{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T03:15:11Z","timestamp":1765422911117,"version":"3.37.3"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Visceral leishmaniasis (VL) caused by<jats:italic>Leishmania infantum<\/jats:italic>is endemic in the Mediterranean area. In the last decades a northward spread of the parasite has been observed in Italy. This paper describes a VL outbreak in Modena province (Emilia-Romagna, Northern Italy) between 2012 and 2015.<jats:italic>Methods<\/jats:italic>. Retrospective, observational study to evaluate epidemiological, microbiological characteristics, and clinical management of VL in patients referring to Policlinico Modena Hospital.<jats:italic>Results<\/jats:italic>. Sixteen cases of VL occurred in the study period. An immunosuppressive condition was present in 81.3%. Clinical presentation included anemia, fever, leukopenia, thrombocytopenia, and hepatosplenomegaly. Serology was positive in 73.3% of cases, peripheral blood PCR in 92.3%, and bone marrow blood PCR in 100%. Culture was positive in 3\/6 cases (50%) and all the isolates were identified as<jats:italic>L. infantum<\/jats:italic>by ITS1\/ITS2 sequencing. The median time between symptom onset and diagnosis was 22 days (range 6\u2013131 days). All patients were treated with liposomal amphotericin b. 18.8% had a VL recurrence and were treated with miltefosine. Attributable mortality was 6.3%.<jats:italic>Conclusions<\/jats:italic>. VL due to<jats:italic>L. infantum<\/jats:italic>could determine periodical outbreaks, as the one described; thus it is important to include VL in the differential diagnosis of fever of unknown origin, even in low-endemic areas.<\/jats:p>","DOI":"10.1155\/2016\/6481028","type":"journal-article","created":{"date-parts":[[2016,11,23]],"date-time":"2016-11-23T21:09:21Z","timestamp":1479935361000},"page":"1-7","source":"Crossref","is-referenced-by-count":25,"title":["Clinical and Microbiological Characteristics of Visceral Leishmaniasis Outbreak in a Northern Italian Nonendemic Area: A Retrospective Observational Study"],"prefix":"10.1155","volume":"2016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6922-5759","authenticated-orcid":true,"given":"E.","family":"Franceschini","sequence":"first","affiliation":[{"name":"Infectious Disease Unit, Azienda Ospedaliero-Universitaria Policlinico Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Puzzolante","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit, Azienda Ospedaliero-Universitaria Policlinico Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Menozzi","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit, Azienda Ospedaliero-Universitaria Policlinico Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Rossi","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit, Azienda Ospedaliero-Universitaria Policlinico Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Bedini","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit, Azienda Ospedaliero-Universitaria Policlinico Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Orlando","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit, Azienda Ospedaliero-Universitaria Policlinico Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Gennari","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Azienda Ospedaliero-Universitaria Policlinico Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Meacci","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Azienda Ospedaliero-Universitaria Policlinico Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7437-1929","authenticated-orcid":true,"given":"G.","family":"Rugna","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Lombardia e dell\u2019Emilia Romagna, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Carra","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Lombardia e dell\u2019Emilia Romagna, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Codeluppi","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit, Azienda Ospedaliero-Universitaria Policlinico Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Mussini","sequence":"additional","affiliation":[{"name":"University of Modena and Reggio Emilia, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1407.071589"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(07)70297-9"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2006.06.019"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.es2013.18.29.20535"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00416-09"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.es2013.18.29.20530"},{"year":"2010","series-title":"WHO Technical Report Series","key":"7"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro1748"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"issue":"10","key":"10","doi-asserted-by":"crossref","first-page":"2877","DOI":"10.1128\/JCM.36.10.2877-2881.1998","volume":"36","year":"1998","journal-title":"Journal of Clinical Microbiology"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.micinf.2005.04.009"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2013.755515"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1097\/qco.0b013e32835c2198"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(74)90148-5"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2007.01998.x"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1089\/vbz.2013.1362"},{"issue":"4","key":"20","first-page":"151","volume":"43","year":"2001","journal-title":"Parassitologia"},{"year":"2015","key":"21"},{"issue":"10","key":"22","volume":"15","year":"2010","journal-title":"Euro Surveillance"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.es2013.18.30.20545"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.119495"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00840-13"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0004304"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.1002\/ddr.21285"}],"container-title":["BioMed Research International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/bmri\/2016\/6481028.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/bmri\/2016\/6481028.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/bmri\/2016\/6481028.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T13:23:26Z","timestamp":1601213006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/bmri\/2016\/6481028\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016]]},"references-count":24,"alternative-id":["6481028","6481028"],"URL":"https:\/\/doi.org\/10.1155\/2016\/6481028","relation":{},"ISSN":["2314-6133","2314-6141"],"issn-type":[{"type":"print","value":"2314-6133"},{"type":"electronic","value":"2314-6141"}],"subject":[],"published":{"date-parts":[[2016]]}}}