Visceral Leishmaniasis in Infants ( < 24 Month Old ) : A Series of 17 Cases

The infantile visceral leishmaniose (IVL) is a systemic infection of the reticuloendothelial system due to a flagellate protozoan of the genus Leishmania. It is characterized by its geographical distribution most frequently around Mediterranean area, India, east Africa and South America. In recent years, we are witnessing a significant recrudescence preferentially in the very young child in Morocco . Its occurrence in the infant (<24 month old) remains rare, clinical signs are distinguished by more accentuated than in the child. The authors' work consists on a retrospective study of 17 cases of visceral leishmaniasis in infants admitted to the pediatric department at the University Hospital of Fez over a period from January 2013 till June 2016. The average age was 15.64 months, girls are more affected, The majority come from the regions of Fez, mainly Taounate. The main reasons are abdominal distension (70%), fever (100%) and pallor in 90% of cases. The clinical examination finds an anemia, a fever and a splenomegaly in all cases. The diagnosis is confirmed by the myelogram performed at the Hematology Laboratory at the University Hospital of Fez. Treatment is based on glucantim at the dose of 80 to 100 mg / kg / day for 21 to 30 days. The evolution was favorable in the majority of cases. We deplored a case of death that occurred in association with macrophage activation syndrome. IVL is the most frequent zoonotic disease in Morocco. Fez and its surroundings form a highly endemic focus. Its eradication must first of all be achieved through the improvement of socio-economic conditions and the fight against malnutrition which constitutes a risk factor.