Visceral leishmaniasis in 26 HIV-negative adults

BMC Research Notes

Wafaa Bono²  Samira Rabhi²  Rhizlane Berrady²  Moncef Amrani¹  Meryem Alami¹  Ahmed B Filali¹  Hazar Lahlou¹ 

[1] Laboratory of Hematology, University Hospital of Fez, Atlas, Fez, Morocco;Internal Medicine Department, University Hospital of Fez, Atlas, Fez, Morocco

关键词: immunofluorescent antibody test;    bone marrow aspirate;    HIV-negative adults;    visceral leishmaniasis;   

Others  :  1167121
DOI  :  10.1186/1756-0500-4-389

 received in 2011-02-10, accepted in 2011-10-08,  发布年份 2011

【 摘 要 】

Background

Visceral leishmaniasis is a notifiable parasitic disease that had increased in incidence in our region on the past few years. It is common in children. In adults, it occurs more on a background of immunodeficiency, and frequently with incomplete clinical manifestations, making the diagnosis complicated.

Findings

The aim of our study is to reveal different features of visceral leishmaniasis in adults, through the analysis of its epidemiological, clinical and biological parameters, in a group of 26 patients. No one was infected with HIV or under immunosuppressive therapy Clinical presentation was generally conservative, but there was few differences in adults compared to children, concerning both the clinical symptoms and the laboratory parameters. Diagnosis was provided by direct examination of bone marrow smears in 24 cases (sensitivity 92%), and anti-leishmanial serology in the others.

Conclusion

We should think to the diagnosis of VL even if the patient is not known immunocompromised, and even if the clinical is incomplete, to avoid a delay of care which can lead to serious complications.

