Authors: Julio Werner Juárez Lorenzana, Ana Gabriela Córdova Recinos, Xavier Eduardo Anzueto Fernández.
Introduction: Leishmaniasis comprises a group of diseases caused by strict intracellular and unicellular eukaryotic protozoa belonging to the genus Leishmania sp. Clinical syndromes ranging from self-limiting skin ulcers to fatal visceral diseases have also been described.
Methods: We describe the clinical, epidemiological, and laboratory characteristics of six children with visceral leishmaniasis evaluated and treated at Roosevelt Hospital, Guatemala City, Guatemala, between 2017-2022.
Results: The mean age was 20.8 months. Fever was present in of the 5/6 cases at the time of diagnosis. All patients presented hepatosplenomegaly and hematologic alterations such as leukopenia, anemia, and thrombocytopenia. Diagnostic confirmation was performed in 5/6 patients through direct visualization of amastigotes in the bone marrow, 3/6 by polymerase chain reaction, and 2/6 by detection of rk39 antigen. A total of five patients received treatment with liposomal amphotericin B; only one case was treated with an antimonial, which failed; thus, treatment with liposomal amphotericin B was required. Resolution of hematologic alterations and decrease in splenomegaly were evident in all cases.
Conclusion: Guatemala is an endemic country for leishmaniasis in all forms, but visceral leishmaniasis (VL) is rare. The classic presentation of VL in children is fever, hematological changes, and organomegaly. The disease should be considered in children with manifestations originating from endemic countries. A liposomal amphotericin B regimen is currently the recommended treatment.
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