Kala azar in childhood

Seven cases of visceral leishmaniasis (kala azar) were diagnosed over a 20-year period, all in children. The clinical features were septic fever, weight loss, prominent hepatomegaly and chronic hemolytic anemia, leukopenia and thrombocytopenia. Blood sedimentation rate was accelerated with a corresponding increase in the plasma globulins. The diagnosis was established by bone marrow aspiration. Four children were treated with pentavalent antimony preparations, three children with diamidine preparations, and two received combined therapy. Six children recovered and one died. The number of recorded cases of leishmaniasis in Israel has decreased rapidly; all our cases came from Arab villages. The most susceptible age is infancy and early childhood.