Cas d'une leishmaniose viscérale en pédiatrie

Pediatric visceral leishmaniasis is a rare parasitosis in France which can be fatal if not treated. Therapy can differ, depending on epidemic areas. We describe the case of a one-year-old child with no previous history. She was hospitalised for oscillating fever and general health impairment, and aid not recently travelled abroad. Her hemogram showed a pancytopenia (Haemoglobin = 8,8 g/dL, blood platelets = 85 000/mm³, white blood cells =5 800/mm ³). Presence of Leishmania infantum amastigotes in bone marrow slides lead to the diagnosis of visceral leishmaniasis. A liposomal B amphotericin regimen was initiated, at the dose of 3 mg/kg/day for 6 days, and allowed recovery. Liposomal B amphotericin is the usual treatment in France. However, it is a very expensive drug. Antimonies are therefore used in developing countries, despite their cardiotoxicity. An oral pharmaceutical formulation (miltefosine) is available, but it is not suitable for children.