Although leishmaniasis is widely prevalent in the eastern states of India namely Bihar, Jharkhand, Uttar Pradesh and West Bengal, diagnosing the illness is still difficult¹. We present a case of 24 yr male with history of recurrent fever , progressive weakness, abdominal discomfort for 30 days. On examnation there was hepatospleenomegaly. A diagnosis of visceral leishmaniasis (kala-azar) was made based on the bone marrow aspiration cytology which show amastigotes forms of Leishmania Donovani.  Routine blood investigations showed pancytopenia and a chest X-ray was normal. The patient was treated by intravenou amphotericine B and the patient became afebrile next day after injection.

1. Sachin Gawade, Mangesh Nanaware, RM Gokhale, PS Adhav. Visceral leishmaniasis: A case report.AMJ 2012; 5(2):130-134.
2. Desjeux P. Human leishmaniases: epidemiology and public health aspects. World Health Stat Q 1992; 45:267- 75.
3. Pourahmad M, Hooshmand F, Rahiminejad M. Cutaneous leishmaniasis associated with visceral leishmaniasis in a case of acquired immunodeficiency syndrome. Int J Dermatol 2003;48:59-61
4. Murray HW. Kala-azar–progress against a neglected disease. N Engl J Med 2002; 347:1793–4.
5. Varma N, Naseem S. Hematologic changes in visceral leishmaniasis/ kala azar. Indian J Hematol Blood Transfus 2010; 26:78–82.
6. Sundar S, Rai M. Laboratory diagnosis of visceral leishmaniasis.Clin Diagn Lab Immunol 2002; 9:951–8.
7. Boelaert M, Verdonck K, Menten J, Sunyoto T, van Griensven J,Chappuis F, et al. Rapid tests for the diagnosis of visceral leishmaniasis in patients with suspected disease. Cochrane Database Syst Rev 2014; 6:Cd009135.

Dr Meenakshi Rana

Junior Resident, Department of Obs and Gynaecology, IGMC Shimla, India