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Leishmania: un parassita, molte infezioni

Virano Silvia¹, Le Serre Daniele¹, Garazzino Silvia², Silvestro Erika³, Tovo Pier-Angelo⁴

¹Medico Frequentatore presso la S.C.D.U. Pediatria II, Divisione di Malattie Infettive, Ospedale Infantile Regina Margherita, Università degli Studi di Torino, Torino
²Dirigente Medico presso la S.C.D.U. Pediatria II, Divisione di Malattie Infettive, Ospedale Infantile Regina Margherita, Università degli Studi di Torino, Torino
³Medico Specializzando presso la S.C.D.U. Pediatria II, Divisione di Malattie Infettive, Ospedale Infantile Regina Margherita, Università degli Studi di Torino, Torino
⁴Direttore della S.C.D.U. Pediatria II, Divisione di Malattie Infettive, Ospedale Infantile Regina Margherita, Università degli Studi di Torino, Torino

A 10-year-old child presented with persistent fever, relevant hepatosplenomegaly and pancytopenia. Abdominal US imaging, serology for most relevant pathogens and Leishmania, PCR for Parvovirus B19 and bone marrow sample were performed in order to discriminate between infectious and oncohaematological aetiology. Free Leishmania cells in bone marrow histiocytes, positive serology for Leishmania and PCR for Parvovirus B19 led to a last diagnosis of visceral Leishmaniosis with Parvovirus B19 super-infection. A specific therapy was set with liposomal preparation of amphotericin B IV. Two fever episodes then occurred during post-hospital discharge follow up, favoured by Leishmania-induced leukopenia: the first was caused by Influenza Virus type AH3, the second was a radiologically-confirmed pneumonia.
Leishmaniosis is an uncommon disease in Italy, but prompt diagnosis and treatment, strict follow up and proper therapy of complications led to the progressive improvement of the patient’s health condition and to his recovery.

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