35

±o}5'1 Jl} : Al110 1'1 All 1:Q.. 2004\'! Vol. 10. No. 1. June 2004

~o}~lAi ~B-~ Visceral Leishmaniasis

Visceral Leishmaniasis in a Child

Hyun-Young Kim, MD., Seung-Eun Jung, MD., Kwi-Won Park, MD., Woo-Ki Kim, MD.

Department of Surgery, Seoul National University College of Medicine

Seoul, Korea

Visceral leishmaniasis is a life-threatening systemic infection caused by a protozoa of the genus leishmania and transmitted by sandfly. We report the first case of visceral leishmana­isis in Korea. The patient was a one-year-old girl admitted with the symptoms of fever,

abdominal distension, pancytopenia, and purpura. She traveled to Argentina 5 months ago, and has had symptoms such as fever and pale appearance. Laboratory findings were: WBC, 12,680/mm3 ; Hg, 3.7g/dL; platelet, lOOK; total bilirubin, 1.2mg/dL; AST/ALT, 48/10 U/L. CT scan

and MRI showed hepato-splenomegaly. On laparotomy, excision of an accessory spleen and splenic hilar lymph nodes were performed. Many amastigotes were microscopically identified in histiocytes from the biopsy tissues. Sodium stibogluconate was administrated for 2 weeks,

which did not relieve the symptoms. After administration of the additional Amphotericin B for 3 weeks. symptoms were improved. (J Kor Assoc Pediatr Surg lO(l)::1'5~38), 2004.

Index Words: Visceral leishmaniasis, Non-endemic areas, Child

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Correspondence: Kwi-Won Park, MD., Department of Surgery,

Seoul National University College of Medicine, 28 Yongon-dong,

Chongno-Gu, Seoul 110-744, Korea

Tel : 02) 760-3635, Fax: 02) 766-3975 E-mail: pedsurg@plaza.snu.ac.kr

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Fig. 1. Skin lesion: purpuric macular lesion abdominal wall(A), and face(8).

Fig. 2. Hepatosplenomegaly in CT image(A) and MRI image(8)

Fig. 3. Microscopic photography, showing the amastigotes in the celis: A, accessory spleen (Giemsa staining: x 400); 8, splenic hilar lymph node (Immunohistochemical staining: x 400).

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