{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:21:41Z","timestamp":1787840501145,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    Visceral leishmaniasis (kala-azar) (VL) is caused by a protozoan parasite of genus\n                    <jats:italic toggle=\"yes\">Leishmania.<\/jats:italic>\n                    India and neighboring countries comprise the largest focus of VL. Moderate to higher degree of fever accompanied by rigor and hepatosplenomegaly is the most typical clinical picture. We present a case of 50-year-old male from Bhadohi (Uttar Pradesh, India) with high grade fever for two months without hepatosplenomegaly. On evaluation, there was bicytopenia with hyper-gammaglobulinemia. Work-up for tropical fever, tuberculosis, chronic viral etiologies and multiple myeloma was negative. Further evaluation on lines of fever of uncertain cause showed amastigote forms of\n                    <jats:italic toggle=\"yes\">Leishmania donovani<\/jats:italic>\n                    (LD bodies) in bone marrow aspiration smears. Serology test rK39 was positive. Thus, final diagnosis of visceral leishmaniasis (kala-azar) with atypical presentation without splenomegaly was made. Fever resolved in a week of starting treatment and blood parameters improved at one month follow-up. As definite treatment options are available, duration of illness and case fatality rate can be reduced by timely detection of atypical cases.\n                  <\/jats:p>","DOI":"10.4103\/jvbd.jvbd_97_25","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T07:00:13Z","timestamp":1761721213000},"page":"272-274","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Visceral leishmaniasis without splenomegaly: An atypical presentation"],"prefix":"10.4103","volume":"63","author":[{"given":"Amita","family":"Yadav","sequence":"first","affiliation":[{"name":"Redcliffe Labs, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LP","family":"Meena","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhash","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"R1-20260604","article-title":"National Vector Borne Disease Control Programme (NVBDCP) Available from:"},{"key":"R2-20260604","article-title":"Goddard J. 2. Boca Raton: CRC Press; 1996. Physician\u2019s Guide to Arthropods of Medical Importance"},{"issue":"1","key":"R3-20260604","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4103\/2224-3151.206887","article-title":"Atypical presentation of visceral leishmaniasis (kala-azar) from non-endemic area","volume":"3","author":"Singh","year":"2014","journal-title":"WHO South-East Asia J Public Health"},{"issue":"4","key":"R4-20260604","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1093\/inthealth\/ihaf013","article-title":"Kala-azar elimination in India: reflections on success and sustainability","volume":"17","author":"Pandey","year":"2025","journal-title":"International Health"},{"issue":"2","key":"R5-20260604","first-page":"233","article-title":"Current status of kala-azar elimination in Uttar Pradesh, India","volume":"57","author":"Kamal","year":"2025","journal-title":"J Commun Dis"},{"key":"R6-20260604","first-page":"85","article-title":"Recent advances in the diagnosis and treatment of Kala-azar","volume":"25","author":"Sundar","year":"2012","journal-title":"The National Medical Journal of India"},{"key":"R7-20260604","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1136\/bmj.38917.503056.7C","article-title":"A meta-analysis of the diagnostic performance of the direct agglutination test and rK39 dipstick for visceral leishmaniasis","volume":"333","author":"Chappuis","year":"2006","journal-title":"BMJ"},{"key":"R8-20260604","first-page":"12","article-title":"Clinical and infective outcome of Parasitologicaly confirmed Kala-azar patients treated with sodium antimony gluconate","volume":"11","author":"Islam","year":"2010","journal-title":"J Medicine"},{"issue":"1","key":"R9-20260604","doi-asserted-by":"crossref","first-page":"96","DOI":"10.4103\/0377-4929.59193","article-title":"Morphological findings in bone marrow biopsy and aspirate smears of visceral Kala-azar: A review","volume":"53","author":"Dhingra","year":"2010","journal-title":"Indian J Pathol Microbiol"},{"key":"R10-20260604","first-page":"57","article-title":"Kala-azar without splenomegaly","volume":"2","author":"Gulati","year":"2009","journal-title":"Ann Trop Med Public Health"},{"key":"R11-20260604","doi-asserted-by":"crossref","first-page":"109","DOI":"10.4103\/1119-0388.158406","article-title":"Atypical presentations of visceral leishmaniasis: A case series and review of literature","volume":"18","author":"Kumar","year":"2015","journal-title":"Trop J Med Res"},{"key":"R12-20260604","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.ejim.2006.07.028","article-title":"A rare presentation of visceral leishmaniasis without fever or splenomegaly in an elderly person","volume":"18","author":"Mohan","year":"2007","journal-title":"Eur J Intern Med"},{"key":"R13-20260604","first-page":"1","article-title":"Uncommon manifestation of Kala-azar with association of hepatocellular carcinoma","volume":"5","author":"Ravishankar","year":"2013","journal-title":"iMed Pub J"}],"container-title":["Journal of Vector Borne Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jvbd.jvbd_97_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:24:02Z","timestamp":1787837042000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jvbd.jvbd_97_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jvbd.jvbd_97_25","relation":{},"ISSN":["0972-9062"],"issn-type":[{"value":"0972-9062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-04-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}}]}}