A 32-year-old woman, diagnosed with SLE and antiphospholipid syndrome for 6 years, monitored in outpatient Rheumatology clinics, treated with prednisone (15 mg per day), aspirin (100 mg per day), calcium (1 g), vitamin D (800 mg).
Fever (40 oC) was predominantly evening, with one week of evolution, with no other accompanying symptoms.
On physical examination, palpable hepatomegaly without lymphadenopathy was only observed.
As for complementary explorations, urinocultive, mantoux are negative; Doppler ultrasound and chest X-ray, within normal limits; normal hemoabdominal TAC without focal hepatomegaly.
In the analytical Hb 6,7, leukocytes 1,000 (400 neutrophils, 500 lymphocytes), platelets 60,000, ANA 1/1,280, antiDNA 42,3, rheumatoid factor 176, CRP 11,9, C3 122/Cammaglobulin 44 (g).
cefzidime bud of SLE, it was decided to transfusion two concentrates sepsis, daily injections of C-GSF, bolus of 1 g of methylprednisolone for three days, and empirical treatment amika.
After four days with the treatment described, fever of 40 oC is maintained, with similar analytical values: in new analytical Hb 8.5, leukocytes 1,000 (400 neutrophils, 500 lymphocytes), platelets 32,000, thinking that the disease does not occur.
It was decided to perform puncture, aiming abundant hemoparasites of the genus Leishmania, confirming the diagnostic suspicion, we started treatment with biosomal amphotericin B 200 mg per day for 5 days, with liposome therapy for the second day
Control analysis at 10 days of treatment: Hb 11, leukocytes 2600 (1,700 neutrophils) and platelets 97.000 at discharge.
