Visceral leishmaniasis as a rare cause of granulomatosis hepatitis: a case report.

Visceral leishmaniasis (VL) is one of the parasitic infections causing different pathogeneses of various systems including intraabdominal solid organs. L. donovani and L.infantum, particularly in Turkey, have been diagnosed in systemic infections. In the present case study, a 43-year-old woman with left upper abdominal pain, persistent fever and splenic pathology according to the radiological findings was investigated. Laboratory findings showed elevated liver function tests and anemia while radiological studies revealed splenomegaly, and nodular infiltration and laceration of the spleen. Because of enlarged intraabdominal lymph nodes observed during surgery, a lymph node biopsy and a liver biopsy were also performed along with the splenectomy. Results from the pathological examination of the spleen were nonspecific and the liver biopsy confirmed a diagnosis of granulomatosis hepatitis. Further examination of the hepatic granulomatosis including parasitic evaluation and serological evaluation with the rK39 dipstick test revealed VL. In conclusion, in cases of visceral organ pathology accompanied by persistent fever, and hematological disorders, parasitic infections, particularly VL, should be considered in the differential diagnosis.

Acanthamoeba culbertsoni and Naegleria fowleri: occurrence of antibodies in man.

Serum samples of 1,054 inhabitants of Bohemia (Czechoslovakia) were examined by means of indirect haemagglutination test with antigens from Naegleria fowleri and Acanthamoeba culbertsoni. With N. fowleri antigen the frequency of positive reactions did not exceed 3.5 per cent in lowest serum dilutions only. N. fowleri could not be identified as a possible causative agent in any chronic form of disease in man. Significant accumulation of positive findings with A. culbertsoni antigen was observed in hepatitis A patients and convalescents (52 per cent). The potential interpretations of this phenomenon are discussed.