Splenic granulomatous lesions in immunocompetent pediatric patients with visceral leishmaniasis

Visceral focal lesions are rarely encountered in patients with leishmaniasi s despite the fact that splenomegaly, and to a lesser extent hepatomegaly, predominate among the clinical features of the disease. We present, using h igh resolution ultrasonography, the first 3 reported cases of focal splenic involvement in immunocompetent children with visceral leishmaniasis. All p atients showed a prompt response to the conventional anti-leishmanial treat ment administered. This favorable outcome Indicates that localized splenic lesions should not be considered as a poor prognostic factor and that alter ation of the standard anti-leishmanial regimens is not justified.