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A, Leishmania species amastigotes (2–3 μm in diameter) are seen within a macrophage in a smear for the bone marrow from a child with VL. B, Hemophagocytic macrophage all X450.
↵* Below the costal margin.
↵† Physical or ultrasound examination.
↵‡ One case formally documented by dermal scraping.
×N indicates times normal; SEM, standard error of the mean.
↵* Number of patients with Hb < 7 g/day at diagnosis: 10/12.
↵† Number of patients with platelets <50 000 at diagnosis: 6/12. Number of patients with platelets <100 000 at diagnosis: 10/12.
↵‡ in parentheses are SEMs.
Evidence of Leishmaniasis at Onset
↵* Eight of 12 marrow smears were positive after repeated examination.
↵† Indirect fluorescence was used to detect IgG antibodies to Leishmania. The antigen was prepared from promastigotes of the World Health Organization reference strain of L infanium.
↵‡ Titer: ≥1:160 to 1:1280; the serology was positive in 3 cases between 1 and 2.5 months after onset.
↵§ Isoenzyme analysis of cultured promastigotes identifiedL infantum MON 1 in 1 case.
Patient Characteristics at Onset and Outcome
NA indicates North African; A, African; F, French; MA, meglumine antimoniate; SS, sodium stibogluconate; C-AMB, amphotericin B (conventional formulation); L-AMB, amphotericin B (liposomal formulation); Pe, pentamidine; VP16, etoposide; CS, corticosteroids.
↵* Subsequently positive.
↵† These children lived in the South of France.
↵‡ Time of admission to time of diagnosis.
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