Leishmaniasis, malaria, and schistosomiasis concurrently in an 8-year-old boy

An overlap in the distribution of the 2 diseases (leishmaniasis and malaria) was reported in endemic areas, and it can cause significant delay in the diagnosis of leishmaniasis. Here, an 8-year-old Yemeni boy who was initially diagnosed as malaria and schistosomiasis, and later on as leishmaniasis is reported. He presented with prolonged fever, hepatosplenomegaly, and diarrhea. His blood film was positive for Plasmodium falciparum malaria, and his stool was positive for Schistosoma mansoni. Although a full therapeutic course of antimalarial and schistosoma was administered, his fever, weight loss, and increased hepatosplenomegaly continued. Bone marrow aspiration was carried out revealing Leishman-Donovan bodies (amastigote form). He was successfully treated with a full course of sodium stibogluconate. This case stresses the importance of alertness among the treating physicians to this disease occurring in a patient from an endemic area, presenting with prolonged fever, and hepatosplenomegaly.