Visceral leishmaniasis in an immunocompetent Hungarian adult patient

Abstract

Visceral leishmaniasis caused by L. infantum Nicolle 1908 (Kinetoplastida, Trypanosomatidae) is very rare in immunocompetent adults. Clinical manifestation of the infection occurs in children and immune-compromised patients associated with AIDS, haemopoietic malignancies or after renal, liver, and heart transplantations in Europe. Hungary is regarded free of leishmaniasis. Except for a single infection in a small girl without a travel history, only a few imported cases have been recorded among Hungarians returning from endemic areas. Case presentation: Visceral leishmaniasis was diagnosed in a 32 years old immumocompetent Hungarian man who had spent his holidays during the previous 3 years in Dalmatian territories (Dubrovnik, Makarska and Trogir) of Croatia. He had two months history of fever, chills, and night sweating associated with weight loss. Physical examination showed mild hepatomegaly and extreme splenomegaly. The protozoon infection was confirmed by parasitological, serological and molecular biological methods. Clinical recovery of the patient was observed after treatment with amphotericin B. Conclusion: We want to highlight the effects of climate changes and to call attention of health care professionals in Central and Eastern European countries to consider the possibility of leishmaniasis as an emerging disease of tourists returned from endemic re-gions.