CASE REPORT
Common symptoms, rare diagnosis – paediatric visceral leishmaniasis in a non-endemic region
1
Department of Paediatrics, Children’s University Hospital, Medical College Jagiellonian University, Kraków, Poland
2
Department and Clinic of Tropical and Parasitic Diseases, University of Medical Sciences, Poznań, Poland
Submission date: 2024-03-07
Final revision date: 2024-04-22
Acceptance date: 2024-05-06
Publication date: 2024-09-23
Corresponding author
Aleksandra Warchoł
Dr. Aleksandra Warchoł, Department of Paediatrics, Children’s University Hospital, Medical College Jagiellonian University, Kraków, Poland
Dr. Aleksandra Warchoł, Department of Paediatrics, Children’s University Hospital, Medical College Jagiellonian University, Kraków, Poland
Pediatr Pol 2024;99(3):262-265
KEYWORDS
TOPICS
ABSTRACT
We hereby present a case of a 5-year-old Polish girl suffering from visceral leishmaniasis (VL) – a worldwide-spread parasitic disease. Due to persistent fever and hepatosplenomegaly, the patient was initially diagnosed with juvenile rheumatoid arthritis. Ineffective treatment of the disease led to repeated inspection of bone marrow, which was analysed in 3 laboratories in Poland, with only one correctly recognising the parasite infiltration. Detailed history revealed traveling to regions endemic for Leishmania spp. in the Mediterranean Sea Region and South America, visited between 3 months – 3.5 years before the onset of the disease. The final diagnosis of the disease was based on bone marrow aspiration and a polymerase chain reaction blood test. Pentavalent antimonial therapy was successfully administered. The case report presents the difficulties in diagnosing VL in a non-endemic country and provides a review of the current literature on the management of VL in children.
REFERENCES (24)
1.
Ravelli A, Minoia F, Davì S, et al. Paediatric Rheumatology International Trials Organisation; Childhood Arthritis and Rheumatology Research Alliance; Pediatric Rheumatology Collaborative Study Group; Histiocyte Society. 2016 Classification Criteria for Macrophage Activation Syndrome Complicating Systemic Juvenile Idiopathic Arthritis: A European League Against Rheumatism/American College of Rheumatology/Paediatric Rheumatology International Trials Organisation Collaborative Initiative. Arthritis Rheumatol 2016; 68: 566-576.
3.
Torres-Guerrero E, Quintanilla-Cedillo MR, Ruiz-Esmenjaud J, et al. Leishmaniasis: a review. F1000 Res 2017; 6: 750.
4.
Alvar J, Vélez ID, Bern C, et al. WHO Leishmaniasis Control Team. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 2012; 7: e35671.
5.
Ahmed MA, Ahmed AA, Omar SM, et al. Epidemiology of visceral leishmaniasis among children in Gadarif hospital, eastern Sudan. BMC Public Health 2016; 16: 1234.
6.
Diro E, Lynen L, Gebregziabiher B, et al. Clinical aspects of paediatric visceral leishmaniasis in North-west Ethiopia. Trop Med Int Health 2014; 20: 8-16.
7.
Gupta A, Singh A, Srivastava S, et al. Visceral leishmaniasis in children: diagnosis, treatment, and prevention. J Pediatr Infect Dis 2017; 12: 214-221.
8.
Kafetzis DA. An overview of paediatric leishmaniasis. J Postgrad Med 2003; 49: 31-8.
9.
Mamunur Rashid AKM. Diagnosis of leishmaniasis in children [Internet]. Leishmaniasis – trends in epidemiology, diagnosis and treatment. InTech 2014. Available from: http://dx.doi.org/10.5772/.
10.
Bern C. Visceral leishmaniasis: epidemiology and control. In: UpToDate, Connor RF (ed.). Wolters Kluwer 2023.
11.
Bern C. Visceral Leishmaniasis: clinical manifestations and diagnosis. In: UpToDate, Connor RF (ed.). Wolters Kluwer 2022.
12.
Krepis P, Krepi A, Argyri I, et al. Childhood visceral Leishmaniasis: distinctive features and diagnosis of a re-emerging disease. An 11-year experience from a tertiary referral center in Athens, Greece. Pediatr Infect Dis J 2018; 37: 419-423.
13.
Cascio A, Colomba C. La leishmaniosi viscerale in età pediatrica [Childhood Mediterranean visceral leishmaniasis]. Infez Med 2003; 11: 5-10.
14.
Aronson N, Herwaldt B, Libman M, et al. Diagnosis and treatment of Leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 2016; 63: e202-e264.
15.
Da Silva MR, Stewart JM, Costa CH. Sensitivity of bone marrow aspirates in the diagnosis of visceral leishmaniasis. Am J Trop Med Hyg 2005; 72: 811-814.
16.
Reithinger R, Dujardin JC. Molecular diagnosis of leishmaniasis: current status and future applications. J Clin Microbiol 2007; 45: 21-25.
17.
Bern C. Visceral Leishmaniasis: treatment. In: UpToDate, Connor RF (ed.). Wolters Kluwer 2022.
18.
Sierżęga-Staykov K, Węcławek-Tompol J, Kawecka E, et al. Visceral leishmaniasis in a six-year-old patient – unexpected diagnosis: case study. Pediatr Pol 2019; 94: 46-49.
19.
Owoc-Lempach J, Kałwak K, Szenborn L, et al. Visceral leishmaniasis in a child from Poland – case report. Acta Haematologica Polonica 2007; 38: 347-352.
20.
Gawełko J, Januś I, Klepacka A, et al. Tourism in 2022. Statistical Office in Rzeszów – Centre for Sport and Tourism Statistics, Centre for Transborder Areas Surveys and Statistics for Euroregions, Centre for Data Engineering, Warszawa, Rzeszów 2023.
21.
Monge-Maillo B, Norman FF, Cruz I, et al. Visceral leishmaniasis and HIV coinfection in the Mediterranean region. PLoS Negl Trop Dis 2014; 8: e3021.
22.
Kumar R., Kumar S. Change in global Climate and Prevalence of Visceral Leishmaniasis. Int J Sci Res Public 2013; 3: 2250-3153.
23.
Koch LK, Kochmann J, Klimpel S, et al. Modeling the climatic suitability of leishmaniasis vector species in Europe. Sci Rep 2017; 7: 13325.
24.
Mihalca AD, Cazan CD, Sulesco T, et al. A historical review on vector distribution and epidemiology of human and animal leishmanioses in Eastern Europe. Res Vet Sci 2019; 123: 185-191.
Share
RELATED ARTICLE
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
