Visceral leishmaniasis in adults from southern Turkey: evaluation of epidemiologic, clinical, laboratory and treatment outcome characteristics of 26 cases


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İnal A. S., Kuşcu F., Kömür S., Kurtaran B., Nazik S., Candevir A., ...More

31st European Congress of Clinical Microbiology & Infectious Diseases, Basel, Switzerland, 9 - 12 July 2021, pp.4601

  • Publication Type: Conference Paper / Full Text
  • City: Basel
  • Country: Switzerland
  • Page Numbers: pp.4601
  • Çukurova University Affiliated: Yes

Abstract

Background

Visceral leishmaniasis (VL) is the most severe form of the infection with an insidious course leading delay in diagnosis and

appropriate. Due to climate change, changes in epidemiology of leishmaniasis have been reported in European countries and

Turkey. The aim of this study is evaluation of the adult VL cases detected in Çukurova region at the southern part of Turkey.

Methods

A total of 26 adult VL cases treated at Infectious Diseases Department in Çukurova University, Faculty of Medicine,

between 2002-2019 were evaluated retrospectively.

Results

The patients comprised 22 males (84.6 %) and 4 females (15,4%) with mean age 40±15 (min17-max70). Of the patients,

80.8% were from Adana, which is a developed and 6th biggest city of Turkey, the rest of the patients were from Mersin

(%7.7), Hatay (%7.7), and Osmaniye (%3.8). Most of the patients (88.5%) were residents of rural area. Employment of the

patients is as follows: Farmer (23.1%), worker (19.2%), self-employed (15.4%), clerk (7.7%), student (3.8%), and

unemployed (26.9%). The distribution of the patients in years is given Figure 1. The number of cases detected monthly in a

year period is presented Table 2. Incubation period of the disease were between 4-365 days (mean 91±SD17). Clinical and

laboratory findings of our patients were presented in the table. Immunosuppression (steroid use) were detected in 20% of the

patients. Treatment (n=25) were constituted by liposomal amphotericin B (LAmB) in 20 patients (80%), by conventional

amphotericin B in one patient (4%) and by meglumin antimoniate in four patients (16%). All patients were treated

successfully except one who died due to sepsis and pulmonary thrombus on seventh day of the hospitalization.

Conclusions

VL is an important public health in urban area in Turkey. Due to climate change and economical issues, changes in

leishmaniasis epidemiology can be expected in the future. Clinicians, especially internal disease specialists must be aware

for VL in patients who have protracted fever, pancytopenia and hepatosplenomegaly. Detection of the amastigotes in bone

marrow is still major tool for diagnosis. Since cultivation of leishmaniasis is not widely available, newer diagnostic tests for

Leishmania spp. could be helpful for early diagnose.