The clinical and hematological features and response to therapy in 17 Sudanese patients with visceral leishmaniasis are described. The clinical features in our cases were similar to those described from Ethiopia and East Africa. Fever, hepatosplenomegaly, leukopenia, lymphopenia, and thrombocytopenia were common findings. An unusual feature is the relatively high frequency of hepatic dysfunction. One patient died of cerebral hemorrhage and another of gastrointestinal bleeding. Hemorrhagic manifestations were attributed to immune complex vasculitis and thrombocytopenia. The response to sodium stibogluconate was good.

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A 32-year-old female presented to the surgeon with history of recurrent excruciating pain at the top of middle finger of her right hand for the last two years. There was no history of trauma or infection. Clinically there were no features of cervical spondylosis or carpal tunnel syndrome and the patient did not complain of numbness in the distribution of the median nerve. Physical examination was unremarkable except for local tenderness. No nodule or discoloration of the skin was noticed.Plain x-rays of the hand were normal. A gadolinium-enhanced MRI of the middle finger of the right hand was then performed (Figure 1, A and B).