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Uncommon cause of hepatosplenomegaly in an immunocompetent patient
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The bone marrow was cellular with myeloid preponderance and a few atypical cells. Amastigotes of Leishmania donovani (LD bodies) were present with an average parasite density of 1–10 parasites per 10 oil immersion fields or 3+ (see fig 1, p 478; LD bodies are arrowed).1
The diagnosis is visceral leishmaniasis. Further tests include the aldehyde test and ELISA to document the presence of IgG antibodies against leishmania antigen in blood. Both these tests were positive in this patient. Other serological methods such as the indirect fluorescent antibody test and the direct agglutination test may also be used for the diagnosis.
The classical presentation of visceral leishmaniasis in immunocompetent individuals is that of high grade fever with hepatosplenomegaly in the setting of a visit to or residence in an endemic area. There were the two atypical features in this patient. Firstly, he lived in a non-endemic zone and had no
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- Uncommon cause of hepatosplenomegaly in an immunocompetent patient
- A Mohan, R Guleria, J C Samantaray, A Kumar Dutta, S Tandon, J N Pande
Postgrad. Med. J. 2003 79: 478.[Extract] [Full Text] [PDF]
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