Congenital visceral leishmaniasis in Ukraine: case report

Abstract

An 8-month-old boy was diagnosed with visceral leishmaniasis in the Ukraine, a non-endemic area. His mother had been treated for visceral leishmaniasis at 28-32 weeks gestation whilst working in Alicante, Spain and delivered her infant at 38 weeks gestation by elective caesarean section in Ukraine. It is presumed that the infant's infection was as a result of vertical transmission.

Visceral leishmaniasis as a cause of postpartum pyrexia — case report

“…This shift in cytokine pattern provides an explanation for the increased susceptibility to Leishmania infection in pregnant mice, and possibly in pregnant women, as was the case with our patient [7,9]. The infection probably took place several months before delivery or much earlier, other such cases are described in the literature, and our patient was either asymptomatic during pregnancy or had a subclinical form of the disease [11,12]. The subclinical form of kala-azar is very common, according to WHO data, and its relation to the clinical form is 5:1 [7].…”

“…Many clinical entities can be confused with visceral leishmaniasis, among them a prolonged enterobacterial infection, the clinical manifestations of which overlap perfectly with the signs and symptoms of visceral leishmaniasis malaria, brucellosis, typhoid fever, acute Chagas disease, hepatosplenic schistosomiasis, lymphoma, multiple myeloma, sickle cell anemia, and leukemias [11]. In such cases, serological tests and bone marrow aspiration prove to be valuable tools for the diagnosis of the disease [5,7,12].…”

Sexual and vertical transmission of visceral leishmaniasis

“…Together these studies strongly support the notion that canine VL is vertically transmitted. Importantly, there have been a number of case reports of congenital transmission of VL in humans even from asymptomatic mothers [27][28][29][30]. Furthermore, vertical transmission has been experimentally demonstrated in mice [17].…”

Transmission to Humans

“…At the age of eight months, the nursing child suddenly exhibited a fever, decreased appetite, weakness, pallor of the integuments, bruising, hepatosplenomegaly, tachypnea, and lymphadenopathy. An aspirate of the bone marrow revealed ovoid cells of 3-5 µm that were identified as Leishman-Donovan bodies [66].…”