Abstract
Visceral leishmaniasis is endemic in the western states of Eritrea, but it is rare in the city of Asmara. We report a case of an 18-month-old female with a high-grade fever, weight loss, and hepatosplenomegaly. No obvious cause of her illness was found. Routine blood investigations showed pancytopenia, and microscopic examination of bone marrow revealed intracellular and extracellular Leishmania amastigotes, so a diagnosis of leishmaniasis (kala-azar) was finally made. Visceral leishmaniasis should be considered when a child presents with fever, weight loss, organomegaly, and pancytopenia.