title: Visceral leishmaniasis (kala-azar) and malaria coinfection in an immigrant in the state of Terengganu, Malaysia: A case report.
abstract: Malaria is endemic in Malaysia. Leishmaniasis is a protozoan infection rarely reported in Malaysia. Here, a 24-year-old Nepalese man who presented with prolonged fever and hepatosplenomegaly is reported. Blood film examination confirmed a Plasmodium vivax malaria infection. Despite being adequately treated for malaria, his fever persisted. Bone marrow examination showed presence of Leishman-Donovan complex. He was successfully treated with prolonged course of amphotericin B. The case highlights the importance of awareness among the treating physicians of this disease occurring in a foreign national from an endemic region when he presents with fever and hepatosplenomegaly. Coinfection with malaria can occur although it is rare. It can cause significant delay of the diagnosis of leishmaniasis.
authors.affiliation: Infectious Disease Clinic, Department of Medicine, Hospital Sultanah Nur Zahirah, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Malaysia. drakar_drfha@yahoo.com
authors.forename: Ahmad Kashfi
authors.initials: AK
authors.lastname: Ab Rahman
authors.affiliation: Microbiology Unit, Department of Pathology, Hospital Sultanah Nur Zahirah, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Malaysia.
authors.forename: Fatimah Haslina
authors.initials: FH
authors.lastname: Abdullah
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D060085:Coinfection / Q000175:diagnosis* / Q000473:pathology*; D054242:Emigrants and Immigrants; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D016780:Malaria, Vivax / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D008296:Malaysia; D008297:Male; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents; D000666:Amphotericin B