【 授权许可】

   
2011 Lahlou et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Chappuis F, Sundar S, Hailu A, et al.: Visceral leishmaniasis: what are the needs for diagnosis, treatment and control? Nat Rev Microbiol 2007, 5:873-882.
• [2]Rosenthal E, Marty P: Actualités sur la leishmaniose viscérale méditerranéenne. Update on visceral Mediterranean leishmaniasis. La Revue de médecine interne 2009, 30:: S24-S28.
• [3]Marty P, Pomares-Estran C, Hasseine L, Delaunay P, Haas H, Rosenthal E: Actualités sur les leishmanioses en France. Leishmaniases in France: an update. Archives de Pediatrie 2009, 16:S96-S100.
• [4]Machado de Assis TS, Basques Caligiornea R, Sierra Romerob GA, Rabelloa A: Detection of Leishmania kDNA in human serum samples for the diagnosis of visceral leishmaniasis. Transactions of the Royal Society of Tropical Medicine and Hygiene 2009, 103:1269-1272.
• [5]Moltóa A, Mateoa L, Lloverasb N, et al.: Visceral leishmaniasis and macrophagic activation syndrome in a patient with rheumatoid arthritis under treatment with adalimumab. Joint Bone Spine May 2010, 77:271-273.
• [6]Quilici M, Dunan S, Mary C: La leishmaniose viscerale méditerranéenne dans le sud-est de la France. Sem Hop Paris 1989, 65:2155-2161.
• [7]Cascio A, Gradoni L, Scarlata F, et al.: Epidemiologic surveillance of visceral leishmaniasis in Sicily, Italy. Am J Trop Med Hyg 1997, 57:75-78.
• [8]Sellami H, Ayadi A, Makni F: La leishmaniose viscérale de l'adulte au cours d'une immunode 'pression non liée au SIDA. Bull Soc Fr Parasitol 1998, 16:80-85.
• [9]Hernandez-Perez J, Yebra-Bango M, Jimenez-Martinez E, et al.: Visceral leishmaniasis (Kala-azar) in solid organ transplantation: report of five cases and review. Clin Infect Dis 1999, 29:918-921.
• [10]Aoun K, Kaaroud H, Hamzaoui S, et al.: Particularités de la leishmaniose viscérale de l'adulte non infecté par le VIH en tunisie. Med Trop 2004, 64:160-162.
• [11]Afrit M, Azzabi S, Cherif E, et al.: Modes de révélation de la leishmaniose viscérale dans un service de médecine interne. La Revue de médecine interne 2008, 29(Suppl 1):S102.
• [12]Hakem D, Médaoud S, Boucelma M, et al.: Leishmanioses viscérales: particularités cliniques et difficultés thérapeutiques. La Revue de médecine interne 2007, 28(Suppl 1):102-103.
• [13]Djidingar D, Chippaux JP, Gragnic G, et al.: La leishmaniose viscérale au Niger: six nouveaux cas confirmés parasitologiquement. « Clinique » 1997. Manuscrit n° 1754
• [14]Pagliano P, Carannante N, Rossi M, Gramiccia M, Gradoni L, Faella FS, Gaeta GB: Visceral leishmaniasis in pregnancy: a case series and systematic review of literature. J Antimicrob Chemother 2005, 55(Suppl 2):229-233.
• [15]Aoun K, Kooli C, Bouratbine A, et al.: Aspects épidémiologiques et cliniques de la leishmaniose viscérale de l'adulte en Tunisie. Méd Mal Infect 2002, 32:387-392.
• [16]Desjeux P: The increase in risk factors for leishmaniasis worldwide. Trans R Soc Trop Med Hyg 2001, 95:239-43.
• [17]Lakhdar Idrissi M, El Ouardi M, Atmani S, et al.: La leishmaniose viscérale infantile: à propos de 209 cas Infantile visceral leishmaniasis: about 209 cases. Journal de pédiatrie et de puériculture 2007, 20:136-141.
• [18]Benlbarhdadi I, Ajana FZ, Benazouz M, et al.: La leishmaniose viscerale chez l'adulte. A propos de 6 cas. Médecine du Maghreb 1995. n° 50
• [19]Pagliano P, Rossi1 M, Rescigno C, Altieri S, Coppola MG, Gramiccia M, Scalone A, Gradoni L, Faella F: Mediterranean visceral leishmaniasis in HIV-negative adults: a retrospective analysis of 64 consecutive cases (1995-2001). Journal of Antimicrobial Chemotherapy 2003, (52):264-268.
• [20]Dedet JP: Leishmanies, leishmanioses. Biologie, clinique et thérapeutique. Encycl Méd Chir, Maladies infectieuses. 2001, 11. 8-506-A-10
• [21]Dedet P: Les leishmanioses. Encycl. Méd. Chir. Maladies infectieuses. 1986, 8. 8094 A10, 4
• [22]Izri A, Belazzoug S: Diagnostic de laboratoire des leishmanioses rencontrées en Algérie. Revue francophone des laboratoires, Novembre 2007., 396(suppl)
• [23]Dedet JP: Les leishmanioses Ellipses. In Edited by Aupelf/Uref, Paris. 1999, 253.
• [24]Sundar S, Singh RK, Maurya R, et al.: Serological diagnosis of Indian visceral leishmaniasis: direct agglutination test versus rK39 strip test. Trans R Soc Trop Med Hyg 2006, 100:533-7.
• [25]Dana M: La leishmaniose viscérale méditerranéenne et son diagnostic immunologique. La Nouvelle Presse Médicale 1972, 20:1363.
• [26]Rolland L, Monjour L, Danis M, Gentilini M: Leishmaniose viscérale. Diagnostic par immuno-empreinte. La Presse Médicale 1992, 21:971-973.
• [27]Abdelmoula MS, Mhamdi Z, Amri F, et al.: La leishmaniose viscérale chez l'enfant. Maghreb Medical 2003, 23:40-42.
• [28]Dedet JP: Les leishmanioses: actualités. Press Med 2000, 29:1019-1026.
• [29]Pearson RD, De Queirozsouza A: Clinical spectrum of leishmaniasis. Clin Infect Dis 1995, 22:1-13.