Visceral leishmaniasis diagnosed by biopsy of an axillary lymph node: case report and literature review

A 56-year-old man presented with fevers up to 40°C and acute pain in the left upper quadrant. Full blood count was normal and biochemical tests revealed increased serum globulin. Abdominal ultrasound revealed hepatomegaly and splenomegaly with multiple enlarged lymph nodes in the neck, axilla, and inguinal regions. The bone marrow smear was negative. Splenectomy was performed and the pathology revealed splenic ischemic infarcts. Biopsy of one of the axillary lymph nodes revealed macrophages filled with leishmanias. The patient tested positive by the rk39 dipstick test. He was treated with sodium stibogluconate and showed full recovery.