Visceral leishmaniasis (kala-azar) after a visit to the Mediterranean region

The case of a 17-year-old patient is presented who became ill 10 months after a holiday visit to Malta. Symptoms included fever peaking daily at 40 degrees C, pancytopenia, and splenomegaly. There was no evidence of bacterial or virological involvement, and probatory treatment with antibiotics followed by corticosteroids was without success. Examination of bone marrow led to the diagnosis of visceral leishmaniasis (kala-azar). A therapy with pentavalent antimony brought rapid improvement in clinical symptoms and led to complete recovery. A short review is presented of the epidemiology, diagnosis, and therapy of visceral leishmaniasis. The aim of this presentation is to remind the attendant physician of the clinical symptoms involved with the possible case of visceral leishmaniasis.