Visceral leishmaniasis: Very rare cases report from Kashmir valley (J&K) with Literature Review

Leishmaniasis is a disease caused by an intracellular protozoa parasite transmitted by the bite of a female sandfly (Phlebotomus species). This vector borne disease has wide clinical spectrum with visceral leishmaniasis being the most severe form. We report a case of visceral leishmaniasis from a Kashmir valley of Jammu and Kashmir (India) where the vector for leishmaniasis does not exist. Only one case of leishmaniasis has been reported from valley. This is the second case, which was reported because of rarity and delay in diagnosis even though it was imported. A 44 Year old male patient presented with intermittent, low grade fever associated with chills and rigors, night sweating for 3 years, took antibiotic and antipyretic, partially responded, was never evaluated properly. Patient had history of travel to outside state. In state like Jammu and Kashmir where tuberculosis is more prevalent visceral leishmaniasis is very unlikely to be diagnosed. On evaluation patient had pancytopenia and hepatosplenomegaly with bone marrow revealing inclusion bodies (LD bodies both intracellular and extra cellular) thus confirming the diagnosis of visceral leishmaniasis.