JUMMEC, 1998;3:62-62.

Abstract

We report a case of visceral leishmaniasis (kala azar) in a 28 year old Bangladeshi migrant. The patient had migrated to Malaysia 9 months prior to admission to our hospital. He was employed in a glove factory. His illness began one week prior to presentation with high swinging fever, chest pain and substantial weight loss. On examination, he was found to be cachetic, with cervical and inguinal lymphadenopathy and niassive hepatosplenomegaly. Investigations revealed a pancytopaenia with a Hb of 9.9 g/L, WBC 3.10 x 10^9/L and a platelet count of 29 x 10g/L. Liver function test revealed an elevated alkaline phosphatase 380 I.U./L and transanlinases AST 169 I.U/L and ALT 95 I.U./L. The serum albumin was 19 g/L. Blood for malaria parasite was negative. A bone marrow examination was performed to look for LD bodies and to exclude haematological malignancies. The bone marrow examination revealed multiple LD bodies. Serology for leishmania was strongly positive. The patient was heated with atnphotericin B to a total dose of 0.6 g. There was resolution of his fever and reduction in the size of the liver and spleen at the end of therapy. There was also a steady gain in his weight. The patient unfortunately failed to return for subsequent follow-ups