Visceral Leishmaniasis with Endobronchial Involvement in an Immunocompetent Adult

Visceral Leishmaniasis with Endobronchial Involvement in an Immunocompetent Adult

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Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia.Cough may be a presenting symptom as well.However, pulmonary involvement is considered rare and mainly described in immunocompromised patients.We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis.

Bronchoscopy revealed a discreet polypoid mucosal endobronchial saxemodel lesion whose biopsy yielded Leishmania amastigotes within histiocytes.Transbronchial needle biopsy of a right paratracheal lymph node was also positive.Leishmania amastigotes were also found on bone raspberry hershey kisses marrow and liver biopsies.Treatment with IV Amphotericin B was successful.

In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement.