Leishmaniose visceral associada a linfoma de Hodgkin

O objetivo deste relato e alertar a comunidade medica sobre a rara associacao entre leishmaniose visceral e linfoma de Hodgkin, doencas que podem cursar com manifestacoes semelhantes e requerem tratamentos diferenciados. Descreve-se o caso de um paciente de 18 anos de idade, que procurou a Unidade de Pediatria do Hospital Universitario de Brasilia com queixa de anorexia, adinamia, aumento de volume abdominal, emagrecimento, coluria, palidez, febre diaria, sudorese e calafrios havia aproximadamente tres meses. Apresentava historia, exame fisico e exames laboratoriais que direcionavam a hipotese de diagnostico de leishmaniose visceral, o que foi confirmada pela pela visao direta do parasito em lâmina de puncao aspirativa de medula ossea. Evoluiu com atenuacao dos sintomas ate o 16.o dia de tratamento especifico com antimoniato pentavalente. Apos esse periodo teve relevante piora do quadro febril, recrudescencia da hepatoesplenomegalia e ausencia de resposta a anfotericina B lipossomica, sendo posteriormente diagnosticado linfoma de Hodgkin associado ao calazar. The objective of this case report is to alert the medical community to the rare association between severe visceral leishmaniasis and Hodgkin's lymphoma, diseases that can course with similar symptomatology and demand different treatments. We report the case of an 18 year-old male adolescent, admitted to the Pediatric Emergency Unit of the University Hospital of Brasilia with anorexy, asthenia, increase of the abdominal circumference, weight loss, coluria, paleness, daily fever and sweating for three months. The history, physical examination and laboratorial results were suggestive of visceral leishmaniasis, which was confirmed by the direct vision of the parasite in the bone marrow aspirate. He had progressive improvement of the symptoms until the 16th day of treatment with antimoniate, but after that, there was recrudescence of the hepatosplenomegaly and the fever, with no response to liposomal amphotericin B, being subsequently diagnosed with Hodgkin lymphoma associated with visceral leishmaniasis.