Abstract
Visceral leishmaniasis is endemic in the western states of Eritrea, but it is rare in the city of Asmara. We report a case of an 18-month-old female with a high-grade fever, weight loss, and hepatosplenomegaly. No obvious cause of her illness was found. Routine blood investigations showed pancytopenia, and microscopic examination of bone marrow revealed intracellular and extracellular Leishmania amastigotes, so a diagnosis of leishmaniasis (kala-azar) was finally made. Visceral leishmaniasis should be considered when a child presents with fever, weight loss, organomegaly, and pancytopenia.
Highlights
No cases of visceral leishmaniasis were recorded before in Asmara city because it is not included in the endemic region of Eritrea
Visceral leishmaniasis (VL) is a parasitic disease caused by Leishmania donovani (L. donovani) infection after being bitten by a sandfly that has the parasite [1]
Srivastava et al argued that much of the disease in Africa is intense in the eastern part of that continent; L. donovani is endemic in the remote parts of Kenya, Uganda, Ethiopia, Somalia, and Sudan [6]
Summary
No cases of visceral leishmaniasis were recorded before in Asmara city because it is not included in the endemic region of Eritrea. Careful examination of the bone marrow helps identify intracellular and extracellular Leishmania bodies. This accurate and inexpensive diagnosis method is recommended when VL is suspected. An 18-month-old female from Asmara, Eritrea, had a two-month history of fever with sweating and chills, weight loss, progressive abdominal distention, and generalized mucocutaneous pallor. She did not respond to empirical antimalarial and antibiotics drugs and had no history of travel outside Asmara city.
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