Case Report: Atypical Presentation of Visceral Leishmaniasis: Two Cases from Northwest Ethiopia

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  • 1 Department of Internal Medicine, University of Gondar, Gondar, Ethiopia;
  • 2 Leishmaniasis Research and Treatment Center, University of Gondar, Gondar, Ethiopia;
  • 3 Department of Pathology, University of Gondar, Gondar, Ethiopia;
  • 4 Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium

Human visceral leishmaniasis (VL) is a life-threatening disease caused by protozoan parasites belonging to the Leishmania donovani complex. Atypical cases of leishmaniasis and HIV coinfection have been documented in case reports, mostly associated with gastrointestinal tract, kidney, and skin involvement. We report two VL cases with atypical localizations not reported from east Africa before, both diagnosed and treated at the Leishmaniasis Research and Treatment Center, Gondar, Ethiopia. The first case was an HIV-infected patient with scrotal and penile involvement. Leishmania parasites were detected in the spleen and the scrotum. The second case was an immunocompetent individual with esophageal, laryngeal, and pharyngeal involvement and facial lesions. Leishmania parasites were detected in the spleen, skin, and esophageal biopsies. Current evidence suggests atypical presentation can occur in patients irrespective of their HIV status. Therefore; we suggest a high index of suspicion for VL among clinicians working in endemic areas of Ethiopia.

Author Notes

Address correspondence to Rezika Mohammed, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia. E-mail: rezikamohammed@yahoo.com

Authors’ addresses: Rezika Mohammed, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia, and Leishmaniasis Research and Treatment Center, University of Gondar, Gondar, Ethiopia, E-mail: rezikamohammed@yahoo.com. Helina Fikre, Tigist Mekonnen, and Arega Yeshanew, Leishmaniasis Research and Treatment Center, University of Gondar, Gondar, Ethiopia, E-mails: naterasa@yahoo.com, tmekonnen20@yahoo.com, and arega4239@yahoo.com. Bewketu Abebe, Department of Pathology, University of Gondar, Gondar, Ethiopia, E-mail: bewketu1981@gmail.com. Ermias Diro, Department of Internal Medicine, University of Gondar, Gondar, Ethiopia, E-mail: ermi_diro@yahoo.com. Johan van Griensven, Department of Clinical Science, Institute of Tropical Medicine, Antwerp, Belgium, E-mail: jvangriensven@itg.be.

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