ABSTRACT
Fulminant liver failure due to visceral leishmaniais is very rare, and has been described only in children. We report an immunocompetent adult man who developed acute liver failure due to leishmaniais and dramatically recovered with amphotericin-B therapy.
Subject(s)
Adult , Amphotericin B/therapeutic use , Antiprotozoal Agents/therapeutic use , Humans , Immunocompetence , Leishmaniasis, Visceral/complications , Liver Failure, Acute/parasitology , Male , Treatment OutcomeABSTRACT
Visceral leishmaniasis is a highly morbid and incapacitating infection, which usually presents with prolonged fever, weight loss and hepato-splenomegaly. Despite the availability of effective treatment, the disease can have a high mortality even at referral centers. A case series of fatal visceral leishmaniasis, encountered during a prospective, two year period is presented. All the patients died due to multisystem organ failure. However, delayed diagnosis due to atypical manifestations was an important factor contributing to the fatal outcome of the patients. Instead of relying solely on the classical clinical features of visceral leishmaniasis, simple laboratory findings like pancytopenia, altered albumin/globulin ratio and appositive aldehyde and rK 39 dipstick tests can help in making an early diagnosis even in atypical cases, thereby reducing the mortality of visceral leishmaniasis.