Visceral leishmaniasis in a patient taking adalimumab for rheumatoid arthritis

Notable Cases tic infection, malignancy or a m trexate and adalimumab were n Her clinical status deteriorate ening malaise and fevers. Over th developed pancytopenia with 0.7 109/L (RI, 1.8–7.7 109/L), h and platelet count of 32 109/L gammaglobulin concentration 13.9 g/L), and her ferritin level in Opportunistic infections have been increasingly recognised with the advent of biological therapy for rheumatic disease. Visceral leishmaniasis (VL) has been reported in Europe in association with tumour necrosis factor-alpha inhibitors. We report the first case of VL in an Australian returned traveller taking adalimumab.