LEISHMANIASIS – AN UNUSUAL CAUSE OF SPLENOMEGALY IN ROMANIA

Authors

  • Teodora ALEXA Regional Institute of Oncology, Iaşi
  • A. LUCA “Dr. C.I. Parhon” Hospital, Iaşi
  • Irina CRACANA “Dr. C.I. Parhon” Hospital, Iaşi
  • Ramona ONUTU “Dr. C.I. Parhon” Hospital, Iaşi
  • Amalia MERTICARIU Regional Institute of Oncology, Iaşi
  • C. DANAILA Regional Institute of Oncology, Iaşi

Keywords:

VISCERAL LEISHMANIASIS, SPLENOMEGALY, TROPICAL DISEASES

Abstract

Leishmaniasis is a parasitic infection caused by protozoans classified as Leishmania species. Romania is not considered an endemic country and there are only few reports of sporadic cases in the last 100 years. However, studies suggest that the disease is spreading north. We present the case of a 44 year old female that presented with asthenia, perspirations, vertigo, weight loss and menometrorhagias in small to medium quantity. Clinical exam revealed the presence of splenomegaly and her blood tests indicated she had pancitopenia; differential diagnosis included myeloproliferative or lymphoproliferative disorders, infections that evolve with spleen enlargement, autoimmune-related splenomegaly and hepatic - all tests were negative. She refused the bone marrow aspiration. Three months later, her condition worsened and the menometrorragias became more severe. Bone marrow aspiration revealed the presence of numerous intra and extracellular Leishmania spp. amastigotes. A detailed anamnesis showed that she had worked for six months in Italy as a care-giver nine months ago. She was transferred to Bucharest where she received optimal treatment. However, due to the continuous bleeding, the evolution was unfavourable. This is an alarm sign for physicians that should take into account the fact that, due to population migration and global warming, tropical infectious diseases are becoming more and more common. The signs and symptoms, as well as the treatment in leishmaniasis are reviewed, as well as a brief history of leishmaniasis in Romania.

Author Biographies

  • Teodora ALEXA, Regional Institute of Oncology, Iaşi

    Department of Oncology

  • A. LUCA, “Dr. C.I. Parhon” Hospital, Iaşi

    Department of Internal Medicine

  • Irina CRACANA, “Dr. C.I. Parhon” Hospital, Iaşi

    Department of Clinical Geriatrics

  • Ramona ONUTU, “Dr. C.I. Parhon” Hospital, Iaşi

    Department of Clinical Geriatrics

  • Amalia MERTICARIU, Regional Institute of Oncology, Iaşi

    Department of Haematology

  • C. DANAILA, Regional Institute of Oncology, Iaşi

    Department of Haematology

References

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Additional Files

Published

2018-05-14

Issue

Vol. 118 No. 1 (2014): The Medical-Surgical Journal

Section

INTERNAL MEDICINE - PEDIATRICS

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