Rare association of leukocytoclastic vasculitis in visceral leishmaniaisis

ABSTRACT

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