IntroductionLeishmaniasis is a diverse group of infectious diseases, caused by Leishmania parasites1,2, intracellular protozoan parasites3, transmitted by female phlebotomine sand flies.3–5 Leishmaniasis is endemic in the Middle East and Mediterranean countries, although more than ninety percent of cases occur in Bangladesh, India, Nepal, and other countries.6 It has various clinical forms (mainly cutaneous, mucosal, or visceral), the most severe form is visceral leishmaniasis (VL).6 VL is also known as kala-azar or Black disease. It is a tropical and subtropical parasitic disease, also prevalent in poor communities where care is lacking.5VL is reported in over 70 countries, and it has become an endemic disease in more than 60 countries.4 There are two species of leishmania that cause VL: L. donovani in the Old World, including Asia, Africa, and Europe, and L. infantum (L. chagasi) in Latin America, Iran, Pakistan, and the Mediterranean countries (Syria).2,5–7 The infection may be asymptomatic or an oligosymptomatic illness that either resolves spontaneously or evolves into active kala-azar.3 Common Clinical symptoms of the disease include: prolonged fever, weakness, loss of appetite, and hepatosplenomegaly.4 Laboratory results, including pancytopenia and hyperglobulinemia.3,4 The gold standard for diagnosis of VL is bone marrow aspiration, lymph node aspiration, or spleen biopsy.4 All patients with VL should receive therapy with anti-leishmanial drugs, the pentavalent antimony compounds or amphotericin B.4 The importance of our clinical case comes from the similarity of the disease to other diseases, the difficulty of diagnosing it, and its sometimes being overlooked, and the fact that early diagnosis and treatment are the two main measures to control leishmaniasis.
