The man who petted sandflies: A rare case of visceral leishmaniasis with panhypopituitarism

Abstract

Leishmaniasis, caused by the protozoan parasite Leishmania transmitted through infected sandfly bites, manifests in various clinical forms, including visceral leishmaniasis (VL), a severe condition prevalent in developing countries like India. Treatment failure is a known complication in VL patients. This case report details a unique case of treatment failure VL in a 56-year-old male. The patient’s 8-month medical journey involved diagnostic dilemmas, hospitalisations and failed treatments, reflecting the challenges in diagnosing and managing VL. Despite appropriate liposomal amphotericin B therapy, the disease persisted, prompting further investigation and unravelling the persistence of infection due to underlying panhypopituitarism induced by a pituitary adenoma, causing immunocompromised status. The patient received treatment according to the schedule with liposomal amphotericin B and was subsequently discharged under secondary prophylaxis with the same, in addition to hormonal supplementation. This report contributes to unravelling the intricacies associated with VL and providing insights into factors that impact treatment outcomes, especially in individuals with compromised immune systems.