Visceral leishmaniasis without splenomegaly: An atypical presentation

Area of Science:

• Tropical Medicine
• Parasitology
• Infectious Diseases

Background:

• Visceral leishmaniasis (kala-azar) is a severe parasitic disease caused by Leishmania parasites.
• It is endemic in India and neighboring countries, typically presenting with fever and hepatosplenomegaly.
• Atypical presentations can delay diagnosis and treatment.

Purpose of the Study:

• To report a case of visceral leishmaniasis with an atypical presentation.
• To highlight the importance of considering visceral leishmaniasis in cases of fever of uncertain origin, even without typical signs like splenomegaly.

Main Methods:

• A case study of a 50-year-old male presenting with prolonged high-grade fever.
• Diagnostic work-up included peripheral blood counts, biochemical tests, and bone marrow aspiration.
• Serological testing (rk-39) was performed.

Main Results:

• The patient presented with high-grade fever for two months but lacked hepatosplenomegaly.
• Bone marrow aspiration revealed Leishmania donovani (LD bodies), and rk-39 serology was positive.
• The patient showed complete fever resolution within a week of treatment initiation.

Conclusions:

• Visceral leishmaniasis can manifest atypically, notably without splenomegaly.
• Timely diagnosis of such atypical cases is essential for effective treatment and reducing morbidity and mortality.
• Prompt detection and treatment of visceral leishmaniasis can significantly improve patient outcomes.