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  • Title: [Visceral leishmaniasis (kala-azar). A rare differential diagnosis of splenomegaly and pancytopenia].
    Author: Baldus M, Schleiffer T, Brass H.
    Journal: Dtsch Med Wochenschr; 1989 Dec 01; 114(48):1876-81. PubMed ID: 2555125.
    Abstract:
    A 53-year-old man developed a septic fever up to 40 degrees C, pancytopenia and hepatosplenomegaly after a holiday in Spain. Administration of piperacillin and amikacin was ineffective, but the fever subsided and partial haematological remission occurred when 1 mg/kg methylprednisolone daily was added. After six months his general condition worsened and pancytopenia with typical inclusion bodies in bone-marrow macrophages was noted, leading to the diagnosis of visceral leishmaniasis (Kala-Azar). The diagnosis was confirmed by serological tests. The causative organism was eliminated and the abnormal findings regressed during treatment with sodium stibogluconate, at first 600 mg/d for two weeks, then 850 mg/d over 16 days, interrupted for 14 days because of side effects.
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