A case of visceral leishmaniasis found by left oblique hernia: A case report

Abstract

Visceral leishmaniasis (VL) is an infectious disease caused by Leishmania protozoa. Since sporadic cases of this disease are noted in non-endemic areas and are associated with a limited outbreak, the disease is easily overlooked. In addition, other illnesses exhibit similar symptoms. It is difficult for clinicians to establish an accurate diagnosis and develop effective treatments for this disease. The present study reported a case of a 25-year-old young man admitted to the hospital due to oblique hernia. The case was diagnosed as VL. The patient presented with persistent night sweats and fatigue as described in his admission history. However, the body temperature was normal. Routine examination revealed that the patient exhibited chronic hepatitis B infection, pancytopenia, hepatosplenomegaly, increased erythrocyte sedimentation rate, significant plasma cell infiltration in bone marrow aspirate and hypergammaglobulinemia. The retrospective analysis of the present case can improve the diagnostic accuracy and treatment rate of VL in non-epidemic areas.

Utility of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Patients with Visceral Leishmaniasis: Case Report and Literature Review

“…7,24,25,27,28 There was no uptake in the spleen in seven cases. 7,[29][30][31] There was a "diffuse" uptake in 51.3% of immunocompetent patients and 40% of IS patients, and a "focal/nodular" pattern was found in 24.3% of immunocompetent patients and 13.3% of IS patients.…”

“…The species of Leishmania was specified in 10 patients, showing L. infantum in six cases [12][13][14]23,25,30 and Leishmania donovani in the remaining four patients. 10,18,26,31 Splenectomy was performed in seven patients because of initial suspicion of malignancy. 12,13,16,19,26,28,30 DISCUSSION Fluorodeoxyglucose positron emission tomography/computed tomography is widely used in oncology to diagnose, stage, and evaluate response to treatment 32 and in the diagnosis of fevers of unknown origin.…”

“…7 Interestingly, 13 cases showed no bone marrow uptake but had a positive bone marrow aspiration. 5,[10][11][12][13]16,17,20,22,30,31 In oncology, studies have shown that the extent of FDG uptake in neoplasms is positively correlated with the number of malignant cells, and there is a higher biopsy yield in the most enhanced areas. 34 We therefore infer that enhanced bone marrow uptake could correlate with a higher parasitic replication rate and increase the diagnostic yield of bone marrow biopsies.…”

“…35 One of the main patterns that may have a similar uptake is the splenic marginal zone lymphoma (SMZL). The SMZL * All PET/CT use 18 FDG tracer, except eight (Myles, 17 Ravaglia, 9 Van Raalte 14 , Vase 30 , Prajapati 29 , Tatarelli 21 , Machelart 16 and Zhang 31 ) that did not mention the tracer in the article.…”

A case of inguinal hernia associated with atypical Dirofilaria repens infection in a dog

“…However, we did not observe any changes to the lymphatic system in our canine patient. Visceral infections with protozoan organisms, including Leishmania donovani [ 25 ] and Toxoplasma gondii [ 26 ], have been reported to be associated with hernias in humans. In these cases, the abdominal hernia was likely caused by (i) protozoan infection-related hepatomegaly and splenomegaly, resulting in increased abdominal pressure; (ii) alterations to the skeletal muscles (e.g.…”