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Review
. 2022 Jan 26;58(2):184.
doi: 10.3390/medicina58020184.

Splenectomy for Visceral Leishmaniasis Out of an Endemic Region: A Case Report and Literature Review

Nebojsa Lekic  1   2 , Boris Tadic  1   2 , Vladimir Djordjevic  1 , Dragan Basaric  1   2 , Marjan Micev  3 , Dragica Vucelic  4 , Milica Mitrovic  5 , Nikola Grubor  1   2
Affiliations
Review

Splenectomy for Visceral Leishmaniasis Out of an Endemic Region: A Case Report and Literature Review

Nebojsa Lekic et al. Medicina (Kaunas). .

Abstract

Visceral leishmaniasis (also known as kala-azar) is characterized by fever, weight loss, swelling of the spleen and liver, and pancytopenia. If it is not treated, the fatality rate in developing countries can be as high as 100% within 2 years. In a high risk situation for perioperative bleeding due to severe thrombocytopenia/coagulopathy, we present a rare challenge for urgent splenectomy in a patient with previously undiagnosed visceral leishmaniasis. A histologic examination of the spleen revealed a visceral leishmaniasis, and the patient was successfully treated with amphotericin B.

Keywords: impaired hemostasis; splenectomy; thromboelastometry; visceral leishmaniasis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Lifecycle of Leishmania spp. [6].
Figure 2
Figure 2
Multidetector computed tomography reveals enlarged, inhomogeneous spleen with intraparenchymal confluent zones of lower density, and a small amount of free fluid is present along the lateral contour of the spleen (A). Abdominal ultrasonographic examination shows enlarged spleen with diffusely inhomogeneous parenchyma (B).
Figure 3
Figure 3
Macroscopic specimen of the removed spleen, 23 × 18 cm in size.
Figure 4
Figure 4
Microscopic examination on higher magnification reveals scattered groups of macrophages (upper right and lower left—see arrows) filled with coarse cytoplasmatic granules consistent with amastigotes of Leishmania protozoan (H&E staining, original magnification 63×, scale bar = 50 µm).
See this image and copyright information in PMC

References

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