title: Visceral leishmaniasis with endobronchial involvement in an immunocompetent adult.
abstract: Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement.
authors.affiliation: Pulmonary Medicine Department, Evaggelismos General Hospital, 45-47 Ypsilantou Street, 10676 Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kotsifas
authors.forename: Eugenios
authors.initials: E
authors.lastname: Metaxas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Koutsouvelis
authors.forename: Athanassios
authors.initials: A
authors.lastname: Skoutelis
authors.forename: Panayiota
authors.initials: P
authors.lastname: Kara
authors.forename: George
authors.initials: G
authors.lastname: Tatsis