Visceral leishmaniasis in a patient with active HBV/HDV co-infection

Visceral leishmaniasis (VL) is an endemic infection in different regions of Italy and Europe caused by protozoan parasites of the genus Leishmania, transmitted to humans through sandflies bites. Reactivation after Solid Organ Transplantation was reported and could be a risk of organ rejection. A 48 years old woman was admitted to our hospital, complaining about low-grade fever, loss of weight and new onset pancytopenia in a known cirrhosis due to active HBV/HDV co-infection. Clinical, microbiological and anatomo-pathological elements were pivotal to define the diagnosis of VL and started an appropriate anti-infective treatment. After that she underwent liver transplantation and a therapy for VL was set. No signs of reactivation were reported in the 14 months of follow-up.