title: [Visceral leishmaniasis without splenomegaly. A pediatric case report].
abstract: Pediatric visceral leishmaniasis is caused by Leishmania infantum, a dog parasite transmitted to humans by the bite of the female phlebotomine sand fly. The well-known clinical triad is fever, pallor, and splenomegaly. A secondary macrophage activation syndrome (MAS) can complicate this infection, which is lethal when not treated. When MAS is observed without any explanation, a visceral leishmaniasis is highly recommended. We report a case of visceral leishmaniasis in a 21-month-old child complicated by a macrophage activation syndrome without splenomegaly. No immunodeficiency was diagnosed that could explain this unusual clinical condition. To our knowledge, this is the first case of visceral leishmaniasis without splenomegaly reported to date.
authors.affiliation: Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France. Electronic address: claire.leblanc@aphp.fr.
authors.forename: C
authors.initials: C
authors.lastname: Leblanc
authors.affiliation: Unité transversale d'immunologie-allergologie, CHU Bretonneau, 2, boulevard Tonnellé, 37044 Tours, France.
authors.forename: D
authors.initials: D
authors.lastname: Nouar
authors.affiliation: Service de parasitologie-mycologie, hôpital Avicenne, hôpitaux universitaires Paris-Seine-Saint-Denis, 125, rue de Stalingrad, 93009 Bobigny cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Izri
authors.affiliation: Service de parasitologie-mycologie, hôpital Avicenne, hôpitaux universitaires Paris-Seine-Saint-Denis, 125, rue de Stalingrad, 93009 Bobigny cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Brun
authors.affiliation: Inserm U1065, service de parasitologie-mycologie, université Nice-Sophia-Antipolis, CHU de Nice, CS 23079, 06202 Nice cedex 3, France.
authors.forename: P
authors.initials: P
authors.lastname: Marty
authors.affiliation: Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Gaudelus
authors.affiliation: Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: De Pontual
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000175:diagnosis*; D013163:Splenomegaly