CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES ›› 2023, Vol. 41 ›› Issue (6): 772-775.doi: 10.12140/j.issn.1000-7423.2023.06.017

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Clinical features and diagnosis and treatment effect in 47 children cases of visceral leishmaniasis in Gansu Province

CHENG Li1(), YANG Chengming2, ZHANG Ni1,*(), XU Xiaonan1, LI Yuanxiao1, LI Yan1, MA Hanwei1, LIU Hui1, DAI Xingxing1   

  1. 1 Lanzhou University Second Hospital, Pediatric Gastroenterology, Lanzhou 730030, Gansu, China
    2 Gansu Center for Disease Control and Prevention, Lanzhou 730030, China
  • Received:2023-07-05 Revised:2023-09-27 Online:2023-12-30 Published:2023-12-20
  • Contact: * E-mail: 1005939382@qq.com
  • Supported by:
    Lanzhou University Education Development Fund(071100149)

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Abstract:

A retrospective analysis was performed on 47 children (< 15 years old) with visceral leishmaniasis diagnosed in the Lanzhou University Second Hospital from May 2011 to December 2021 clinical features and diagnostic features. The results showed that all 47 cases had a history of living in endemic areas. Among them, 26 cases were boys (55.3%), which is than 21 cases of girls (44.7%). Most cases were of infants under 3 years old (59.6%). The number of cases was the highest in summer, with 17 cases (36.2%), and sporadic in the rest of the month. The main clinical manifestations were recurrent fever (44 cases, 93.6%), anemia (45 cases, 95.7%), abdominal distension (35 cases, 74.5%), accompanied by spleen enlargement (38 cases, 80.9%), liver enlargement (34 cases, 72.3%) and lymph node enlargement (16 cases, 34.0%). The main laboratory tests were anemia (45 cases, 95.7%), pancytopenia (31 cases, 66.0%) and elevated inflammatory index (43 cases, 91.5%). The rK39 immunochromatographic test was performed for 47 cases, of which 46 cases (97.9%) were positive for Leishmania antibody. Thirty-eight patients underwent bone marrow biopsy smear examination, of which 23 (60.5%) found Leishmania-Donovan bodies. A total of 45 cases were treated with antimony, of which 36 cases were cured after standard antimony treatment (150-200 mg/kg antimony sodium gluconate, divided into 6 days). Significant improvement was seen in 5 cases after 3-6 days of additional treatment, and the effective rate of antimony was 91.1%. One patient died, and three patients had relapse, with a recurrence rate of 6.7%. It is suggested that children with a history of living in endemic areas and meeting the clinical manifestations of visceral leishmaniasis should be diagnosed as early as possible by rK39 immunotomographic test, combined with bone marrow smear examination and standard antimony treatment. When standard antimony treatment is ineffective, additional antimony treatment days are recommended.

Key words: Visceral leishmaniasis, Children, Clinical characteristics, Retrospectively analysis

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