Macrophage Activation Syndrome Secondary to Visceral Leishmaniasis: A Case Report

Introduction: Macrophage activation syndrome (MAS) secondary to visceral leishmaniasis is a rare clinical entity. We report the case of a 4-year-old boy with no prior medical history, who had presented with fever and pallor for three weeks. Clinical examination revealed a temperature of 39°C, hepatomegaly, and splenomegaly. Laboratory tests showed bicytopenia, hypertriglyceridemia, and elevated lactate dehydrogenase (LDH). Bone marrow examination revealed Leishman bodies and hemophagocytic images. The patient was hospitalized and received treatment. The clinical and biological course was favorable. Conclusion: Visceral leishmaniasis associated with hemophagocytic syndrome is severe and may be life-threatening. Physicians should consider this diagnosis in children presenting with fever and splenomegaly. Urgent complementary investigations are needed to confirm this association and initiate appropriate treatment.