A case of Leishmania infection with focal splanchnic involvement without systemic symptoms: a potential anti-inflammatory role for vitamin D

ABSTRACT

Case Report: We report the case of a 59 year-old woman with persistent nausea, hyporexia, fatigue and mild abdominal discomfort. The patient was hospitalized upon suspicion of malignancy due to multiple hepatic and splenic nodules found on an abdominal ultrasound. Hypercalcemia emerged at initial diagnostic workup, which was considered secondary to iatrogenic vitamin D intoxication. After an adequate management of hypercalcemia and normalization of serum calcium level, all symptoms presented by the patient completely regressed. In order to characterize splanchnic lesions, several biochemistry, microbiology and radiological tests were performed, including two bioptic specimens of a focal hepatic lesion. Eventually, a diagnosis of leishmanial infection was made. The patient started a specific anti-leishmanial treatment, and the focal hepatic and splenic lesions progressively disappeared.

Conclusion: To our knowledge, this is the first reported case of asymptomatic leishmanial infection with a widespread focal splanchnic involvement. The anti-inflammatory effect of vitamin D could be related to this atypical presentation of visceral leishmaniasis without systemic symptoms.

KEYWORDS:

• Leishmania
• vitamin D
• hepatic lesions
• splenic lesions

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

As case report based on normal clinical practice, the approval by the Local Ethical Committee was not mandatory.

Consent to publish

Index patient was aware of our intention to publish this manuscript. A freely given informed consent was obtained.

Authors’ contributions

Zaghi I and Ielasi L equally contributed to description of this case and to the review of the pertinent literature; Ielasi L and Riefolo M contributed to figure collection; All authors contributed to review and editing the manuscript.

Availability of data and materials

Clinical, laboratory and radiological reports concerning the case described in this manuscript are available from the corresponding author on reasonable request.

Additional information

Funding

The authors received no financial support to produce this manuscript.