Visceral leishmaniasis in a six-year-old patient – unexpected diagnosis: case study

Abstract

Visceral leishmaniasis is a parasitic disease caused by protozoa of the Leishmania genus and transmitted by the bites of phlebotomine sandfly species. The disease may be a diagnostic challenge in nonendemic countries. The following study presents a case of a six-year-old girl with recurrent fever, hepatosplenomegaly, lymphadenopathy, and pancytopaenia. During the diagnostic work-up acute leukaemia, metabolic diseases, and connective tissue diseases were excluded. A second examination of the bone marrow revealed macrophages containing inclusions typical of Leishmania amastigotes. The diagnosis was confirmed by identification of the parasite's DNA in a PCR test of a bone marrow sample and serologic detection of antibodies to Leishmania spp. Treatment with liposomal amphotericin B was administered with good effect.