Visceral leishmaniasis (kala-azar) is a disseminated protozoal infecti
on that occurs in areas of the world other than North America. In ende
mic regions, kala-azar is also an opportunistic infection associated w
ith the acquired immunodeficiency syndrome. We report a case of acquir
ed immunodeficiency syndrome-associated kala-azar acquired abroad that
was first expressed in New York City. Human immunodeficiency virus-in
fected patients who have lived or traveled abroad may present in this
country with unusual infections.