PMC8320547_01
(a) Distended abdomen with splenomegaly and (b) hepatomegaly.
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Abdominal examination revealed right upper quadrant tenderness to palpation, and hepatosplenomegaly (liver was palpable at right flank 9.5 cm from the midclavicular line, and spleen with Hackett's system grade V) (Figure 1).
(a) Bone marrow aspirate evidencing macrophages with Leishmania amastigotes. (b) Increased magnification of the bone marrow aspirate demonstrating amastigotes.
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Bone marrow biopsy showed hypocellularity, discrete collagen fibrosis, and increased macrophages with severe intracellular colonization of Leishmania donovani (Figure 2).