Abstract
Visceral leishmaniasis (VL) is endemic to the southern plains of Nepal. Here, we report the first case of VL from a non-endemic Himalayan region of Nepal. The patient presented with a history of high-grade fever, splenomegaly, and anemia but had not traveled to a VL-endemic region. Visceral leishmaniasis was diagnosed following microscopic detection of the Leishmania species amastigote in a bone marrow aspirate, positive result for the rK39 test, and further validation by nested polymerase chain reaction (PCR). The patient was treated with 5 mg/kg liposomal amphotericin B and was clinically improved upon discharge. Our result suggests that VL is expanding towards non-endemic regions of Nepal, and it should therefore be considered that VL surveillance systems be strengthened, particularly for non-program districts and VL be included as a differential diagnosis in febrile illnesses.
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Acknowledgements
We thank Thomas Templeton, Nagasaki University, for critical reading of the manuscript. We gratefully thank the staffs of the Kanti Children Hospital for providing facility and care to the patient. Assessment and treatment of patients were carried out in accordance with the standard clinical procedures at the Kanti Children Hospital, Kathmandu, Nepal.
Financial support
This study was supported by Nepal Academy of Science and Technology.
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This study was approved by the Ethical Review Board of Nepal Health Research Council. The blood samples were collected after obtaining informed consent from the patient’s parent and the concerned hospital.
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Shrestha, M., Pandey, B.D., Maharjan, J. et al. Visceral leishmaniasis from a non-endemic Himalayan region of Nepal. Parasitol Res 117, 2323–2326 (2018). https://doi.org/10.1007/s00436-018-5887-6
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DOI: https://doi.org/10.1007/s00436-018-5887-6