VISCERAL LEISHMANIASIS IN A YOUNG-CHILD - DIAGNOSTIC DIFFICULTIES DUETO HEMOPHAGOCYTOSIS

Background. - Hemophagocytosis has already been reported in cases of v isceral leishmaniasis and thus may complicate search for diagnosis. Ca se report. - A previously healthy 2 year-old boy was referred for feve r and splenomegaly with pancytopenia. An initial diagnosis of kala-aza r war refuted because of absence of biological inflammatory syndrome, negativity of bone-marrow aspiration and splenic ponction and of speci fic serology. After three months of clinical deterioration and apparit ion of active hemophagocytosis, both bone marrow aspiration and specif ic serology for visceral leishmaniasis became positive. The boy was gi ven sodium stibogluconate for 20 days; he improved gradually with comp lete and definitive remission. Conclusion. - Diagnosis of visceral lei shmaniasis may be difficult, even in countries where this condition is relatively frequent; the association with hemophagocytosis is possibl e and does not constitute a poor factor of prognosis if specific thera py is proposed.