A 50 year old male resident of Bihar presented to MVJ Medical college hospital with h/o fever, Upper abdominal pain - on and off from 6 months. He was a known diabetic, on treatment.
Examination revealed Pallor, Icterus, Hepatomegaly, No splenomegaly, No Lymphadenopathy. USG confirmed the findings, Liver and Bone-marrow biopsy showed LD BODIES, with F/S/O Hepato-cellular carcinoma. Patient expired even after appropriate treatment.
Association of malignancy has been reported in literature, more in cutaneous Leishmaniasis, causing basal cell carcinoma and hematological malignancies.
The classical presentation of Kala-azar includes prolonged fever, splenomegaly, hepatomegaly, anaemia, weight loss and sometimes adenopathy. Atypical presentations can be equally challenging to the clinician like in our case.
Point of interest in this case is KALA-AZAR without splenomegaly and association with HEPATO- CELLULAR CARCINOMA.