Diagnostically Challenging Case: Coexistence of Two Zoonoses

Area of Science:

• Infectious Diseases
• Tropical Medicine
• Clinical Case Study

Background:

• Brucellosis and visceral leishmaniasis (VL) are endemic infectious diseases.
• Coinfection presents diagnostic challenges due to overlapping clinical manifestations.
• Prompt diagnosis and appropriate treatment are crucial for patient outcomes.

Observation:

• A male patient presented with fever, cytopenia, and hepatosplenomegaly.
• Initial brucellosis testing was positive, but the patient did not respond to treatment.
• Subsequent bone marrow biopsy revealed Leishmania amastigotes, and PCR confirmed VL.

Findings:

• The patient was diagnosed with a coinfection of visceral leishmaniasis and brucellosis.
• The presentation included B symptoms (fever, night sweats, weight loss) and cytopenia.
• The diagnostic process was complicated by the overlapping symptoms of both diseases.

Implications:

• This case underscores the importance of considering coinfections in endemic areas.
• Diagnostic algorithms should account for atypical presentations of common diseases.
• Early identification of coexisting visceral leishmaniasis and brucellosis is vital for effective management.