[Visceral leishmaniasis (kala-azar). A rare differential diagnosis of splenomegaly and pancytopenia].
A 53-year-old man developed a septic fever up to 40 degrees C, pancytopenia and hepatosplenomegaly after a holiday in Spain. Administration of piperacillin and amikacin was ineffective, but the fever subsided and partial haematological remission occurred when 1 mg/kg methylprednisolone daily was added. After six months his general condition worsened and pancytopenia with typical inclusion bodies in bone-marrow macrophages was noted, leading to the diagnosis of visceral leishmaniasis (Kala-Azar). The diagnosis was confirmed by serological tests. The causative organism was eliminated and the abnormal findings regressed during treatment with sodium stibogluconate, at first 600 mg/d for two weeks, then 850 mg/d over 16 days, interrupted for 14 days because of side effects.
Baldus
M
M
Medizinische Klinik A, Klinikum der Stadt Ludwigshafen am Rhein.
Schleiffer
T
T
Brass
H
H
D000967:Antimony Sodium Gluconate / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006529:Hepatomegaly / Q000209:etiology*; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000209:etiology*; D013163:Splenomegaly / Q000209:etiology*; D014195:Travel
D000967:Antimony Sodium Gluconate
Viszerale Leishmaniose (Kala-Azar). Eine seltene Differentialdiagnose bei Splenomegalie und Panzytopenie.