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Published on: April 4, 2025
Visceral leishmaniasis with endobronchial involvement in an immunocompetent adult
Konstantinos Kotsifas1, Eugenios Metaxas, Ioannis Koutsouvelis
1Pulmonary Medicine Department, Evaggelismos General Hospital, 45-47 Ypsilantou Street, 10676 Athens, Greece.
Abstract:
Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement.
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