Resumen

Background: We undertook this study to describe the clinical experience in diagnosis and treatment of visceral leishmaniasis in patients < 15 years of age who were treated fron 1990-2010 in the Hospital General Dr. Rafael Pascacio Gamboa of Tuxtla Gutiérrez, Chiapas. Methods: This was a retrospective descriptive study. We reviewed the clinical files and epidemiological reports fron the Department of Pediatrics of the Hospital General Dr. Rafael Pascacio Gamboa of Tuxtla Gutiérrez, Chiapas. All patients with a diagnosis of visceral leishmaniasis confirmed by serology, indirect immunofluorescence and the presence of amastigotes in the bone marrow aspirate were included. Epidemiological and clinical data were collected. Results: Fron 1990-2010, 72 children with the diagnosis of visceral leishmaniasis were reported. Nine cases were discarded because necessary data for the analysis were not collected. Sixty three subjects who were analyzed were between 2 months and 13 years of age; 56/63 (88%) were <5 years of age. Female:male ratio was 1:1.2. Fever was present in 100% of the cases, splenomegaly in 97%, hepatomegaly in 87% and pancytopenia in 95%. Serology for leishmania by indirect immunofluorescence was >1:32, positive in 98% of cases. The presence of amastigotes was found in 79% of the bone marrow aspirates. Leishmania chagasi was identified in culture medium 3N (Nicolle-Novy-McNeal) in five children; 75% of the children presented malnutrition. Conclusions: In the state of Chiapas, diagnosis of visceral leishmaniasis should be considered in patients with fever, hepatosplenomegaly, and pancytopenia. The search for the parasite should be begun early to avoid clinical deterioration and pain, which leads to malnutrition and puts patients at risk of dying.

Palabras clave: Visceral leishmaniasis Chiapas hepatosplenomegaly pancytopenia.

2011-05-05   |   775 visitas   |   Evalua este artículo 0 valoraciones

Vol. 68 Núm.2. Marzo-Abril 2011 Pags. 83-87 Bol Med Hosp Infant Mex 2011; 68(2)