Leishmaniasis diagnosed by liver biopsy - Management of two atypical cases

Two patients presenting with pyrexia of unknown origin were diagnosed as ha ving visceral leishmaniasis based on the presence of Leishmania donovani bo dies in liver tissue. Of particular interest is that these two case reports suggest that in patients with pyrexia of unknown origin, a liver biopsy fo r L. donovani bodies should be considered even when several months have pas sed since leaving an endemic area, when splenomegaly is absent, when bone m arrow examination and serology are not diagnostic, and even when abnormal c oagulation necessitates a transjugular liver biopsy.