Nonmigrant Children with Visceral Leishmaniasis from the Nonendemic Area of Uttarakhand

The emergence of visceral leishmaniasis (VL) in nonendemic areas is a matter of great concern. We conducted a study and present a brief description of six nonmigrant children with VL from the nonendemic area of Uttarakhand, diagnosed in our tertiary teaching hospital from February 2012 to June 2013. We also present here a geographic distribution of these cases to assess the impact of global warming and climate change on the spread of the disease. Patients were diagnosed as VL by clinical findings and confirmed by demonstration of Leishmania donovani bodies in the bone marrow or a positive serum rK39 test. Four cases were treated successfully with amphotericin B. One patient died during treatment and one patient was discharged on persistent request. Clinicians should suspect and investigate for VL in patients with pyrexia of unknown origin, even in nonmigrant patients from nonendemic regions, for an early diagnosis.