High visceral leishmaniasis mortality rate in Barra Mansa, a new area of visceral leishmaniasis transmission in the State of Rio de Janeiro, Brazil.

INTRODUCTION: Nine cases of visceral leishmaniasis occurred recently in Barra Mansa, State of Rio de Janeiro, with a high mortality rate. METHODS: We reviewed the medical records of the patients. RESULTS: Eight were male; 7 were adults. Patients who died progressed to death quickly and presented with aggravating factors: systemic steroid therapy before diagnosis, bleeding, severe liver involvement, infection, and/or refusal to receive transfusion. CONCLUSIONS: We warn clinicians to be aware of the emergence of visceral leishmaniasis in new areas and to keep in mind the possibility of atypical clinical pictures and aggravating factors, so timely diagnosis can be made and prompt and adequate treatment can be initiated.

Expansion of vicceral leishmaniasis in the stat of rio de janeiro, Brazil: repport of the first autochthonous case in the municipality of volta redonda and the difficulty of diagnoiis / Expansão da leishmaniose visceral no estado do Rio de Janeiro, Brasil: relato do primeiro caso autóctone no município de Volta Redonda e a dificuldade de diagnóstico

Visceral Leishmaniasis has been showing remarkable epidemiological changes in recent decades, with marked expansion and an emergence of cases in urban areas of the North, Southeast and Midwest regions of Brazil. The Kala-azar cases reported here, despite being very characteristic, presented a great difficulty of diagnosis, because the disease is not endemic in Volta Redonda. The child underwent two hospitalizations in different hospitals, but got the correct diagnosis only after 11 months of symptom onset. In this report we discuss the main differential diagnoses and call attention to the suspected symptoms of visceral leishmaniasis in patients with prolonged fever, hepatosplenomegaly and pancytopenia, even in areas not traditionally endemic for the disease.

A leishmaniose visceral vem apresentando mudanças epidemiológicas marcantes nas últimas décadas, com acentuada expansão e surgimento de casos em áreas urbanas do Norte, Sudeste e Centro-Oeste do Brasil. O caso de Calazar aqui relatado, apesar de ser muito característico, apresentou grande dificuldade de diagnóstico, por se tratar de doença não-endêmica em Volta Redonda. A criança passou por duas internações em hospitais diferentes, porém, só obteve o diagnóstico correto após 11 meses do início dos sintomas. Neste relato são discutidos os principais diagnósticos diferenciais e chama-se a atenção de sempre considerar a hipótese de leishmaniose visceral em todo paciente com febre prolongada, hepatoesplenomegalia e pancitopenia, mesmo em áreas tradicionalmente não endêmicas.

Outbreak of canine visceral leishmaniasis in Barra Mansa, State of Rio de Janeiro.

INTRODUCTION: In Brazil, visceral leishmaniasis (VL) has spread to various regions. This study reports canine cases of VL in Barra Mansa, where human VL cases were recently reported. METHODS: Using the human index case, a canine survey was performed by dual-path platform immunochromatography and enzyme-linked immunosorbent assay. Seropositive animals were euthanized. Cultures were collected to detect Leishmania parasites. RESULTS: Serological tests detected 141 canine VL cases, and Leishmania chagasi were isolated from 82.2% animals. CONCLUSIONS: Leishmania chagasi is in circulation in Barra Mansa. This study broadens information on the parasite's distribution in the State of Rio de Janeiro.