ArticleInfection and drug resistance2026
mNGS-Assisted Diagnosis of Visceral Leishmaniasis Presenting as Hemophagocytic Lymphohistiocytosis: Two Cases Confirmed by rK39.
Article in Infection and drug resistance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Kala-azar, or visceral leishmaniasis (VL), is a parasitic disease caused by Methods: We report two cases of visceral leishmaniasis-related hemophagocytic lymphohistiocytosis, in which no Leishman-Donovan bodies were detected by conventional assays. Metagenomic next-generation sequencing (mNGS) successfully identified Leishmania pathogens, and the diagnosis was confirmed by the rK39 rapid test. Results: mNGS successfully identified Leishmania pathogens in both patients. Targeted anti-leishmanial treatment led to rapid clinical improvement in both patients. Conclusion: This study demonstrates that mNGS can serve as a valuable adjunct for the rapid etiological diagnosis of VL, particularly when conventional tests are negative. Nevertheless, its current use is largely restricted to endemic areas where advanced laboratory infrastructure is available; therefore, mNGS should be regarded as a complementary diagnostic tool rather than a substitute for routine assays. Broader implementation in clinical practice will require further studies on cost‑effectiveness and operational feasibility.
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