Unusual manifestations of visceral leishmaniasis in children: a case series and its spatial dispersion in the western region of SAo Paulo state, Brazil

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art_PRESTES-CARNEIRO_Unusual_manifestations_of_visceral_leishmaniasis_in_children_a_2019.PDF (3.82 MB)
Citações na Scopus
9
Tipo de produção
article
Data de publicação
2019
Editora
BMC
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
PRESTES-CARNEIRO, Luiz Euribel
SPIR, Patricia Rodrigues Naufal
FONTANESI, Mateus
GARCIA, Karen Gabriella Pereira
SILVA, Francisco Assis da
FLORES, Edilson Ferreira
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
BMC INFECTIOUS DISEASES, v.19, article ID 70, 9p, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
BackgroundVisceral leishmaniasis (VL) is becoming endemic in SAo Paulo state, in the southeastern region of Brazil. Unusual manifestations with non-specific signs and symptoms may make diagnosis difficult and delay treatment, increasing the risk of severity and death, particularly in new endemic areas. There are few studies on patients with these characteristics in Brazil. We describe a case series of unusual manifestations of VL in children and its spatial dispersion in the western region of SAo Paulo state.Cases presentationFrom 2009 to 2014, five clinical cases involving children treated in the Regional Hospital of Presidente Prudente (RH) were selected. Two patients had multiple relapses requiring liposomal amphotericin B; one patient had VL-cytomegalovirus-dengue co-infection and liver injury; one patient was diagnosed with X-linked agammaglobulinemia, a primary immunodeficiency; and one patient was diagnosed with VL-human immunodeficiency virus/acquired immunodeficiency syndrome (VL-HIV/AIDS) co-infection. Primary or secondary immunodeficiencies were found in four children, and associated viral infections were found in three children. Three patients were referred from other hospitals to RH. With regard to the geographic spread of VL, more cases were found in the northern area, in the epicenter of the infection where the first cases were registered, flowing south; a spatial-temporal occurrence was found.ConclusionsPrimary and secondary immunodeficiencies and viral co-infectious should be considered among unusual manifestations of VL, especially in those with multiple relapses. Spatial-temporal occurrence was found. Thus, integrated actions and effective monitoring of the disease are needed to complement curative practices to stem the tide of the epidemic.
Palavras-chave
Visceral leishmaniasis, Children, Unusual manifestations, spatial dispersion
URI
https://observatorio.fm.usp.br/handle/OPI/30975
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/56
Artigos e Materiais de Revistas Científicas - ODS/03