Leishmaniasis from a Laboratory Perspective

By Teuta KURTI DEDEJ, Edmond PUCA, Sara BAJRAKTARI, Ambra METASANA

Abstract
Visceral leishmaniasis is a severe infectious disease caused by Leishmania spp.,
characterized by a strong host immune response and significant hematological abnormalities. Clinically, the disease presents with prolonged fever, splenomegaly, severe anemia, pancytopenia, and hypergammaglobulinemia, and delayed diagnosis may worsen patient outcomes. This retrospective descriptive study included 23 patients with confirmed visceral leishmaniasis admitted between January 2022 and March 2023 to the Infectious Diseases Service and the Pediatric Infectious Diseases Service at the Mother Teresa University Hospital Center in Tirana. Demographic characteristics, clinical manifestations, and laboratory parameters—including hematological indices, inflammatory markers, biochemical tests, and bone marrow examination—were collected and analyzed. The disease was more frequent in the pediatric population, with most affected children under 5 years of age, while the mean age among adults was 48 years. HIV–Leishmania coinfection was identified in three patients. Anemia was present in all cases and was frequently associated with neutropenia and thrombocytopenia. Bone marrow examination confirmed the presence of the parasite in all evaluated samples, supporting its role as the diagnostic gold standard. Additional laboratory abnormalities included changes in inflammatory markers, liver enzyme levels, and the albumin–globulin ratio. The correlation of laboratory findings with clinical manifestations may facilitate earlier suspicion and diagnosis of visceral leishmaniasis, particularly in non-specialized centers, enabling timely confirmation and management of the disease.
Keywords: Visceral leishmaniasis; laboratory findings; anemia; splenomegaly; bone marrow examination.