Visceral Leishmaniasis imported from Spain to Germany
jshaw at tba.com.br
Wed Jul 26 14:52:01 BRT 2000
ProMED-AHEAD Digest Tuesday, July 25 2000 Volume 2000 : Number 114
Date: 25 July 2000
From: Tomas Jelinek <jelinek at lrz.uni-muenchen.de>
Source: TropNetEurop [edited]
_Leishmania donovani_ imported from Spain to Germany
In early July, an 8 month old German girl was admitted at the Pediatric
Department, the University Hospital in Munich with increasing fever, cough,
general weakness, hepatosplenomegaly and marked pancytopenia. Symptoms had
developed over 4 weeks. Material from bone marrow aspiration was send to
the Department of Infectious Diseases and Tropical Medicine of the
University of Munich where infection with _Leishmania_ spp. was diagnosed.
Serological testing showed significant titers of antibodies against
_Leishmania donovani_ (IFT 1:512, immunobloting: IgG and IgM antibodies
against 14 and 16 kDa antigens). Treatment with liposomal amphotericin B
was initiated and led to complete recovery within 10 days.
The girl has been born in Bavaria, Germany, after an uneventful pregnancy
and has never been outside the country. Neither the girl nor the mother
(29y, first pregnancy) ever received blood products. However, serological
testing of the mother produced significant antibody titers against
_Leishmania donovani_, as well. Further inquiries revealed that the mother
had travelled to Spain (near Alicante) during the pregnancy (29th-32nd
week). During the last 15 years, she had travelled repeatedly to Italy and
Spain, but never to countries outside Europe. She was never symptomatic.
Further investigation of the mother revealed no pathological findings,
blood samples and breast milk were negative for _Leishmania_ spp. in
culture and PCR. To our knowledge, 10 cases of probable [transplacental
infection] with _Leishmania_ spp. have been published.
Tomas Jelinek, MD DTMP
University of Munich
Department of Infectious Diseases and Tropical Medicine
80802 Munich, Germany
<jelinek at lrz.uni-muenchen.de>
[The case reminds us that Leishmania is common in Southern Europe (France,
Italy, Spain and particular Malta) and that asymptomatic infections occur.
Dogs are the main reservoir in and the infection is transmitted by
sandflies. - Mod.EP]
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