Visceral Leishmaniasis: A Cause of Pyrexia of Unknown Origin

Objective: to determine the cause of pyrexia of unknown origin. study design: cross-sectional study. setting: the subjects for this study were enrolled at the private setup in northern areas of gilgit and hyderabad from january 2006 to december 2007. method and material: all patients presenting with pyrexia unresponsive to antibiotic and antimalarial therapies with negative serology for salmonella,malaria,tuberculosis and brucellosis underwent bone marrow aspiration. the specimens were analyzed at armed force institute of pathology (afip) rawalpindi and department of pathology,liaquat university of medical and health sciences (lumhs) jamshoro. patients were treated on the basis of microscopic findings and observations were recorded. result: among total 77 subjects 72 (98.51%) were of <8-years age and 5 (6.49%) were of 8-25 years age. males were 53 (68.83%) and females were 24 (31.17%). microscopic examination reported all 77 specimens as amastigote positive. subjects became symptom-free after antileishmaniasis therapy. conclusion: patients belonging to the northern areas and azad kashmir living anywhere in pakistan,not responding to antibiotics and antimalarial treatment with negative serology for salmonella,brucellosis,tuberculosis and malaria should be considered for visceral leishmaniasis and be investigated and treated promptly.