{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:40:22Z","timestamp":1756287622716,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,7,14]]},"abstract":"<jats:p>We present the case of a 23-year-old student admitted with fever, night sweats and splenomegaly. These non-specific signs and symptoms posed a diagnostic challenge which was further complicated by a history of recent foreign travel. The range of potential diagnoses required a variety of investigations in order to reach the final diagnosis. The incidental finding of an incompetent bicuspid aortic valve and an inflamed gallbladder further clouded the diagnostic process. Despite treatment with broad spectrum antibiotics, the patient continued to deteriorate. Serological testing finally provided a diagnosis of visceral leishmaniasis. The patient subsequently developed haemophagocytic lymphohistiocytosis, a life-threatening immune hyperactivity state that very rarely complicates leishmaniasis infection. With the use of amphotericin B and high-dose steroids, the patient made an excellent recovery.<\/jats:p>","DOI":"10.1136\/bcr-2018-224775","type":"journal-article","created":{"date-parts":[[2018,8,21]],"date-time":"2018-08-21T00:15:55Z","timestamp":1534810555000},"page":"bcr-2018-224775","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Fever in a returning traveller: visceral leishmaniasis triggering haemophagocytic lymphohistiocytosis"],"prefix":"10.1136","volume":"2018","author":[{"given":"Thabo","family":"Mahendiran","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Hospitals Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemina","family":"Doolub","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Nisbet","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,8,20]]},"reference":[{"key":"2025082702102171000_2018.aug20_1.bcr-2018-224775.1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2011.1.178"},{"key":"2025082702102171000_2018.aug20_1.bcr-2018-224775.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2008.02.013"},{"key":"2025082702102171000_2018.aug20_1.bcr-2018-224775.3","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000000916"},{"key":"2025082702102171000_2018.aug20_1.bcr-2018-224775.4","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"key":"2025082702102171000_2018.aug20_1.bcr-2018-224775.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2014.04.034"},{"key":"2025082702102171000_2018.aug20_1.bcr-2018-224775.6","doi-asserted-by":"crossref","unstructured":"McGwire BS , Satoskar AR . Leishmaniasis: clinical syndromes and treatment: Oxford University Press, 2014:7\u201314. (cited 20 Jan 2018).","DOI":"10.1093\/qjmed\/hct116"},{"key":"2025082702102171000_2018.aug20_1.bcr-2018-224775.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0035671","article-title":"Leishmaniasis worldwide and global estimates of its incidence","volume":"7","author":"Alvar","year":"2012","journal-title":"PLoS One"},{"key":"2025082702102171000_2018.aug20_1.bcr-2018-224775.8","unstructured":"Gradoni L , L\u00f3pez-V\u00e9lez R , Mokni M . Manual on case management and surveillance of the leishmaniases in the WHO European region. 2017 http:\/\/www.who.int\/leishmaniasis\/resources\/EURO_WHO_Leish_manual_on_case_management_and_surveillance_9789289052511_2017.pdf (cited 6 Jan 2018)."},{"key":"2025082702102171000_2018.aug20_1.bcr-2018-224775.9","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1111\/bjh.12412","article-title":"Visceral leishmaniasis with haemophagocytic lymphohistiocytosis: the importance of scrutinising your samples","volume":"162","author":"Hussein","year":"2013","journal-title":"Br J Haematol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-224775","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:10:29Z","timestamp":1756285829000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-224775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,20]]},"references-count":9,"alternative-id":["10.1136\/bcr-2018-224775"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-224775","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,8,20]]}}}