Rocha Natália A, Silva Geraldo B Júnior, Oliveira Michelle J C, Abreu Krasnalhia Lívia S, Franco Luiz F L G, Silva Marcos P, Garcia Ana Valeska V, Daher Elizabeth F
Department of Internal Medicine, School of Medicine, Federal University of Ceará, Ceará, Brazil.
Turk J Pediatr. 2011 Mar-Apr;53(2):154-60.
There are few studies regarding the clinical presentation of visceral leishmaniasis (VL) in children. The aim of this study was to investigate the clinical manifestations, major complications and causes of death in children with VL. A retrospective study was performed with pediatric patients (< or = 14 years old) with a diagnosis of VL in Fortaleza, state of Ceara, in Northeast Brazil. A total of 120 patients were included. The mean age was 5 +/- 3.9 years, and 53.4% were male. The main clinical manifestations at admission were: fever (94.2%), splenomegaly (94.2%), hepatomegaly (82.5%), anorexia (55%), malaise (47.5%), cough (41.6%), abdominal pain (27.5%), vomiting (25.5%), and diarrhea (16.6%). Acute kidney injury was found in 25% of the patients. The main complication during hospital stay was pulmonary infection, found in 27.5% (n = 33), leading to sepsis in 3 cases. Glucantime was the drug of choice in 90% (n = 108) of the cases, amphotericin B in 7.5% (n = 9) and AmBisome in 2.5% (n = 3). Death occurred in 4 cases (3.3%) due to sepsis (3 cases) and hemorrhagic complications (1 case). Visceral leishmaniasis is a frequent infection among children in our region. The main complications were pulmonary infection and acute kidney injury related to antiparasitic therapy, along with sepsis and hemorrhage.
关于儿童内脏利什曼病（VL）临床表现的研究较少。本研究旨在调查儿童VL的临床表现、主要并发症及死亡原因。对巴西东北部塞阿拉州福塔莱萨市诊断为VL的儿科患者（≤14岁）进行了一项回顾性研究。共纳入120例患者。平均年龄为5±3.9岁，53.4%为男性。入院时的主要临床表现为：发热（94.2%）、脾肿大（94.2%）、肝肿大（82.5%）、厌食（55%）、不适（47.5%）、咳嗽（41.6%）、腹痛（27.5%）、呕吐（25.5%）和腹泻（16.6%）。25%的患者出现急性肾损伤。住院期间的主要并发症是肺部感染，占27.5%（n = 33），其中3例导致败血症。90%（n = 108）的病例首选葡糖酸锑钠，7.5%（n = 9）使用两性霉素B，2.5%（n = 3）使用安必素。4例（3.3%）患者死亡，原因是败血症（3例）和出血并发症（1例）。内脏利什曼病在我们地区的儿童中是一种常见感染。主要并发症是与抗寄生虫治疗相关的肺部感染和急性肾损伤，以及败血症和出血。
