Nuwayri-Salti et al identified a number of atypical presentations for systemic leishmaniasis. The authors are from the American University of Beirut, Rafic Hariri University Hospital, Cleveland Clinic, and Beirut Arab University.
Typical presentations for systemic leishmaniasis includes:
(1) chronic fever
(2) hepatosplenomegaly
(3) wasting
Atypical presentations may include:
(1) child with failure to thrive
(2) frequent and recurrent infections
(3a) skin and subcutaneous tissue (boils, etc)
(3b) upper respiratory tract
(3c) GI tract with diarrhea)
(3) weakness and poor energy (chronic fatigue syndrome)
(4) fever of unknown origin (FUO)
(5) malnutrition (rule out malabsorption)
Some patients may be worked up for an immunodeficiency state (including HIV disease).
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