{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:48:29Z","timestamp":1780332509859,"version":"3.54.1"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Visceral leishmaniasis (VL) is a severe endemic disease with a fatal outcome if left untreated. The symptoms of patients are diverse and atypical. Against the background of anemia and pancytopenia, the condition of the patients gradually worsens with marked cachexia. Through sharing our experience, we aim to draw attention to this deadly disease. Clinical and laboratory data for 58 patients with VL treated over a forty-five-year period are presented. The diagnosis was established within a duration of 1 to 28 months of illness. Continuous fever (38\u201342 \u00b0C), splenomegaly, hepatomegaly, severe anemia (decreased hemoglobin to lowest values of 31 g\/L), leucopenia (lowest values of leucocytes et 0.5 g\/L), and thrombocytopenia (reduced thrombocyte count to 29 g\/L) were observed. The diagnosis was made on the basis of microscopic evidence of amastigote forms in bone marrow smears and serological tests. The patients were treated with Glucantime for 17 to 21 days. Relapses were observed in seven patients (12.1%) and fatal outcome was observed in two patients (3.5%) during treatment, who developed acute respiratory and cardiovascular failure. In Bulgaria, Visceral leishmaniasis is primarily endemic in the southern regions and should be suspected not only in patients who have returned from tropical and subtropical countries, but also in those who have not traveled abroad. The challenges associated with VL stem from delayed diagnosis of patients, as this disease remains unrecognized by physicians.<\/jats:p>","DOI":"10.3390\/pathogens13030205","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T06:50:23Z","timestamp":1708930223000},"page":"205","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Autochthonous and Imported Visceral Leishmaniasis in Bulgaria\u2014Clinical Experience and Treatment of Patients"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1907-2082","authenticated-orcid":false,"given":"Kamenna","family":"Vutova","sequence":"first","affiliation":[{"name":"Medical College, Medical University of Sofia, 3 \u201cY. Filaretova St.\u201d, 1606 Sofia, Bulgaria"},{"name":"Medical Center of University Hospital \u201cSt. I. Rilski\u201d EAD, 15 \u201cAcad. I. Geshov Blvd.\u201d, 1606 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0095-263X","authenticated-orcid":false,"given":"Nina","family":"Yancheva-Petrova","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Parasitology and Tropical Medicine, Faculty of Medicine, Medical University of Sofia, 17 \u201cAcad. I. Geshov Blvd.\u201d 17, 1606 Sofia, Bulgaria"},{"name":"Specialized Hospital of Infectious and Parasitic diseases \u201cProf. I. Kirov\u201d, 17 \u201cAcad. I. Geshov Blvd.\u201d, 1606 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossitsa","family":"Tchipeva","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Parasitology and Tropical Medicine, Faculty of Medicine, Medical University of Sofia, 17 \u201cAcad. I. Geshov Blvd.\u201d 17, 1606 Sofia, Bulgaria"},{"name":"Specialized Hospital of Infectious and Parasitic diseases \u201cProf. I. Kirov\u201d, 17 \u201cAcad. I. Geshov Blvd.\u201d, 1606 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0161-6993","authenticated-orcid":false,"given":"Valeri","family":"Velev","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Parasitology and Tropical Medicine, Faculty of Medicine, Medical University of Sofia, 17 \u201cAcad. I. Geshov Blvd.\u201d 17, 1606 Sofia, Bulgaria"},{"name":"Specialized Hospital of Infectious and Parasitic diseases \u201cProf. I. Kirov\u201d, 17 \u201cAcad. I. Geshov Blvd.\u201d, 1606 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/S0140-6736(18)31204-2","article-title":"Leishmaniasis","volume":"392","author":"Burza","year":"2018","journal-title":"Lancet"},{"key":"ref_2","first-page":"127","article-title":"Kala\u2013Azar Progress against a Neglected Disease","volume":"145","author":"Murray","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.idc.2012.03.005","article-title":"Visceral Leishmaniasis","volume":"26","author":"Diro","year":"2012","journal-title":"Infect. Dis. Clin. N. 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