PP-075 Diagnosis and outcome of visceral leismaniasis in Tunisia

• Published in: BMJ paediatrics open 2024-07, Vol.8 (Suppl 5), p.A96-A96
• Main Authors: Fatma, Khalsi, Aisha, Turki, Soumaya, Kbaier, Samia, Hamouda, Sarra, Cheikhrouhou, Kalthoum, Kalllel, Khedija, Boussetta
• Format: Article
• Language: English
• Subjects: Antifungal agents; children; leishmaniasis; liposomal amphotericin B; Medical diagnosis; outcome; Pediatrics; Poster Presentation; western blot
• ISSN: 2399-9772
• DOI: 10.1136/bmjpo-2024-EPAC.219

AimEvaluate the clinical and therapeutic features of visceral leishmaniasis (VL) in children.Material and MethodWe conducted a retrospective study of all cases of VL hospitalized in the Child Department B on a period of 10 years (January 2014-December 2023). We analyzed clinical and para-clinical data for each child. The therapeutic procedures and outcome were also registered.ResultsThirty patients were collected. They were aged 24 months on average (7 months-10 years old). Patients come mainly from the northwest of Tunisia. Their complaints were dominated by prolonged fever (78%) and abdominal distension (22%). Physical examination find fever, splenomegaly and pallor in all cases. The blood count showed pancytopenia in 16 cases and bicytopenia in 14 cases. Neutropenia was severe in 6 cases. Hemolytic anrmia was found in 5 cases. All patients had had myelogram. It showed the body of Leishmania in 25 patients. The rapid serologic test was performed in 10 patients and was positive in these cases. The diagnosis was established within 5 days on average. Twenty patients recieved meglumine antimoniate during 28 days and ten patients recieved liposomal amphotericin B during two days. A macrophage activation syndrome(MAS) was sought in the half of the caes. It leads to death in one case.ConclusionsVL should be systematically suspected in any febrile pancytopenia. The diagnosis is provided by rapid test and myelogram that contributes to confirm MAS, a rare but a serious complication.