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Kala-Azar: A Case Report.

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  • 1Internal Medicine, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, PRT.

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|March 16, 2023
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Summary

Visceral leishmaniasis, a rare disease in immunocompetent individuals in Portugal, presents with non-specific symptoms like fever and enlarged organs. Early diagnosis and treatment with Amphotericin B are crucial for this parasitic zoonosis.

Keywords:
high feverimmunocompetent adultunintentional weight lossvisceral leishmaniasis (vl)“pancytopenia”

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Area of Science:

  • Parasitology
  • Infectious Diseases
  • Tropical Medicine

Background:

  • Leishmaniasis is a protozoan zoonosis transmitted by sandflies, endemic in tropical regions.
  • It manifests as cutaneous, mucocutaneous, or visceral leishmaniasis (kala-azar).
  • Visceral leishmaniasis affects the reticuloendothelial system, causing fever, hepatosplenomegaly, and pancytopenia.

Observation:

  • This case highlights visceral leishmaniasis in an immunocompetent patient in Portugal, a region where it is considered rare.
  • The patient presented with classic, yet non-specific, symptoms of fever, hepatosplenomegaly, and pancytopenia.
  • Non-specific clinical signs often delay diagnosis, particularly in non-endemic areas.

Findings:

  • Diagnosis relies on direct protozoan visualization and molecular methods like PCR.
  • Amphotericin B is the established first-line treatment for visceral leishmaniasis.
  • Prompt diagnosis and treatment are vital due to the high mortality rate in untreated cases.

Implications:

  • This case underscores the importance of considering visceral leishmaniasis even in immunocompetent individuals in non-endemic areas.
  • It emphasizes the need for heightened clinical suspicion and diagnostic vigilance for non-specific febrile illnesses.
  • Timely intervention is critical for improving patient outcomes and preventing fatal complications of visceral leishmaniasis.