visceral leishmaniasis as fever of unknown origin

visceral leishmaniasis is the second most common cause of fever of unknown origin in our study. this disease is not common in adults, although it's endemic among the pediatric age group. the majority of the affected individuals were young. high grade spiking fever, chills and splenomegaly were unique findings. other common findings were neutropenia, anemia, abnormal liver function tests, sterile pyuria and microscopic hematuria. except for i case, parasites were absent from tissue biopsies (e.g. bone marrow, liver, lymph node). diagnosis was suggested by indirect fluorescent antibody (ifa) and confirmed by response to meglumine antimonate (glucantime) and decline of ifa titer on follow-up.