{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:06:34Z","timestamp":1782777994551,"version":"3.54.5"},"reference-count":13,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,2,20]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>We present a rare case of recurrent leishmaniasis infection in a female in her 80s who re-presented with a pleural effusion. The patient was initially investigated as an outpatient for cytopenia and underwent a bone marrow biopsy which subsequently diagnosed visceral leishmaniasis. Following full treatment, and apparent recovery, she re-presented with pleural effusion, hypoalbuminaemia and cytopenia. Leishmania was eventually isolated in a pleural fluid sample obtained on therapeutic drainage, and she was treated for a recurrence at a tertiary infectious disease unit. This interesting and challenging case demonstrates the importance of suspecting leishmaniasis recurrence in previously treated cases and the diagnostic benefit of pleural fluid analysis in the context of suspected leishmaniasis.<\/jats:p>","DOI":"10.1136\/bcr-2023-256632","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T14:08:24Z","timestamp":1710338904000},"page":"e256632","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Recurrent leishmaniasis infection isolated in the pleural fluid"],"prefix":"10.1136","volume":"17","author":[{"given":"Hina","family":"Qiam","sequence":"first","affiliation":[{"name":"Respiratory Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Lowe","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1068-4859","authenticated-orcid":false,"given":"Adriel Heilong","family":"Fung","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"},{"name":"Norwich Medical School, University of East Anglia Norwich Medical School, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasanna","family":"Sankaran","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"},{"name":"Norwich Medical School, University of East Anglia Norwich Medical School, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"2025082708305512000_17.3.e256632.1","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/S0140-6736(98)10178-2","article-title":"Leishmaniasis","volume":"354","author":"Herwaldt","year":"1999","journal-title":"The Lancet"},{"key":"2025082708305512000_17.3.e256632.2","doi-asserted-by":"crossref","DOI":"10.1590\/s1678-9946202062028","article-title":"A comprehensive systematic review of Leishmaniasis in patients undergoing drug-induced immunosuppression for the treatment of dermatological, Rheumatological and Gastroenterological diseases","volume":"62","author":"Kurizky","year":"2020","journal-title":"Rev Inst Med Trop Sao Paulo"},{"key":"2025082708305512000_17.3.e256632.3","unstructured":"World Health Organisation . 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Atypical presentation of visceral Leishmaniasis from non-Endemic region. 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