# name
Acute liver failure due to visceral leishmaniasis in Barcelona: a case report

# metadata.dc.description.abstract[].value
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.

# metadata.dc.rights[].value
cc by (c) Martínez de Narvajas et al., 2019

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Acute liver failure due to visceral leishmaniasis in Barcelona: a case report