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Case Reports in Medicine
Volume 2011, Article ID 561985, 5 pages
http://dx.doi.org/10.1155/2011/561985
Case Report

Visceral Leishmaniasis with Endobronchial Involvement in an Immunocompetent Adult

1Pulmonary Medicine Department, Evaggelismos General Hospital, 45-47 Ypsilantou Street, 10676 Athens, Greece
25th Department of Internal Medicine, Evaggelismos General Hospital, Greece
3Department of Pathology, Evaggelismos General Hospital, Athens, Greece

Received 23 September 2010; Revised 21 December 2010; Accepted 19 January 2011

Academic Editor: Simin Goral

Copyright © 2011 Konstantinos Kotsifas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement.