The case of a 13 year old boy with a severe form of visceral leishmani
asis (VL) mimicking portal hypertension and of unfavorable outcome is
presented. The authors stress the usefulness of investigating humoral
immune response by using Western Blot assay in order to confirm the di
agnosis when the parasite cannot be isolated. Since VL may be responsi
ble for death if the treatment is delayed, screening of the disease in
children presenting with chronic liver disease is important in endemi
c area.