title: Visceral leishmaniasis-associated hemophagocytic lymphohistiocytosis in a traveler returning from a pilgrimage to the Camino de Santiago.
abstract: We report the case of a 73-year-old American traveler who presented with 3 weeks of fatigue, fevers, chills, and pancytopenia. Clinical and laboratory findings were consistent with hemophagocytic lymphohystiocytosis (HLH) and bone marrow biopsy revealed amastigotes consistent with visceral leishmaniasis. The range of endemic visceral leishmaniasis transmission now extends into northern Spain and travelers to this region should use personal protective measures against sand fly exposure.
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Watkins
authors.forename: Sriram
authors.initials: S
authors.lastname: Shamasunder
authors.forename: Thomas
authors.initials: T
authors.lastname: Cascino
authors.forename: Kristie L
authors.initials: KL
authors.lastname: White
authors.forename: Shereen
authors.initials: S
authors.lastname: Katrak
authors.forename: Caryn
authors.initials: C
authors.lastname: Bern
authors.forename: Brian S
authors.initials: BS
authors.lastname: Schwartz
mesh_terms: D000368:Aged; D001853:Bone Marrow / Q000469:parasitology / Q000473:pathology; D015616:Histiocytosis, Non-Langerhans-Cell / Q000188:drug therapy / Q000469:parasitology*; D006801:Humans; D007299:Insect Bites and Stings / Q000469:parasitology*; D007893:Leishmania donovani / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000188:drug therapy / Q000469:parasitology* / Q000473:pathology; D008297:Male; D013030:Spain; D014195:Travel; D016896:Treatment Outcome; D014481:United States