02515nas a2200349   4500000000100000008004100001260001200042653002700054653004000081653001900121653003900140653001900179653002700198653001300225653003500238100001800273700001500291700001400306700001500320700001600335700001800351700001400369700001500383700001300398700001500411245010000426856004400526300000900570490000700579520156500586022001402151       2025                            d  bMDPI AG10aBone marrow aspiration10aLymphohistiocytosis, Hemophagocytic10aAmphotericin B10aNeglected tropical diseases (NTDs)10aVector control10avisceral leishmaniosis10aZoonosis10apediatric emergency department1 aAndreottola V1 aSantucci C1 aBellini T1 aMatarese S1 aCanzoneri F1 aDell’Orso G1 aFinetti M1 aFioredda F1 aMesini A1 aPiccotti E00aVisceral Leishmaniasis in Pediatrics: A Case Series and a Narrative Review with Global Insights  uhttps://www.mdpi.com/2414-6366/10/5/136  a1-160 v103 a<p>Visceral leishmaniasis (VL) is a severe parasitic disease caused by Leishmania spp., with a significant impact on pediatric populations, particularly in endemic regions. The diagnosis of VL in children requires a high index of suspicion, as clinical manifestations—such as prolonged fever, hepatosplenomegaly, and pancytopenia—overlap with other infectious and hematologic diseases. While serological and molecular tests aid in detection, bone marrow aspiration remains the gold standard for definitive diagnosis. In this case series, we describe five pediatric patients diagnosed with VL in Italy, emphasizing the importance of a timely and accurate diagnostic approach. Liposomal amphotericin B (LAmB) is the first-line treatment in Southern Europe due to its high efficacy and reduced toxicity. Our patients received a standard regimen of 3 mg/kg daily for five days, plus an additional dose on day 10, leading to rapid clinical improvement. However, some cases required supportive care, such as red blood cell transfusions, particularly in patients with co-infections. Despite being a neglected disease, VL is re-emerging in Europe, influenced by climate change, increased pet ownership, and migration from endemic regions. Prevention strategies focus on vector control, canine vaccination, and public health awareness. The global rise in pediatric VL highlights the need for improved surveillance, access to affordable treatments, and the development of effective vaccines to mitigate the disease burden in both endemic and non-endemic areas.</p>
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