Year 2025 / Volume 117 / Number 8
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Disturbed by a sandfly: visceral leishmaniasis in ileal Crohn’s disease under combined immunosuppression

457-458

DOI: 10.17235/reed.2023.10097/2023

Andreia Rei, Irina Mocanu, Carlos Pontinha, Isabel Medeiros,

Abstract
This case reports illustrates a 44-year-old Caucasian male with ileal Crohn´s disease under combined immunosuppression that first presented with unspecific constitutional symptoms, newly pancytopenia and elevated inflammatory markers. The infectious screening was negative except for an ileal abscess that resolved with conservative antibiotic therapy. Due to concerns for lymphoproliferative disease in a patient under anti-TNF and azathioprine, a myelogram was performed that ruled out dysplastic changes. After abscess resolution the symptoms relapsed with evening fever, nocturnal sudoresis and worsen pancytopenia. A more thorough work-up was performed with bone marrow and ileal biopsies that demonstrated numerous intra-and-extracellular leishmania amastigote forms, which confirmed the diagnosis of visceral leishmaniasis infiltrating the small bowel. The patient recovered after adequate treatment and withheld of immunosuppression during follow-up.
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Rei A, Mocanu I, Pontinha C, Medeiros I. Disturbed by a sandfly: visceral leishmaniasis in ileal Crohn’s disease under combined immunosuppression. 10097/2023


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Publication history

Received: 17/11/2023

Accepted: 23/11/2023

Online First: 30/11/2023

Published: 24/07/2025

Article Online First time: 13 days

Article editing time: 615 days


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