Disseminated Leishmaniasis Due to Using Immunosuppression Drugs: A Case Report



Afshoon M¹ ; Abdolsalehi M² ; Alinia G¹ ; Borhani K² ; Yaghmaie B¹ ; Khodabandeh M¹ Show Affiliations
Source: Iranian Journal of Parasitology Published:2020

Abstract

Visceral leishmaniasis is a common parasitic disease between humans and animals, transmitted by sandflies (Phlebotomus) in the Mediterranean coun-tries, including Iran. The statistics have been reported less than real due to errors in the diagnosis and reporting of affected cases. In this report, we will present the symptoms and manifestations of this disease to reduce late detection and exacerbating factors. The patient was a three-year-old girl from Tehran, Iran who had ascites and hepatomegaly. When she was 9 month-old, she was diagnosed as autoimmune hepatitis after liver biopsy and she was treated with immunosuppressive drugs (Azathioprine, predni-solone, and cyclosporine) for 22 months, but later she suffered from fever, pancytopenia, and hepatosplenomegaly. Then a bone marrow biopsy was done for her. There was a large amount of Leishman body in her bone marrow and treatment for Kala-azar was started for her. In patients with prolonged fever and splenomegaly, especially association with pancytope-nia, consider leishmaniasis. Immunosuppressive drugs can disseminate parasitic diseases, including visceral leishmaniasis. © 2020, Tehran University of Medical Sciences (TUMS). All rights reserved.