[Visceral leishmaniasis as a rare cause of a fever of unknown origin associated with splenomegaly].

We present a case of a 22-year-old man admitted to the hospital because of prolonged fever associated with splenomegaly. During the previous 2 years the patient spent several months as a manual worker in the south of Italy. Manifestations of the disease included progressive weight loss, hyperhydrosis, biphasic fever, marked splenomegaly and slightly enlarged liver. Results of laboratory examination showed thrombocytopenia, leukopenia, hypergammaglobulinemia and features of hepatic lesions. A bone marrow biopsy revealed amastogotes of Leishmania within macrophages and in the extracellular matrix. A diagnosis of visceral leishmaniasis was confirmed by positive serological tests for Leishmania infantum antigens.