title: [Visceral leishmaniasis and multiple organ failure].
abstract: BACKGROUND
  Visceral leishmaniasis is a parasitic disease which has a good prognosis in previously healthy patients who have been successfully treated. At present, visceral leishmaniasis is increasingly reported in immunocompromised patients including those with AIDS, whose display a fulminating form and higher mortality. We report a case of visceral leishmaniasis in a healthy patient with a non classical clinical evolution of the disease.
  
  
  METHODS
  A 17 years old patient without immunosuppressive factors was diagnosed by histologic evaluation of bone marrow which revealed intracellular leishmania amastigotes. Immediately the patient received treatment with antimony therapy.
  
  
  RESULTS
  Patient developed a multi-organic failure (respiratory distress, disseminated intravascular coagulation, hepatic and renal insufficiency) and died at 13 days his after intensive care unit admission.
  
  
  CONCLUSIONS
  The major new finding of this study is that in normal humans visceral leishmaniasis can have a dramatic short-term follow up in spite of correctly treatment. We suggest a possible immunological mechanism similar at non septic pathology.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Clínico Universitario, Valencia.
authors.forename: A
authors.initials: A
authors.lastname: Mesejo
authors.forename: C
authors.initials: C
authors.lastname: Núñez
authors.forename: A
authors.initials: A
authors.lastname: Llombart
authors.forename: P L
authors.initials: PL
authors.lastname: Pérez
authors.forename: M
authors.initials: M
authors.lastname: Simó
authors.forename: F
authors.initials: F
authors.lastname: Ruiz
authors.forename: J
authors.initials: J
authors.lastname: Blanquer
mesh_terms: D000293:Adolescent; D000818:Animals; D001853:Bone Marrow / Q000469:parasitology; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D017809:Fatal Outcome; D006801:Humans; D007891:Leishmania / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D009102:Multiple Organ Failure / Q000209:etiology*; D009942:Organometallic Compounds / Q000627:therapeutic use
chemical_list: D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate
vernacular_title: Leishmaniasis visceral y fracaso multiorgánico.