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Title: Acute liver failure due to visceral leishmaniasis in Barcelona: a case report
Author: Martínez de Narvajas, Iratxe
Díaz, Alba
Bassegoda, Octavio
Carpio, Adriá
Fuster, Carla
Valls, M. Eugenia
Álvarez Martínez, Míriam
Garcia Vidal, Carolina
Soriano Viladomiu, Alex
Martínez, José Antonio
Ambrosioni, Juan
Keywords: Leishmaniosi
Insuficiència hepàtica
Liver failure
Issue Date: 2019
Publisher: BioMed Central
Abstract: Background: Leishmaniasis is an emerging infectious disease. Due to human migration and tourism, visceral leishmaniasis may become more common in non-endemic areas. In the Mediterranean basin, visceral leishmaniasis typically occurs in rural regions. Case presentation: We present an unusual urban case of acute liver failure due to visceral leishmaniasis, following a prolonged fever of unknown origin. After obtaining negative results from the bone marrow aspirate, we performed a liver biopsy that elucidated the diagnosis. The liver involvement in visceral leishmaniasis may appear as chronic granulomatous hepatitis. However diffuse hepatitis process, a necro-inflammatory pattern, without forming granulomas were observed in the liver biopsy specimens in this case. Intracytoplasmic Leishmania amastigotes were observed in the liver biopsy specimens and a polymerase chain reaction confirmed the diagnosis. Only five pathological confirmed cases of acute hepatitis due to visceral leishmaniasis have been described so far, just two in adults and both from Barcelona. A revision of the literature is performed. Conclusions: Acute hepatitis is an uncommon debut of visceral leishmaniasis in immunocompetent patients. Furthermore there are only few cases in the literature that describe the histopathological changes that we found in this patient. In conclusion, in case of acute hepatitis leading to liver failure, leishmaniasis should be considered a differential diagnosis (even in non-endemic countries and without clear epidemiological exposure) and liver biopsy can elucidate the diagnosis.
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It is part of: BMC Infectious Diseases, 2019, vol. 19
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ISSN: 1471-2334
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (ISGlobal)

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