Sarah P Georgiadou1, Aggelos Stefos1, Gregory Spanakos2, Stergios Skrimpas1, Konstantinos Makaritsis1, Nikolaos V Sipsas3, George N Dalekos4. 1. Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Biopolis, 41110, Larissa, Greece. 2. Department of Parasitology, Entomology and Tropical Diseases, National School of Public Health, Athens, Greece. 3. Department of Pathophysiology, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Athens, Greece. 4. Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Biopolis, 41110, Larissa, Greece. Electronic address: georgedalekos@gmail.com.
Abstract
OBJECTIVES: Visceral leishmaniasis (VL) is re-emerging in endemic areas. The epidemiological, clinical, laboratory, and treatment outcome characteristics in a large cohort of VL patients is described herein. METHODS: The cases of 67 VL patients (57% male, mean age 56 years) treated in two Greek hospitals over the last 7 years were identified and evaluated retrospectively. RESULTS: Forty-six percent of patients reported contact with animals. Seventeen patients (25%) were immunocompromised, and 22% were co-infected with another pathogen. Sixty-four percent of patients had fever, 57% had weakness, 37% had sweats, 21% had weight loss, and 13% had a dry cough, while 6% developed haemophagocytic syndrome. The median duration of symptoms was 28 days. Fifty-eight percent of patients had splenomegaly, 49% had hepatomegaly, and 36% had lymphadenopathy. The diagnosis was established by positive PCR in peripheral blood (73%) and/or bone marrow specimens (34%). Sixty-one patients (91%) received liposomal amphotericin (L-AMB). Six patients (10%) did not respond or relapsed but were eventually cured after a second cycle of L-AMB. During a 6-month follow-up, the overall mortality was 9%, although none of these deaths was attributed to VL. CONCLUSIONS: VL is still a common disease in endemic areas, affecting immunocompetent and immunocompromised patients. Its diagnosis is challenging, and molecular techniques are valuable and helpful tools to achieve this. Treatment with L-AMB is safe and very effective.
OBJECTIVES:Visceral leishmaniasis (VL) is re-emerging in endemic areas. The epidemiological, clinical, laboratory, and treatment outcome characteristics in a large cohort of VL patients is described herein. METHODS: The cases of 67 VL patients (57% male, mean age 56 years) treated in two Greek hospitals over the last 7 years were identified and evaluated retrospectively. RESULTS: Forty-six percent of patients reported contact with animals. Seventeen patients (25%) were immunocompromised, and 22% were co-infected with another pathogen. Sixty-four percent of patients had fever, 57% had weakness, 37% had sweats, 21% had weight loss, and 13% had a dry cough, while 6% developed haemophagocytic syndrome. The median duration of symptoms was 28 days. Fifty-eight percent of patients had splenomegaly, 49% had hepatomegaly, and 36% had lymphadenopathy. The diagnosis was established by positive PCR in peripheral blood (73%) and/or bone marrow specimens (34%). Sixty-one patients (91%) received liposomal amphotericin (L-AMB). Six patients (10%) did not respond or relapsed but were eventually cured after a second cycle of L-AMB. During a 6-month follow-up, the overall mortality was 9%, although none of these deaths was attributed to VL. CONCLUSIONS: VL is still a common disease in endemic areas, affecting immunocompetent and immunocompromised patients. Its diagnosis is challenging, and molecular techniques are valuable and helpful tools to achieve this. Treatment with L-AMB is safe and very effective.
Authors: Isabel A Maia; Frank S Bezerra; André Luis Pereira de Albuquerque; Heitor F Andrade; Antonio C Nicodemo; Valdir S Amato Journal: Am J Trop Med Hyg Date: 2016-11-28 Impact factor: 2.345
Authors: Natascia Bruni; Barbara Stella; Leonardo Giraudo; Carlo Della Pepa; Daniela Gastaldi; Franco Dosio Journal: Int J Nanomedicine Date: 2017-07-26
Authors: Earl A Middlebrook; Alicia T Romero; Bernard Bett; Daniel Nthiwa; Samuel O Oyola; Jeanne M Fair; Andrew W Bartlow Journal: Zoonoses Public Health Date: 2022-01-15 Impact factor: 2.954
Authors: Verena Schwetz; Christian Trummer; Claudia Friedl; Christine Beham-Schmid; Roman Kulnik; Albert Wölfler; Karl Horvath; Stefanie Wunsch; Jürgen Prattes; Ines Zollner-Schwetz; Thomas R Pieber; Julia K Mader; Robert Krause Journal: Clin Case Rep Date: 2017-11-28
Authors: Sarah Georgiadou; Nikolaos K Gatselis; Aggelos Stefos; Kalliopi Zachou; Konstantinos Makaritsis; Eirini I Rigopoulou; George N Dalekos Journal: World J Clin Cases Date: 2019-11-06 Impact factor: 1.337