Recurrent leishmaniasis infection isolated in the pleural fluid

Area of Science:

• Infectious Diseases
• Parasitology
• Internal Medicine

Background:

• Visceral leishmaniasis is a serious parasitic disease, typically treated with medication.
• Recurrence after treatment can occur, especially in immunocompromised or elderly patients.
• Diagnosis often involves bone marrow biopsy, but pleural fluid analysis can be vital in specific presentations.

Observation:

• An elderly female patient with cytopenia was diagnosed with visceral leishmaniasis via bone marrow biopsy.
• Following treatment and apparent recovery, she developed pleural effusion, hypoalbuminemia, and cytopenia.
• Leishmania parasites were identified in pleural fluid obtained during therapeutic drainage.

Findings:

• The patient experienced a recurrence of visceral leishmaniasis, indicated by parasitic isolation from pleural fluid.
• Pleural effusion can be a presenting symptom of recurrent visceral leishmaniasis.
• Therapeutic drainage of pleural fluid facilitated diagnosis.

Implications:

• Clinicians should consider leishmaniasis recurrence in previously treated patients presenting with similar symptoms.
• Pleural fluid analysis is a valuable diagnostic tool for suspected leishmaniasis recurrence, particularly when effusion is present.
• Early and accurate diagnosis of recurrent leishmaniasis is essential for effective management and improved patient outcomes.