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PLoS Negl Trop Dis. 2018 Oct 4;12(10):e0006727. doi: 10.1371/journal.pntd.0006727. eCollection 2018 Oct.

A rare case of visceral leishmaniasis in an immunocompetent traveler returning to the United States from Europe.

Author information

1
Department of Internal Medicine, Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America.
2
Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, United States of America.
3
Department of Internal Medicine, Section of Hematology and Oncology, Yale University School of Medicine, New Haven, Connecticut, United States of America.
4
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America.
5
Department of Internal Medicine, Section of Hematology and Oncology, Weill Cornell Medicine, New York, New York, United States of America.

Abstract

A young, healthy traveler returning to the United States presented with fever, night sweats, splenomegaly, and pancytopenia. Bone marrow biopsy revealed leishmaniasis (Leishmania infantum), likely acquired in southern France. Although many cases of endemic visceral leishmaniasis (VL) have been reported in Europe, this is a rare case of imported VL in a healthy traveler returning from Europe to the US. Despite successful initial treatment with liposomal amphotericin B (LamB), relapse occurred. Treatments for VL in immunocompetent individuals are highly effective, but relapse can occur. There is more extensive experience in endemic areas with treating relapse that may be lacking in North America. This case alerts physicians in the US that immunocompetent adults can acquire VL during brief visits to endemic areas in Europe. It is important that travelers be counseled on preventive measures. Patients should be monitored after treatment for relapse.

PMID:
30286207
PMCID:
PMC6171829
DOI:
10.1371/journal.pntd.0006727
[Indexed for MEDLINE]
Free PMC Article

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