Pediatric visceral leishmanisis in the southwest part of Iran: a study of 215 cases

To study the epidemiological, clinical characteristics and laboratory findings of visceral leishmaniasis [VL] in children. It is a retrospective study, hospital records of all children with diagnosis of VL were reviewed from 1991 through 2003. Hospitals affiliated to Ahvaz Jondi-Shapour University of Medical Sciences in the southwestern part of Iran. Two hundreds and fifteen patients [153 males and 62 females] were enrolled in the study. The mean age of the patients was 31 +/- 22 months. Fever and splenomegaly were present in >95% of the patients and hepatomegaly and lymphadenopathy in 76% and 3.7% of cases, respectively. Common laboratory findings were anemia, leukopenia and thrombocytopenia. All patients were treated with meglumine antimoniate.Relapse were observed in 4% of the patients and fatality rate was 5%. Visceral leishmaniasis is endemic in the southwestern part of Iran. The clinical profile of the disease is typical of the Mediterranean infantile form

Primary amebic meningoencephalitis

This is the first case description of primary amebic meningoencephalitis [PAM] in an Iranian child. The patient was an eighteen months old boy referred to the hospital with signs and symptoms of acute meningitis. Cerebrospinal fluid [CSF] examination indicated pleocytosis with predominance of neutrophils, low sugar and high protein. Gram staining and culture of CSF for bacteria were negative. Microscopic examination of CSF revealed the motile amebae with pseudopodia. In Giemsa staining of CSF, the trophozoites of amebae were observed. The initial response to a six-week treatment course with amphotericin B, rifampin and chloramphenicol was satisfactory, but in the follow-ups the patient regressed neurologically. Although PAM is a rare and fatal disease, it should be differentiated from bacterial meningitis and treatment must be promptly carried out