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Visceral Leishmaniasis — RACP Paediatrics MCQ

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HardInfectious DiseaseVisceral LeishmaniasisRACP Paediatrics

A 9-year-old presents with high fever for 10 days, hepatosplenomegaly, pancytopenia, and hypergammaglobulinaemia. He travelled to India 3 months ago. A bone marrow aspirate shows intracellular amastigotes within macrophages. What is the most likely diagnosis?

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Correct answer: C — Visceral leishmaniasis (kala-azar)

Visceral leishmaniasis (kala-azar) presents with prolonged fever, hepatosplenomegaly, pancytopenia, and weight loss following travel to endemic areas (Indian subcontinent, East Africa, South America). Diagnosis is confirmed by demonstration of Leishmania amastigotes (Donovan bodies) in bone marrow or splenic aspirate. Treatment is with liposomal amphotericin B.

Reference: Therapeutic Guidelines – 2024 – Antibiotic: Parasitic Infections