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Visceral leishmaniasis causes fever and decompensation in patients with cirrhosis
  1. Pasquale Pagliano1,
  2. Novella Carannante2,
  3. Marina Gramiccia3,
  4. Tiziana Ascione4,
  5. Gianfranca Stornaiuolo4,
  6. Luigi Gradoni5,
  7. Francesco S Faella6,
  8. Giovanni B Gaeta7
  1. 11st Division of Infectious Diseases, D Cotugno Hospital, Naples, Italy
  2. 2Department of Infectious Diseases, Viral Hepatitis Unit, Second University of Naples, Naples, Italy
  3. 3Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
  4. 4Department of Infectious Diseases, Viral Hepatitis Unit, Second University of Naples, Naples, Italy
  5. 5Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
  6. 61st Division of Infectious Diseases, D Cotugno Hospital, Naples, Italy
  7. 7Department of Infectious Diseases, Viral Hepatitis Unit, Second University of Naples, Naples, Italy
  1. Correspondence to:
    Professor G B Gaeta
    Department of Infectious Diseases, Second University of Naples, Via Cotugno 1, 80135 Naples, Italy;giovannib.gaeta{at}unina2.it

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Infections and fever due to bacterial infections are well-known complications of liver cirrhosis, and often trigger decompensation and death.1 Visceral leishmaniasis (VL), a protozoan infection endemic in the Mediterranean area, causes a febrile disease, the clinical and laboratory features (splenomegaly, pancytopenia, reduced serum albumin and increased γ-globulin concentrations) of which largely overlap with those of cirrhosis.2,3 Although the areas where VL is endemic coincide with areas where the prevalence of cirrhosis is high, no study has described VL in patients with cirrhosis.

During a 12-year period, all patients with cirrhosis admitted for decompensation and fever lasting more than 1 week, unresponsive to broad-spectrum antibiotics, underwent diagnostic procedures for VL. For each case diagnosed as VL, three consecutive cases of bacterial infection observed in the same period were enrolled. Cirrhosis was defined …

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