Young age at presentation, delayed presentation, poverty and high morbidity and mortality are among the hallmarks of the disease in this region. A high index of suspicion, proper evaluation and therapeutic trial in suspected patients is essential for an early diagnosis and timely definitive treatment, in order to decrease the morbidity and mortality associated with this disease. Factors that were found to be associated with high morbidity and mortality in this study need to be addressed. Acknowledgement The authors are grateful to all

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