Case Report: The First Case Report of Visceral Leishmaniasis in Cambodia

• Type of Material: Article
• Authors: Sam Lyvannak, Angkor Hospital for Children; Korb Sreynich, Angkor Hospital for Children; Sing Heng, Angkor Hospital for Children; Miliya Thyl, Angkor Hospital for Children; Arjun Chandna, Angkor Hospital for Children; Ngoun Chanpheaktra, Angkor Hospital for Children; Ngeth Pises, Angkor Hospital for Children; Prak Farrilend, Angkor Hospital for Children; Jason Jarzembowski, Medical College of Wisconsin; Vasiliki Leventaki, Medical College of Wisconsin; Jonathan Davick, University of Iowa; Cindy Neunert, Columbia University; Frank Keller, Emory University; Leslie Kean, Emory University; Bruce Camitta, Medical College of Wisconsin; Katherine Tarlock, Seattle Children's Hospital; Ben Watkins, Emory University
• Language: English
• Date: 2022-08-01
• Publisher: AMER SOC TROP MED & HYGIENE
• Publication Version: Final Published Version
• Copyright Statement: © The American Society of Tropical Medicine and Hygiene
• Final Published Version (URL): http://dx.doi.org/10.4269/ajtmh.22-0085
• Title of Journal or Parent Work: AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
• Volume: 107
• Issue: 2
• Start Page: 336
• End Page: 338
• Keywords: Life Sciences & Biomedicine; Tropical Medicine; Science & Technology; Public, Environmental & Occupational Health
• Research Categories: Health Sciences, Public Health

Abstract

Leishmaniasis is considered a neglected tropical disease that is commonly found in Asia, Africa, South America, and Mediterranean countries. Visceral leishmaniasis (VL) is the most severe form of the disease and is almost universally fatal if left untreated. The symptoms of VL overlap with many infectious diseases, malignancies, and other blood disorders. The most common findings include fever, cytopenias, and splenomegaly. Given the nonspecific symptoms, the diagnosis requires detailed laboratory investigations, including bone marrow examination, that can be challenging in low- and middle-income countries. Diagnostic limitations likely lead to the underdiagnosis or delay in diagnosis of VL. We describe, to our knowledge, the first case report of VL in Cambodia in a child presenting with fever, anemia, and thrombocytopenia. The diagnosis required a liver biopsy and multiple bone marrow biopsies to visualize intracellular Leishmania spp. Our case illustrates the diagnostic challenges and the importance of timely diagnosis. This case also highlights the need for heightened awareness of the diagnostic findings of VL and improved reporting of tropical diseases.