Pediatrik Kutanöz Leishmania Olgularının Değerlendirilmesi

Year 2023, Volume: 45 Issue: 6, 902 - 908, 24.10.2023

Merve İşeri Nepesov , Yalçın Kara , Mahmut Can Kızıl , Hilal Kaya Erdoğan , Kursat Bora Carman , Nihal Doğan , Tercan Us , Ömer Kılıç , Ener Çağrı Dinleyici

https://doi.org/10.20515/otd.1321525

Abstract

Kutanöz Leishmaniasis (KL), enfekte dişi tatarcık sineğinin ısırması ile bulaşan ve ülsere nodüler lezyonlarla karakterize, leishmania tipi protozoanların neden olduğu bir hastalık olup, dünyanın bazı bölgelerinde endemik olarak görülmektedir. Çalışmaya çocuk enfeksiyon hastalıkları ve dermatoloji tarafından takip edilen 21 pediatrik kutanöz leishmania olgusu dahil edildi. Hastaların demografik ve klinik özellikleri, aldıkları lokal veya sistemik tedaviler ve yan etkileri retrospektif olarak incelendi. Olguların 14'ü (%66) kız, 7'si (%34) erkekti. Olguların ortalama yaşı 6.4 yıldı. Hastaların 15'i mülteciydi (hastalardan yedisi Iraklı, sekizi Suriye'liydi). Hastaların 10'unda (%47) sadece yüzde, 6'sında (%28) hem yüzde hem de elde, 4'ünde (%20) alt ekstremitede lezyon vardı. Yedi hastada (%34) tek lezyon, ondördünde çoklu lezyon ve yedi hastada dörtten fazla lezyon vardı. 13 hastanın direk mikroskopik incelemesinde amastigot gözlendi. 15 hastaya intralezyonel tedavi, 6 hastaya sistemik tedavi verildi, 2 hasta sistemik tedaviyi reddetti. Beş hastaya meglumin antimoniat, bir hastaya amfoterisin B verildi. Bir hastada amfoterisin b sonrası yüzde şişlik, kızarıklık ve ödem gibi yan etkiler gelişti ve tedavi meglumin antimoniat olarak değiştirildi. Kutanöz Leishmaniasis, leishmania cinsi protozoalarının neden olduğu kronik bir hastalıktır. Uluslararası seyahat, göç ve mülteciler nedeniyle sadece endemik bölgeler değil, tüm dünyada nispeten yaygın bir durum haline gelmiştir. Endemik bölgelerin dışında kronik, ağrısız cilt lezyonları olduğunda Kutanöz Leishmania düşünülmelidir

Keywords

kutanöz leishmania, çocuk, endemi, göç, mülteci

Evaluation of Pediatric Cutaneous Leishmania Cases

Abstract

Cutaneous Leishmaniasis (CL) is a disease caused by leishmania-type protozoans, which is transmitted by the bite of infected female phlebotomine sandflies and is characterized by ulcerated nodular lesions. Twenty-one pediatric cutaneous leishmania cases followed by pediatric infectious diseases and dermatology were included in the study. The demographic and clinical characteristics of the patients, the local or systemic treatments, and side effects were analyzed retrospectively. 14 (66%) of the patients were female and 7 (34%) were male. The mean age of the cases was 6.4 years. Fifteen of the patients were refugees (seven of the patients were from Iraq, and eight of them were from Syria). Ten of the patients ( 47%) had lesions only on the face, 6 (28%) were both on the face and hand, 4 (20%) were on the lower extremities. Seven patients (34%) had a single lesion, fourteen had multiple lesions and seven had more than four lesions. Amastigote was observed in the microbiological examination of skin scraping samples of 13 patients. Intralesional therapy was given to 15 patients, systemic treatment was given to 6 patients, and 2 patients refused systemic treatment. Five patient was given meglumine antimoniate, one patient was given amphotericin B. In one patient, side effects such as facial swelling, rash, and edema developed after amphotericin b, and the treatment was changed to meglumine antimoniate. Leishmaniasis is a chronic disease caused by flagellate protozoa of the genus Leishmania. especially in endemic countries. CL has become a relatively common condition all over the world due to international travel, migration, and refugees. Cutaneous Leishmania should be considered when there are chronic, painless skin lesions outside of endemic areas.

Keywords

cutaneous leishmania, child, endemic area, refugees

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