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[Kala-azar acquired in Croatia].
Wien Klin Wochenschr. 1992; 104(24):757-60.WK

Abstract

Six weeks after his return from a two-week vacation in Croatia a 52 year-old janitor from Graz complained of loss of appetite, fever, headache, and a 9-kg weight loss. The spleen was enlarged to 16cm as measured by sonography. Laboratory tests revealed pancytopenia, a prolonged prothrombin time and elevation of serum LDH concentration. While repeated bone marrow biopsy showed no signs of leishmaniasis, high antibody titers against leishmania antigen led to the diagnosis of kala-azar. The indirect immunofluorescent antibody test (1:128) and a haemagglutination-inhibition test (1:512) showed diagnostic elevations of titers. Therapy with pentostam led to prompt defervescence and resulted in a full recovery of the patient. After six weeks a marked decrease of antibody titers in the haemagglutination-inhibition test (1:16) could be observed. Leishmaniasis has to be considered in patients with fever of unknown origin who return from Mediterranean countries. Despite a negative bone marrow biopsy a diagnosis is possible on the basis of serological tests. This is important because effective therapy is available as illustrated by this patient and because of the fact that the disease runs a lethal course if the diagnosis is missed.

Authors+Show Affiliations

Wenzl H
Medizinische Klinik, Karl-Franzens-Universität, Graz.
Petritsch W
No affiliation info available
Decrinis M
No affiliation info available
Schreiber F
No affiliation info available
Warnkross H
No affiliation info available
Pristautz H
No affiliation info available
Krejs GJ
No affiliation info available

MeSH

AnimalsAntibodies, ProtozoanAntimony Sodium GluconateCroatiaDiagnosis, DifferentialHumansLeishmania donovaniLeishmaniasis, VisceralMaleMiddle AgedTravel

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

ger

PubMed ID

1337639

Citation

Wenzl, H, et al. "[Kala-azar Acquired in Croatia]." Wiener Klinische Wochenschrift, vol. 104, no. 24, 1992, pp. 757-60.
Wenzl H, Petritsch W, Decrinis M, et al. [Kala-azar acquired in Croatia]. Wien Klin Wochenschr. 1992;104(24):757-60.
Wenzl, H., Petritsch, W., Decrinis, M., Schreiber, F., Warnkross, H., Pristautz, H., & Krejs, G. J. (1992). [Kala-azar acquired in Croatia]. Wiener Klinische Wochenschrift, 104(24), 757-60.
Wenzl H, et al. [Kala-azar Acquired in Croatia]. Wien Klin Wochenschr. 1992;104(24):757-60. PubMed PMID: 1337639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Kala-azar acquired in Croatia]. AU - Wenzl,H, AU - Petritsch,W, AU - Decrinis,M, AU - Schreiber,F, AU - Warnkross,H, AU - Pristautz,H, AU - Krejs,G J, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - 757 EP - 60 JF - Wiener klinische Wochenschrift JO - Wien Klin Wochenschr VL - 104 IS - 24 N2 - Six weeks after his return from a two-week vacation in Croatia a 52 year-old janitor from Graz complained of loss of appetite, fever, headache, and a 9-kg weight loss. The spleen was enlarged to 16cm as measured by sonography. Laboratory tests revealed pancytopenia, a prolonged prothrombin time and elevation of serum LDH concentration. While repeated bone marrow biopsy showed no signs of leishmaniasis, high antibody titers against leishmania antigen led to the diagnosis of kala-azar. The indirect immunofluorescent antibody test (1:128) and a haemagglutination-inhibition test (1:512) showed diagnostic elevations of titers. Therapy with pentostam led to prompt defervescence and resulted in a full recovery of the patient. After six weeks a marked decrease of antibody titers in the haemagglutination-inhibition test (1:16) could be observed. Leishmaniasis has to be considered in patients with fever of unknown origin who return from Mediterranean countries. Despite a negative bone marrow biopsy a diagnosis is possible on the basis of serological tests. This is important because effective therapy is available as illustrated by this patient and because of the fact that the disease runs a lethal course if the diagnosis is missed. SN - 0043-5325 UR - https://www.unboundmedicine.com/medline/citation/1337639/[Kala_azar_acquired_in_Croatia]_ DB - PRIME DP - Unbound Medicine ER -