The Turkish Journal of Pediatrics 2011 , Vol 53 , Num 2
Disseminated Leishmaniasis in a Four-Year-Old Child in Yaoundé, Cameroon
1Pediatric Unit, Yaoundé Gynaeco-Obstetric and Pediatric Hospital/Pediatric Department, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, 2Centre Pasteur du Cameroun, Laboratoire d'Anatomie Pathologique/ Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, 3Centre Mere Enfant Foundation Chantal Biya/Pediatric Department, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, 4 District Hospital Biyem Assi, Yaoundé, and 5Pediatric Department, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon Leishmaniasis is a disease caused by a protozoan parasite of the genus leishmania with worldwide distribution and is transmitted to man by phlebotomine sand flies. The clinical presentation could range from a single cutaneous ulcer to disseminated leishmaniasis. We report the case of a four- year-old boy admitted to our hospital with ulcers, wasting, progressively distending abdomen, and fatigue evolving for about two months. On admission, he was febrile and pale, with diffuse oozing wet ulcers on the limbs and face, hepatosplenomegaly, and enlarged inguinal lymph nodes. The complete blood count revealed pancytopenia with low reticulocyte count, and serum protein electrophoresis showed hypoalbuminemia and hypergammaglobulinemia. Skin biopsy revealed amastigotes in phagocytic cells. The above findings suggested cutaneous and visceral localization of the leishmania; however, the parents absconded with the boy just when treatment was instituted, believing that the child was bewitched. The outcome is expected to be fatal visceral involvement. Keywords : cutaneous ulcers, lymph nodes, splenomegaly, prolonged fever, leishmania.
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