A case of visceral leishmaniasis in Austria.
We report a patient aged 41 years with fever of unknown origin. Notable aspects of his travel history were a trip to the Philippines and a sailing trip around Sicily. The patient presented with fever up to 40 degrees C since 4 weeks, weakness, headache, hepatosplenomegaly and night sweat. No specific cause could be found. Based on clinical findings tuberculosis was suspected and empirical tuberculostatic treatment was started. However, during the following 6 weeks the patient's condition deteriorated. A bone marrow biopsy performed to exclude a haematological malignancy revealed Leishmania sp. in macrophages. This histological diagnosis was confirmed retrospectively by re-examination of a previously performed liver biopsy and by an increased anti-leishmania serum antibody titer of 1:1280. The patient was treated with sodium stibogluconate (pentostam, 850 mg) for 30 days and recovered slowly.
Stoiser
B
B
First Department of Medicine, University of Vienna, Austria.
Thalhammer
F
F
Chott
A
A
Breyer
S
S
Burgmann
H
H
Graninger
W
W
D000328:Adult; D000818:Animals; D001317:Austria; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D003937:Diagnosis, Differential; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D007893:Leishmania donovani; D018314:Leishmania infantum; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000473:pathology / Q000635:transmission; D008297:Male; D014195:Travel