History:

An 18-month-old infant lives in a rural area suffered pyrexia of unknown origin (PUO) associated with chills and anemia for more than two months duration. He presented by his parents with fever, generalized gray-brown pigmentation intermingled with rounded hypopigmented macules, anemia and marked hepatosplenomegaly. Kala-azar (visceral leishmaniasis, dumdum fever, black fever) was suspected on clinical background and proved through identification of Leishman-Donovan complexes in bone marrow aspirate.