Visceral leishmaniasis without fever in an 11-month-old infant: a rare clinical feature of Kala-azar.
Visceral leishmaniasis or kala-azar is an endemic parasitic disease in some parts of the world which is characterized by fever, splenomegaly, and pancytopenia in most of the cases. Herein we report an 11 month-old male infant with diagnosis of kala-azar who presented with pallor, hepatosplenomegaly, failure to gain weight, and no history of fever. Surprisingly, fever started after beginning of meglumine antimoniate treatment in this patient. As far as we are aware of, this is a rare presentation of visceral leishmaniasis. Therefore, clinicians especially in endemic areas are highly recommended to include kala-azar among differential diagnosis of unexplained anemia without fever to prevent misdiagnosis of this potentially fatal, but treatable condition.
Department of Pediatrics, Ali Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran.
Shirin
S
Sayyahfar
Department of Pediatrics, Ali Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran.
Shahla
S
Ansari
Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Mehdi
M
Mohebali
Department of Genetics and Molecular Biology, Ali Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran.
Babak
B
Behnam
D000666:Amphotericin B / Q000627:therapeutic use; D000740:Anemia / Q000175:diagnosis* / Q000469:parasitology; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D003840:Deoxycholic Acid / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004338:Drug Combinations; D019353:Endemic Diseases; D005334:Fever; D006801:Humans; D007223:Infant; D007492:Iran; D018314:Leishmania infantum / Q000472:pathogenicity; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000627:therapeutic use; D013163:Splenomegaly / Q000469:parasitology
D000981:Antiprotozoal Agents; D004338:Drug Combinations; D009942:Organometallic Compounds; D003840:Deoxycholic Acid; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination
Leishmania infantum; afebrile; anemia; kala-azar; splenomegaly; visceral leishmaniasis