Clinical analysis of 46 cases of childhood visceral leishmaniasis
10.3969/j.issn.1000-3606.2017.03.009
- VernacularTitle:儿童黑热病46例临床分析
- Author:
Fang HE
- Keywords:
visceral leishmaniasis;
clinical features;
child
- From:
Journal of Clinical Pediatrics
2017;35(3):191-194
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical characteristics, diagnosis and treatment of childhood visceral leishmaniasis. Methods A retrospective analysis of 46 cases of children with visceral leishmaniasis was performed, epidemiological and clinical characteristics, laboratory and special inspection, diagnosis and treatment were analyzed. Results All 46 cases (27 males and 19 females) were mostly from the epidemic area and sporadically happened in spring, autumn, and winter, lacking of specific symptoms. Clinical features include long-term and repeated fever, anemia, abdominal distention and respiratory infection, the most common feature is fever accompanied with liver, spleen and lymph node enlargement. Laboratory tests were mainly found with anemia, pancytopenia in peripheral blood , damaged liver function, and elevated CRP. Bone marrow cytology smear found duchenne body- in 26 cases, the positive rate was 61.36%. Visceral leishmaniasis serological antibody were positive in 28 patients, positive rate was 96.29% (28/30). 30 cases were treated with meglumine antimoniate, 26 cases were cured, 3 cases died, and 1 case were not cured and discharged from the hospital. The treatment effective rate was 86.67%. Conclusions Childhood visceral leishmaniasis is still popular in recent years lacking of characteristic clinical symptom. Therefore, for the patients in the epidemic area who presented with long-term fever, anemia, or pancytopenia in peripheral blood, hepatosplenomegaly (especially the splenomegaly), and liver function damage, bone marrow puncture, visceral leishmaniasis antibodies and/or RK39 dipstick test and relevant auxiliary examination should be considered for early diagnosis and treatment, thus to reduce the complications and to improve the cure rate.
