title: A Rare Presentation of Leishmaniasis.
abstract: Leishmaniasis or kala-azar is a protozoan disease that can present as cutaneous, mucocutaneous, visceral, and disseminated disease. In India, it is usually localized in distinct areas of Bihar, Jharkhand, West Bengal, and parts of Eastern Uttar Pradesh. Visceral leishmaniasis (VL) involves the visceral organs, mainly the liver, the spleen and bone marrow. VL is characterized by prolonged fever, massive splenomegaly, weight loss, progressive anemia, pancytopenia, and hypergammaglobulinemia, and can be complicated by serious infections. In most of the patient the diagnosis is made on bone marrow biopsy or splenic aspirate. We hereby present an unusual case of kala-azar in a 52-year-old patient non-resident of endemic area presenting with pyrexia of unknown origin, in whom bone marrow biopsy was negative for Leishmanin Donovan (LD) bodies, and diagnosis was made by liver biopsy in which LD bodies were seen.
authors: Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors: Ritesh
authors: R
authors: Prajapati
authors: Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors: Ashish
authors: A
authors: Kumar
authors: Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors: Praveen
authors: P
authors: Sharma
authors: Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors: Vikas
authors: V
authors: Singla
authors: Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors: Naresh
authors: N
authors: Bansal
authors: Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India.
authors: Shashi
authors: S
authors: Dhawan
authors: Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors: Anil
authors: A
authors: Arora
keywords: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ANA, anti-nuclear antibodies; AST, aspartate aminotransferase; CT, computerized tomography; E, eosinophils; ESR, erythrocyte sedimentation rate; GGT, gamma glutamyl transferase; HBsAg, hepatitis B surface antigen; HCV, hepatitis C virus; HIV, human immunodeficiency virus; L, lymphocytes; LD, Leishmanin Donovan; Leishmanin Donovan bodies; P, polymorphs; PET, positron emission tomography; PUO, pyrexia of unknown origin; VL, visceral leishmaniasis; WBC, white blood count; kala-azar; protozoan disease; pyrexia of unknown origin; visceral leishmaniasis