Hippokratia 2003; 7(3): 125-131
K Tziomalos, V Perifanis, A Karagiannis, N Krikis, P Semertzidis, A Diakou, V Garypidou, N Harsoulis
2nd Dpt Internal Medicine, Hippokratio General Hospital, Thessaloniki, Greece
The clinical manifestations and treatment of six male adult patients from North Greece who were diagnosed with visceral leishmaniasis during 2001-2002 are being presented. The mean age of the patients was 36 years (range 18-60 years), only one reported contact with animals and none was HIV positive. The mean interval from the onset of symptoms to hospital admission was 3.2 months. Splenomegaly was observed in all the patients, hepatomegaly in five, while fever was present in four of them. Thrombocytopenia was observed in all patients, leukopenia in five, while anaemia was present in one of them. A bone marrow myelogram was obtained in all cases and Leishmania amastigotes were found in three of the patients. Three patients were treated with meglumine antimonate and the rest with liposomal amphotericin B. One patient who received meglumine antimonate relapsed and subsequently was treated successfully with liposomal amphotericin B. Our findings demonstrate the diverse clinical image of visceral leishmaniasis and suggest that liposomal amphotericin B should be considered as treatment of choice, since it is both safe and effective.
Keywords: visceral leismaniasis, splenomegaly, hepatomegaly, thrombocytopenia, leukopenia