Resumo

APODACA, Silvio et al. Clinical behavior of Visceral Leishmaniosis in children. Ten Years of Experience Reference Center Paraguay. Rev. Inst. Med. Trop. [online]. 2015, vol.10, n.1, pp.12-18. ISSN 1996-3696.  https://doi.org/10.18004/imt/201510112-18.

Aim: To analyze the clinical, laboratory and development of pediatric patients hospitalized for visceral leishmaniasis at the Institute of Tropical Medicine features. Observational study conducted at the Institute of Tropical Medicine in patients <15 years hospitalized during the period 2003 to 2013 with diagnosis of visceral leishmaniasis. The diagnosis of visceral leishmaniasis was performed by visualizing amastigotes in bone marrow and / or positivity rK 39. Results: During the study 53 patients were identified, mean age 35.4 ± 32 pts months (ratio Female / Male: 28/27). Most cases were in the age group <2 years 28/53 (52%), followed by the group of 2-5 years. The mean time between onset of symptoms and hospitalization was 73 ± 43 days and the average days of hospitalization 22 ± 10 days. The triad of fever, hepatosplenomegaly was present in almost all patients. Anemia, leukopenia and thrombocytopenia in 94%, 58%, 58% of cases, respectively, and pancytopenia in 38% of patients. It was found amastigotes in bone marrow in 94% (50/53) of patients seropositive for rK39 in 51/53 patients (96%). Complications in 33/53 patients (62%), most infectious, of which (32%) had pneumonia and 9 (17%) urinary tract infection were observed. Seven patients (13%) had hemophagocytic syndrome. As for the initial treatment 47 patients (91%) were treated with antimonial compounds, of which 2 patients required treatment change to amphotericin B, due to adverse effects of medication. 6 patients (9%) received initial treatment with liposomal amphotericin B (classical scheme: 5/6, shortened treatment with single doses of 10 mg/kg/d: 1/6), all associated hemophagocytic syndrome. Only one patient had recurrence of the disease. Registered mortality was 2% (1/53)

Palavras-chave : children; Institute of Tropical Medicine; hepatosplenomegaly.

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