ABSTRACT
Atypical forms of visceral leishmaniasis associated with immunosuppressive treatment are difficult to diagnose and cause high mortality. The purpose of this report is to describe a case involving a 42-year-old patient living in a leishmaniasis-endemic area, who was undergoing immunosuppressive treatment using corticosteroids and methotrexate for pemphigus. Despite clinical and laboratory findings consistent with visceral leishmaniasis, detection of Leishmania bodies was a coincidental finding of cytological examination of bone marrow during workup for pancytopenia and associated clinical signs. This case argues in favor of systematic screening for this opportunistic parasitic disease before undertaking immunosuppressive treatment in patients presenting risk factors and consistent clinical/laboratory findings.
Subject(s)
Immunosuppression Therapy/adverse effects , Immunosuppressive Agents/adverse effects , Leishmaniasis, Visceral/chemically induced , Pemphigus/drug therapy , Adult , Humans , Male , MoroccoSubject(s)
AIDS-Related Opportunistic Infections/diagnosis , Cryptosporidiosis/diagnosis , Isosporiasis/diagnosis , Meningitis, Cryptococcal/diagnosis , AIDS-Related Opportunistic Infections/epidemiology , AIDS-Related Opportunistic Infections/parasitology , Abdominal Pain/parasitology , Adult , Cerebrospinal Fluid/parasitology , Cryptococcus neoformans , Cryptosporidiosis/epidemiology , Cryptosporidiosis/parasitology , Diarrhea/parasitology , Endemic Diseases/statistics & numerical data , Fatal Outcome , Female , Gastrointestinal Hemorrhage/parasitology , Humans , Isosporiasis/epidemiology , Isosporiasis/parasitology , Meningitis, Cryptococcal/epidemiology , Meningitis, Cryptococcal/parasitology , Morocco/epidemiology , Population Surveillance , Spinal PunctureABSTRACT
Acute pancreatitis and pregnancy is a rare and serious combination that poses difficult diagnostic and therapeutic problems. Three cases of acute pancreatitis occurred in the post-partum period. Based on these cases and a literature review, we analyzed the different aspects of this interesting association. Biliary origin is particularly evident. Acute pancreatitis after delivery is a serious problem compared to other forms of acute pancreatitis. Late diagnosis caused by circumstances of happening contribute to the severity at least partially.