[Big spleen, big problems]

The history of a Moroccan girl is described with splenomegaly, lymphadenopathy and pancytopenia after a holiday in her native country. Bone marrow smears were considered negative for Leishmaniasis in four different laboratories. All other diagnostic options could also not be confirmed. Reexamination of the bone marrow smears in a laboratory for tropical diseases revealed Leishmania donovani organisms. Treatment with sodium antimony gluconate was successful. Epidemiology, symptoms and diagnostic problems are discussed.