A 3-year-old girl from Bangladesh consults for intermittent febrile episodes of 3 weeks' duration, associated with weakness and loss of appetite. Physical examination showed marked splenomegaly and mucocutaneous pallor. Complementary tests include: hemoglobin 8.5 mg/dL, hematocrit 26%, MCV 86 fL, MCH 29 pg, leukocytes 2800/mL with 300 neutrophils /ml, platelets 54000/ml, GOT 85 U/l, GPT92 U/l and polyclonal hypergammaglobulinemia in serum proteinogram. Indicate the most probable diagnosis with the data available at this time:
Data such as pancytopenia and hypergammaglobulinemia are very characteristic of kala-azar. The origin of the girl is also indicative of this diagnosis, although it is a disease that also occurs in the Mediterranean area. In the differential diagnosis, it is important to keep in mind the possibility of leukosis.
Acute lymphoblastic leukemia.
Burkitt's lymphoma.
Visceral leishmaniasis.
Miliary tuberculosis.
Chronic malaria.
Data such as pancytopenia and hypergammaglobulinemia are very characteristic of kala-azar. The origin of the girl is also indicative of this diagnosis,