BACKGROUND: Visceral leishmaniasis is a parasitic disease which has a good prognosis in previously healthy patients who have been successfully treated. At present, visceral leishmaniasis is increasingly reported in immunocompromised patients including those with AIDS, whose display a fulminating form and higher mortality. We report a case of visceral leishmaniasis in a healthy patient with a non classical clinical evolution of the disease. METHODS: A 17 years old patient without immunosuppressive factors was diagnosed by histologic evaluation of bone marrow which revealed intracellular leishmania amastigotes. Immediately the patient received treatment with antimony therapy. RESULTS: Patient developed a multi-organic failure (respiratory distress, disseminated intravascular coagulation, hepatic and renal insufficiency) and died at 13 days his after intensive care unit admission. CONCLUSIONS: The major new finding of this study is that in normal humans visceral leishmaniasis can have a dramatic short-term follow up in spite of correctly treatment. We suggest a possible immunological mechanism similar at non septic pathology.
BACKGROUND:Visceral leishmaniasis is a parasitic disease which has a good prognosis in previously healthy patients who have been successfully treated. At present, visceral leishmaniasis is increasingly reported in immunocompromised patients including those with AIDS, whose display a fulminating form and higher mortality. We report a case of visceral leishmaniasis in a healthy patient with a non classical clinical evolution of the disease. METHODS: A 17 years old patient without immunosuppressive factors was diagnosed by histologic evaluation of bone marrow which revealed intracellular leishmania amastigotes. Immediately the patient received treatment with antimony therapy. RESULTS:Patient developed a multi-organic failure (respiratory distress, disseminated intravascular coagulation, hepatic and renal insufficiency) and died at 13 days his after intensive care unit admission. CONCLUSIONS: The major new finding of this study is that in normal humansvisceral leishmaniasis can have a dramatic short-term follow up in spite of correctly treatment. We suggest a possible immunological mechanism similar at non septic pathology.