Acute kidney injury as initial presentation of visceral leishmaniasis in a young patient- A case report. (June 2022)

• Record Type: Journal Article
• Authors: Mohamed, Abdirashid Hashi; Bashir, Ahmed Muhammad
• Is Part Of: Annals of medicine and surgery. Volume 78(2022)
• Publication Date: 2022-06
• Subjects: Acute kidney injury -- Visceral leishmaniasis -- Kala-azar -- Somalia; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.103821
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Visceral leishmaniasis is endemic in Somalia and in East Africa at large. Clinically, patients present with recurrent fever, weight loss, hepatosplenomegaly and pancytopenia. Sometimes, patients in low resource countries with no properly functioning primary healthcare facilities may present with complications. Case presentation: Here, we report a case of 19 years old male patient who presented with impaired renal function. After diagnosing with VL and starting Sodium Stibogluconate, patient developed acute pancreatitis, that compelled us to shift to liposomal amphotericin B, which he responded well and finally was discharged within a good condition. Clinical discussion: Early diagnosis and proper treatment is necessary to restore the renal function. Conclusion: This case report elaborates some of the clinical presentations of VL, complications of treatment and encouraging physicians in endemic areas to keep VL into their list of differential diagnosis in patients with fever and hepatosplenomegaly. Highlights: Visceral leishmaniasis is endemic in Somalia and in East Africa at large. Clinical presentation dependents on both the infecting species of Leishmania and the host's immune response. Persistent fever, splenomegaly and pancytopenia are the chief characteristicsof visceral leishmaniasis. Renal involvement of VL is a well-known and can present as acute or chronic renal insufficiency. Although, sodium stibogluconate and paromomycin are considered safe, acute pancreatitis is one of the side effects patients can develop during treatment as of our patient.