A case of visceral leishmaniasis in Oltenia region (Romania).

Visceral leishmaniasis is produced by a protozoan parasite that belongs to the genus Leishmania. Transmission is made through sting, the vector being represented by a species of the genus Phlebotomus. The first case of visceral leishmaniasis in Romania was reported by Manicatide (1912). In 1934, it was described a focus of visceral leishmaniasis in Oltenia region (24 cases).The symptoms of disease are unspecific: fatigue, feverishness, cephalalgia, anorexia, nausea, obnubilation status. The fever is irregular, with high oscillations. Clinical, a sallow pallor of the skin, enlarge lymph nodes, hepatomegaly, splenomegaly, weight loss have been observed. Laboratory exams showed frequently severe anemic syndromes or other cytopenias, erythrocytes sedimentation rate was increased, hypergammaglobulin-emia with monoclonal peak has been found. Immunolectrophoresis showed hyper-IgG and hyper-IgM. Bone marrow biopsy showed lympho-plasmocyte infiltration, histiocytes, Leishman-Donovan bodies intracellular or extracellular. The prognosis of the disease is unfavorable in the absence of specific treatment with antimony. In case of resistance, it is used immunotherapy, amphotericin or miltefosine.