Rare association of leukocytoclastic vasculitis in visceral leishmaniaisis

A 30-year-old man presented with fever, hepatosplenomegaly, and a rash over his lower limbs [palpable purpura]. Evaluation revealed pancytopenia and hypergammaglobulinemia. A subsequent bone marrow examination and serology confirmed visceral leishmaniasis [kala-azar], while the biopsy of skin lesion suggested leukocytoclastic vasculitis. No alternate cause of vasculitis was forthcoming, and the patient was treated with conventional amphotericin B for 14 days after which resolution of symptoms [including the rash] was noted. Cutaneous vasculitis is an extremely rare complication following visceral leishmaniasis with no known cases reported thus far. Hence, a high index of suspicion is warranted in achieving timely diagnosis and initiation of appropriate therapy

Isolated splenic cold abscesses in an immunocompetent individual

Tubercular splenic abscess is extremely rare, but are reported commonly in HIV-positive and immunocompromised patients along with miliary or disseminated tuberculosis. Isolated tubercular splenic abscess in an immunocompetent individual is rarely reported. Here we present a case of a young, immunocompetent male with isolated splenic cold abscesses, who was diagnosed with splenic tuberculosis and managed successfully with percutaneous drainage and anti-tubercular therapy alone