[Kala-azar in Mexico: report of 2 cases].

Visceral leishmaniasis is a rare parasitosis in our country; in a 30 year period only exists the report of five cases, three in the state of Puebla and two in the state of Guerrero. Now it has been identified another two cases in the state of Chiapas. In these patients the common presentation of the disease were fever, hepatosplenomegaly, hypergammaglobulinemia and pancytopenia. The parasite can be found in liver, spleen, lymph nodes and bone marrow macrophages. A definitive diagnosis depends on the demonstration of the parasite in tissue; spleen biopsy is the most useful because it is positive in 98% of the cases, in other tissues the amastigotes are seen in 50-80% of the cases. Negative PAS-stained smears maintains the diagnosis until another more specific method as electronic microscopy or culture is available. Pentavalent antimonial compounds are the drugs of choice and as an alternative or in case of failure amphotericin B can be used.