Unusual manifestations of visceral leishmaniasis in children: a case series and its spatial dispersion in the western region of São Paulo state, Brazil
Abstract Background Visceral leishmaniasis (VL) is becoming endemic in São 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 e...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-018-3652-1 |
| _version_ | 1818309938893553664 |
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| author | Luiz Euribel Prestes-Carneiro Patricia Rodrigues Naufal Spir Mateus Fontanesi Karen Gabriella Pereira Garcia Francisco Assis da Silva Edilson Ferreira Flores Dewton de Moraes Vasconcelos |
| author_facet | Luiz Euribel Prestes-Carneiro Patricia Rodrigues Naufal Spir Mateus Fontanesi Karen Gabriella Pereira Garcia Francisco Assis da Silva Edilson Ferreira Flores Dewton de Moraes Vasconcelos |
| author_sort | Luiz Euribel Prestes-Carneiro |
| collection | DOAJ |
| description | Abstract Background Visceral leishmaniasis (VL) is becoming endemic in São 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 São Paulo state. Cases presentation From 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. Conclusions Primary 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. |
| first_indexed | 2024-12-13T07:38:07Z |
| format | Article |
| id | doaj.art-015a88a017144576aa5876f15a5ed9e2 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-13T07:38:07Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-015a88a017144576aa5876f15a5ed9e22022-12-21T23:55:01ZengBMCBMC Infectious Diseases1471-23342019-01-011911910.1186/s12879-018-3652-1Unusual manifestations of visceral leishmaniasis in children: a case series and its spatial dispersion in the western region of São Paulo state, BrazilLuiz Euribel Prestes-Carneiro0Patricia Rodrigues Naufal Spir1Mateus Fontanesi2Karen Gabriella Pereira Garcia3Francisco Assis da Silva4Edilson Ferreira Flores5Dewton de Moraes Vasconcelos6Infectious Diseases and Immunology Department, Oeste Paulista UniversityPediatrics Department, Oeste Paulista UniversityImunodeficiencies Outpatient Clinic, Pediatrics Outpatient Clinic, Regional Hospital of Presidente PrudenteImunodeficiencies Outpatient Clinic, Pediatrics Outpatient Clinic, Regional Hospital of Presidente PrudenteInfectious Diseases and Immunology Department, Oeste Paulista UniversityStatistics Department, Paulista State UniversityLaboratory of Medical Investigation Unit 56, Hospital das Clınicas da Faculdade de Medicina da Universidade de São PauloAbstract Background Visceral leishmaniasis (VL) is becoming endemic in São 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 São Paulo state. Cases presentation From 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. Conclusions Primary 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.http://link.springer.com/article/10.1186/s12879-018-3652-1Visceral leishmaniasisChildrenUnusual manifestations, spatial dispersion |
| spellingShingle | Luiz Euribel Prestes-Carneiro Patricia Rodrigues Naufal Spir Mateus Fontanesi Karen Gabriella Pereira Garcia Francisco Assis da Silva Edilson Ferreira Flores Dewton de Moraes Vasconcelos Unusual manifestations of visceral leishmaniasis in children: a case series and its spatial dispersion in the western region of São Paulo state, Brazil BMC Infectious Diseases Visceral leishmaniasis Children Unusual manifestations, spatial dispersion |
| title | Unusual manifestations of visceral leishmaniasis in children: a case series and its spatial dispersion in the western region of São Paulo state, Brazil |
| title_full | Unusual manifestations of visceral leishmaniasis in children: a case series and its spatial dispersion in the western region of São Paulo state, Brazil |
| title_fullStr | Unusual manifestations of visceral leishmaniasis in children: a case series and its spatial dispersion in the western region of São Paulo state, Brazil |
| title_full_unstemmed | Unusual manifestations of visceral leishmaniasis in children: a case series and its spatial dispersion in the western region of São Paulo state, Brazil |
| title_short | Unusual manifestations of visceral leishmaniasis in children: a case series and its spatial dispersion in the western region of São Paulo state, Brazil |
| title_sort | unusual manifestations of visceral leishmaniasis in children a case series and its spatial dispersion in the western region of sao paulo state brazil |
| topic | Visceral leishmaniasis Children Unusual manifestations, spatial dispersion |
| url | http://link.springer.com/article/10.1186/s12879-018-3652-1 |
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