Kala-azar – A case of unknown origin fever

Abstract

Leishmaniasis, a vector-borne disease, is a disease caused by
obligate intra-macrophage protozoa. It is endemic to the tropical
and subtropical regions, with a worldwide prevalence of 12 million
cases. In our country, over the last years, reports ranged from
15 to 20 cases/year. There are four main forms of Leishmaniasis
disease: cutaneous leishmaniasis, mucocutaneous leishmaniasis,
visceral leishmaniasis (kala-azar), and post-kala-azar dermal
leishmaniasis. Authors present the case of a 41 year-old woman,
immunocompetent, admitted for fever and pancytopenia, associated with anorexia, asthenia and 17 kg weight loss in seven
months. Investigation revealed to be a visceral leishmaniasis. The
treatment was started with liposomal amphotericin B, getting a
good clinical and analytic response. The disease subsided after
nine months of follow-up. This case emphasizes the importance
of considering a diagnosis of leishmaniasis, especially in non-
-endemic areas, and the need of exam reevaluation when the
diagnosis is not clear in first approach.