title: Atypical American visceral leishmaniasis caused by disseminated Leishmania amazonensis infection presenting with hepatitis and adenopathy.
abstract: Leishmania amazonensis is widely recognised as a cause of cutaneous leishmaniasis in Latin America, but it can also disseminate to produce atypical visceral leishmaniasis with hepatitis and lymphadenopathy. The patient, an 8-year-old Brazilian boy, presented with a febrile illness and hepatosplenomegaly, elevated liver enzymes and generalised adenopathy. Serological tests using antigens of L. chagasi, the typical cause of visceral leishmaniasis in Latin America, were inconclusive. Leishmania amazonensis was eventually isolated in a culture of a lymph node. The patient recovered fully after treatment with meglumine antimoniate. As this case illustrates, L. amazonensis produces a spectrum of disease that includes atypical American visceral leishmaniasis with evidence of hepatocellular injury and generalised lymphadenopathy.
authors.affiliation: Department of Biochemistry, Universidade Federal do Rio Grande do Norte, CP 1624, Natal, RN 59072-970, Brazil.
authors.forename: J A
authors.initials: JA
authors.lastname: Aleixo
authors.forename: E T
authors.initials: ET
authors.lastname: Nascimento
authors.forename: G R
authors.initials: GR
authors.lastname: Monteiro
authors.forename: M Z
authors.initials: MZ
authors.lastname: Fernandes
authors.forename: A M O
authors.initials: AM
authors.lastname: Ramos
authors.forename: M E
authors.initials: ME
authors.lastname: Wilson
authors.forename: R D
authors.initials: RD
authors.lastname: Pearson
authors.forename: S M B
authors.initials: SM
authors.lastname: Jeronimo
mesh_terms: D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D006505:Hepatitis / Q000188:drug therapy / Q000469:parasitology*; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000150:complications* / Q000188:drug therapy; D008206:Lymphatic Diseases / Q000188:drug therapy / Q000469:parasitology*; D008297:Male; D016896:Treatment Outcome
chemical_list: D000981:Antiprotozoal Agents