should be raised when fever and spleen enlargement occur. Biological data are hardly specific. Diagnosis is based on finding the parasite in human fluids, mainly by molecular techniques. The rapid establishment of a specific treatment is vital.
authors.affiliation: Laboratoire de parasitologie-mycologie, hôpital Fattouma-Bourguiba, rue 1er-Juin, 5000 Monastir, Tunisie. nawel.aguir@laposte.net
authors.forename: N
authors.initials: N
authors.lastname: Essabbah Aguir
authors.forename: A
authors.initials: A
authors.lastname: Toumi
authors.forename: C
authors.initials: C
authors.lastname: Loussaïf
authors.forename: M
authors.initials: M
authors.lastname: Gorcii
authors.forename: S
authors.initials: S
authors.lastname: M'rad
authors.forename: H
authors.initials: H
authors.lastname: Ben Brahim
authors.forename: M
authors.initials: M
authors.lastname: Chakroun
authors.forename: H
authors.initials: H
authors.lastname: Babba
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D005260:Female; D006801:Humans; D007121:Immunocompetence; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies