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Volume 44, Number 1, February 2011

Visceral leishmaniasis (kala-azar) and malaria coinfection in an immigrant in the state of Terengganu, Malaysia: A case report


Ahmad Kashfi Ab Rahman, Fatimah Haslina Abdullah


Received: April 28, 2009    Revised: July 30, 2009    Accepted: November 30, 2009   

 

Corresponding author:

Infectious Disease Clinic, Department of Medicine, Hospital Sultanah Nur Zahirah, Kuala Terengganu, 20400
Terengganu, Malaysia.
E-mail address: drakar_drfha@yahoo.com (A.K. Ab Rahman).



 

Background and purpose: 

Malaria is endemic in Malaysia. Leishmaniasis is a protozoan infection rarely reported in Malaysia. Here, a 24-year-old Nepalese man who presented with prolonged fever and hepatosplenomegaly is reported. Blood film examination confirmed a Plasmodium vivax malaria infection. Despite being adequately treated for malaria, his fever persisted. Bone marrow examination showed presence of Leishman-Donovan complex. He was successfully treated with prolonged course of amphotericin B. The case highlights the importance
of awareness among the treating physicians of this disease occurring in a foreign national from an endemic region when he presents with fever and hepatosplenomegaly. Coinfection with malaria can occur although it is rare. It can cause significant delay of the diagnosis of leishmaniasis.



 

Key words:

Amphotericin B; Coinfection; Leishmaniasis; Malaria; Treatment