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[Imported visceral leishmaniasis (kala azar) in a German infant]
M Emeis1, O Liesenfeld, G Henze
1Kinderklinik des Universitätsklinikum Rudolf Virchow, Standort Wedding, Freie Universität Berlin.
Insights
A child returning from Mallorca was diagnosed with visceral leishmaniasis, a parasitic infection. Early diagnosis using PCR and treatment with stibogluconate led to rapid improvement, highlighting the importance of considering this infection in travelers.
Area of Science:
- Tropical Medicine
- Parasitology
- Pediatrics
Background:
- Visceral leishmaniasis is a serious parasitic disease often associated with travel to endemic areas.
- Differential diagnosis in febrile children with pancytopenia and splenomegaly can be challenging, sometimes mimicking malignancy.
Observation:
- A pediatric case presented with pancytopenia, splenomegaly, and fever after returning from Mallorca, Spain.
- Microscopic examination of bone marrow and PCR of peripheral blood confirmed Leishmania donovani infection.
Findings:
- Treatment with stibogluconate for 25 days resulted in rapid defervescence and clinical improvement within 4 days.
- Polymerase Chain Reaction (PCR) demonstrated high sensitivity for diagnosing visceral leishmaniasis in this case.
Implications:
- Leishmania donovani infections should be considered in the differential diagnosis of suspected malignancies in patients with travel history to Mediterranean countries.
- PCR is a valuable and sensitive diagnostic tool for visceral leishmaniasis, aiding prompt treatment and management.
Abstract:
We here report the case of a 1 4/12 year old girl with visceral leishmaniasis. Returning from a trip to Mallorca she presented with pancytopenia, splenomegaly and fever and was admitted to hospital with suspected malignancy. Diagnosis was established microscopically from bone marrow smear and confirmed by PCR-assisted amplification of leishmania-specific DNA from peripheral blood. Treatment was conducted with stibogluconate for 25 days. Defervescence and improvement of clinical symptoms was seen after 4 days of treatment. Infection due to Leishmania donovani can be acquired throughout the entire mediterranean area and should therefore be included in the differential diagnosis of suspected malignancies in patients with a history of travel to mediterranean countries. PCR proved to be a sensitive tool for establishing the diagnosis of visceral leishmaniasis.