Abstract:

Objective To summarize the clinical characteristics and diagnostic key points of kala-azar, thus reducing misdiagnosis and mistreatment. Methods The clinical diagnosis and treatment processes of 2 children with kala-azar who were misdiagnosed as hemophagocytic syndrome in our hospital were reviewed. Results Two children with kala-azar who were misdiagnosed as hemophagocytic syndrome were admitted due to fever, liver and spleen enlargement, and hemophagocytic syndrome was considered after the improvement of relevant examinations. They were poorly responsive to hormone therapy. The bone marrow smear of 1 case showed a large amount of Leishmania. The other case was confirmed as leishmania infantile by high-throughput sequencing of pathogenic microorganism and dot immunogold chromatographic assay for positive recombinant antigen rk39. Antimony treatment was successful, presenting a normal body temperature, liver and spleen shrinkage, and normal blood routine testing and coagulation testing of four indexes.Conclusion For patients with fever, enlargement of liver and spleen and pancytopenia, detailed epidemiological information should be inquired and pathogen examination related to kala-azar should be conducted as soon as possible to reduce misdiagnosis and mistreatment.

Key words: leishmaniasis, visceral, misdiagnosis, hemophagocytic syndrome