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Comparative Analysis of Pediatric and Adult Visceral Leishmaniasis in Brazil.
MedLine Citation:
PMID:  23249921     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: The aim of this study was to compare clinical manifestations, laboratory data, morbidity and mortality between adults and children with visceral leishmaniasis (VL), with a focus on kidney function. METHODS:: This was a retrospective cohort study with 432 patients with VL diagnosed at one center in the northeast of Brazil. Patients were divided into two groups according to age (>21 years and ≤21 years old). RESULTS:: The time between onset of symptoms and beginning of treatment was longer in adults (89.5 vs. 48.5 days, p<0.001), signs and symptoms were similar in both groups. Failure of treatment with glucantime was more common in adults (17.6% vs. 8.8%, p=0.008). Acute kidney injury was observed in 160 patients (37.0%), and it was more severe in adults. Risk factors for acute kidney injury in adults were hypokalemia, leukopenia, chills and amphotericin B use. In children, secondary infections were found to increase the risk for acute kidney injury. Overall mortality was 8.8% and it was significantly higher in adults (12.6% vs. 4.1%, p=0.002). CONCLUSIONS:: The adult population had more severe laboratory abnormalities and a worse prognosis, possibly due to delay in diagnosis. Acute kidney injury is prevalent in both groups and it is usually more severe in adults.
Authors:
Natália A Rocha; Michelle J C Oliveira; Luiz F L G Franco; Geraldo B Silva Júnior; Marília P Alves; Aline M Sampaio; Bárbara R L Montenegro; Ana Patrícia F Vieira; Camilla N Jacinto; Krasnalhia Lívia S Abreu; Elizabeth F Daher
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-17
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  -     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Division of Nephrology, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil. 2School of Medicine, Health Sciences Center, University of Fortaleza. Fortaleza, Ceará, Brazil.
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