Visceral leishmaniasis during childhood in southern Greece

Records were reviewed of 82 immunocompetent children (median age, 2.5 years ) from southern Greece who were diagnosed with visceral leishmaniasis from 1986 through 1998. Forty-nine (58%) patients originated from the city of At hens; of them, 46 (94%) lived by hills bordering the city. The median inter val from the onset of symptoms to admission was 10 days. Fever and splenome galy were observed in >95% of the patients. Thrombocytopenia was the most f requent hematological finding (80%), All patients were treated with meglumi ne antimonate; 20 (24%) of them were partially treated on an outpatient bas is. Rapid clinical response was noted in all patients but one. Five patient s relapsed; 3 responded to reintroduction of meglumine antimonate, 1 respon ded to liposomal amphotericin B, and 1 underwent splenic artery ligation. W e conclude that pentavalent antimonials remain the first choice of treatmen t for visceral leishmaniasis in immunocompetent children in areas where res istance has not become a problem, It is possible to treat affected patients with outpatient administration of these agents, making them feasible optio ns for therapy.