Visceral Leishmaniasis Mimicking Myelodysplastic Syndrome

We present the case of a 71-years-old white female who presented to the emergency department with a two-week history of fever of unknown origin, mild anemia and marked thrombocytopenia. The patient was admitted to the hospital and was treated with a high dose broad spectrum antibiotic. The patient also gave a history of returning from an African country where the disease is endemic about three months prior to her presentation at ER. Because of her hematologic findings (anemia and marked thrombocytopenia) she underwent a bone marrow examination which revealed the presence of Leishman Donovan bodies. Furthermore, the bone marrow aspirate smear revealed marked dysmyelopoietic changes involving all three hematopoietic cell lines akin to features commonly seen in patients with Myelodysplastic Syndrome (MDS).