Hemophagocytic syndrome as the presenting manifestation of visceral leishmaniasis

Hemophagocytosis in visceral leishmaniasis is rare and usually mild. However, presentation as hemophagocytic syndrome is exceptionally rare. We report the case of a 28 years man who presented with fever, hepatosplenomegaly, pancytopenia, reactive histiocytes and severe hemophagocytosis. Subsequent investigations revealed he had Leishmania donovani infection.