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Pediatric lymphatic leishmaniasis: a case report

BACKGROUND: There are three main forms of leishmaniases: visceral (the most serious form because it is almost always fatal without treatment), cutaneous (the most common, usually causing skin ulcers), and mucocutaneous (affecting mouth, nose, and throat). Leishmaniasis is caused by protozoan parasit...

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Autores principales: Kindie, Endeshaw Asaye, Yefter, Ermias Teklehaimanot, Alemu, Bewketu Abebe, Gurji, Tiruzer Bekele, Tadesse, Amanuel Kassa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077700/
https://www.ncbi.nlm.nih.gov/pubmed/37020261
http://dx.doi.org/10.1186/s13256-023-03852-x
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author Kindie, Endeshaw Asaye
Yefter, Ermias Teklehaimanot
Alemu, Bewketu Abebe
Gurji, Tiruzer Bekele
Tadesse, Amanuel Kassa
author_facet Kindie, Endeshaw Asaye
Yefter, Ermias Teklehaimanot
Alemu, Bewketu Abebe
Gurji, Tiruzer Bekele
Tadesse, Amanuel Kassa
author_sort Kindie, Endeshaw Asaye
collection PubMed
description BACKGROUND: There are three main forms of leishmaniases: visceral (the most serious form because it is almost always fatal without treatment), cutaneous (the most common, usually causing skin ulcers), and mucocutaneous (affecting mouth, nose, and throat). Leishmaniasis is caused by protozoan parasites, which are transmitted by the bite of infected female phlebotomine sandflies. The disease affects some of the world’s poorest people and is associated with malnutrition, population displacement, poor housing, a weak immune system, and lack of financial resources. An estimated 700,000 to 1 million new cases occur annually. Only a small fraction of those infected by parasites causing leishmaniasis will eventually develop the disease. We report a case of exclusive lymph node involvement in leishmaniasis, presenting as localized lymphadenopathies. The diagnosis of lymphatic leishmaniasis was confirmed by the presence of Leishmania donovani bodies in fine needle aspiration cytology, and positive anti-rK39 antibodies. The bone marrow aspiration was negative for Leishmania donovani bodies. Abdominal ultrasound was done and there was no organomegaly. Furthermore, localized lymphadenopathies may provide a diagnostic challenge by clinically mimicking a lymphoma or other causes of lymphadenopathy. Due to its rarity and its tendency to pose a clinical diagnostic challenge, we decided to report a case of lymphatic leishmaniasis. CASE PRESENTATION: A 12-year-old Amara male patient presented to the University of Gondar comprehensive specialized hospital, Northwestern Ethiopia, with six discrete right lateral cervical lymphadenopathies, the largest measuring 3 × 2 cm(2), with no cutaneous lesion. Fine needle aspiration cytology confirmed the diagnosis of leishmaniasis in lymph node, and he was put on sodium stibogluconate (20 mg/kg body weight/day) and paromomycin (15 mg/kg body weight/day) injections, which are given intramuscularly for 17 days. Having completed his medication at the University of Gondar comprehensive specialized hospital, he had a smooth course and was discharged with appointment scheduled for follow-up after 3 months. CONCLUSION: In the clinical evaluation of a patient with isolated lymphadenopathies, leishmaniasis must be considered as a differential diagnosis in immunocompetent subjects in endemic areas for early diagnostic workup and management.
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spelling pubmed-100777002023-04-07 Pediatric lymphatic leishmaniasis: a case report Kindie, Endeshaw Asaye Yefter, Ermias Teklehaimanot Alemu, Bewketu Abebe Gurji, Tiruzer Bekele Tadesse, Amanuel Kassa J Med Case Rep Case Report BACKGROUND: There are three main forms of leishmaniases: visceral (the most serious form because it is almost always fatal without treatment), cutaneous (the most common, usually causing skin ulcers), and mucocutaneous (affecting mouth, nose, and throat). Leishmaniasis is caused by protozoan parasites, which are transmitted by the bite of infected female phlebotomine sandflies. The disease affects some of the world’s poorest people and is associated with malnutrition, population displacement, poor housing, a weak immune system, and lack of financial resources. An estimated 700,000 to 1 million new cases occur annually. Only a small fraction of those infected by parasites causing leishmaniasis will eventually develop the disease. We report a case of exclusive lymph node involvement in leishmaniasis, presenting as localized lymphadenopathies. The diagnosis of lymphatic leishmaniasis was confirmed by the presence of Leishmania donovani bodies in fine needle aspiration cytology, and positive anti-rK39 antibodies. The bone marrow aspiration was negative for Leishmania donovani bodies. Abdominal ultrasound was done and there was no organomegaly. Furthermore, localized lymphadenopathies may provide a diagnostic challenge by clinically mimicking a lymphoma or other causes of lymphadenopathy. Due to its rarity and its tendency to pose a clinical diagnostic challenge, we decided to report a case of lymphatic leishmaniasis. CASE PRESENTATION: A 12-year-old Amara male patient presented to the University of Gondar comprehensive specialized hospital, Northwestern Ethiopia, with six discrete right lateral cervical lymphadenopathies, the largest measuring 3 × 2 cm(2), with no cutaneous lesion. Fine needle aspiration cytology confirmed the diagnosis of leishmaniasis in lymph node, and he was put on sodium stibogluconate (20 mg/kg body weight/day) and paromomycin (15 mg/kg body weight/day) injections, which are given intramuscularly for 17 days. Having completed his medication at the University of Gondar comprehensive specialized hospital, he had a smooth course and was discharged with appointment scheduled for follow-up after 3 months. CONCLUSION: In the clinical evaluation of a patient with isolated lymphadenopathies, leishmaniasis must be considered as a differential diagnosis in immunocompetent subjects in endemic areas for early diagnostic workup and management. BioMed Central 2023-04-06 /pmc/articles/PMC10077700/ /pubmed/37020261 http://dx.doi.org/10.1186/s13256-023-03852-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Kindie, Endeshaw Asaye
Yefter, Ermias Teklehaimanot
Alemu, Bewketu Abebe
Gurji, Tiruzer Bekele
Tadesse, Amanuel Kassa
Pediatric lymphatic leishmaniasis: a case report
title Pediatric lymphatic leishmaniasis: a case report
title_full Pediatric lymphatic leishmaniasis: a case report
title_fullStr Pediatric lymphatic leishmaniasis: a case report
title_full_unstemmed Pediatric lymphatic leishmaniasis: a case report
title_short Pediatric lymphatic leishmaniasis: a case report
title_sort pediatric lymphatic leishmaniasis: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077700/
https://www.ncbi.nlm.nih.gov/pubmed/37020261
http://dx.doi.org/10.1186/s13256-023-03852-x
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