Acute form of visceral leishmaniasis in a 3-month-old infant

The case of a 3-month-old infant who died with an acute form of visceral leishmaniasis is reported. The liver presented an unusual pattern with widespread patchy cellular necrosis besides marked reticulin proliferation and some fibrosis. The marked systemic histiocytic proliferation contrasted with the paucity of Leishman-Donovan bodies, responsible for the negativity of two bone marrow aspirates and a needle biopsy of the liver. Visceral leishmaniasis must be considered in the differential diagnosis of cholestatic syndromes in infancy.