Contents lists available at ScienceDirect Veterinary Parasitology: Regional Studies and Reports journal homepage: www.elsevier.com/locate/vprsr Case Report Fatal visceral leishmaniosis in a dog caused by Leishmania infantum in Bosnia and Herzegovina: A case report Amer Alić a, ⁎ , Senad Prašović a , Denis Čamo b , Agnesa Ćoralić b , Dajna Preldžić b , Georg Gerhard Duscher c , Adnan Hodžić c a Department of Pathology, Faculty of Veterinary Medicine, University of Sarajevo, Zmaja od Bosne 90, 71000 Sarajevo, Bosnia and Herzegovina b Internal Diseases Department, Faculty of Veterinary Medicine, University of Sarajevo, Zmaja od Bosne 90, 71000 Sarajevo, Bosnia and Herzegovina c Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria ARTICLE INFO Keywords: Bosnia and Herzegovina Canine leishmaniosis Clinical examination Histopathology Leishmania infantum PCR ABSTRACT Canine leishmaniosis (CanL) caused by Leishmania infantum, is a zoonotic vector-borne disease endemic in the Mediterranean region. Here, we report a molecularly confirmed case of fatal CanL caused by L. infantum in the south of Bosnia and Herzegovina where epidemiology data are scarce. A 2.5-year-old, male golden retriever presented with a history of lethargy, prostration, and anorexia. Clinical examination revealed pale mucosae membranes, reduced capillary refill time, anuria, and ulcerated oral mucosae and skin of the legs. Complete blood count discovered severe non-regenerative, normocytic and normochromic anemia. Biochemistry profile showed hyperglycemia, hypoalbuminemia, hypercholesterolemia, increased potassium, and considerably ele- vated creatinine, urea, and phosphorus. Rapid Leishmania SNAP test was negative, as well as the serum neu- tralization test for leptospirosis. At necropsy, mildly enlarged and firm yellow to tan kidneys were the most prominent lesions. Macrophages laden with amastigotes in bone marrow, liver, spleen, kidneys, lymph nodes and the skin were seen in histopathology. Molecular testing by PCR and sequencing (cpb gene) confirmed and identified the pathogen as L. infantum. This study highlights the lack of key measures necessary to undertake the proper control of this important zoonosis in the country. Nationwide epidemiologic study on CanL and its vector (s), along with adoption and establishment of proper diagnostic approach with quantitative serologic and mo- lecular methods in place are warranted. 1. Introduction Leishmaniosis is a zoonotic vector-borne disease caused by different protozoan species of the genus Leishmania. The three most important species in Europe are: Leishmania infantum reported both in the Old and New world, L. tropica present in the Ionian islands and Crete, and L. major widespread from West Africa to the Middle East and India (Pennisi, 2015). In Europe, L. infantum causes visceral and also cuta- neous leishmaniosis in humans, and a mixed or generalized form of disease in dogs (Baneth et al., 2008; Pennisi, 2015). Clinically, canine leishmaniosis (CanL) ranges from subclinical infection to severe lethal disease, with a wide spectrum of clinical signs, which depend on the organ system affected by the parasite (Solano-Gallego et al., 2011; Paltrinieri et al., 2016; Meléndez-Lazo et al., 2018). Based on previous investigations, classification of the clinical manifestations in CanL is heterogeneous, and hinders the comparison of clinical and epidemiological studies (Meléndez-Lazo et al., 2018). However, lesions in dogs caused by L. infantum are well characterized (Koutinas and Koutinas, 2014). Canine leishmaniosis is endemic in many Mediterranean countries (Alvar et al., 2012). In the last decade, a significant increase in the prevalence of infected dogs, and further northwards incursion of the disease into non-endemic regions were observed (Pennisi, 2015; Le Rutte et al., 2018). However, the awareness of the veterinarians and physicians, as well as the general public and animal owners is still low in regards to this threat (Le Rutte et al., 2018). In Bosnia and Herzegovina, CanL and subclinical canine Leishmania infection are known to occur in the southern and south-eastern regions of Bosnia and Herzegovina, but data on the species involved, its vectors, and clinical and pathology findings are very limited. A recent study (Colella et al., 2018, in press) confirmed the exposure to or infection by L. infantum of a large proportion of 408 dogs tested from various regions https://doi.org/10.1016/j.vprsr.2018.100260 Received 21 July 2018; Received in revised form 12 December 2018; Accepted 26 December 2018 ⁎ Corresponding author at: Department of Pathology, Faculty of Veterinary Medicine, University of Sarajevo, Zmaja od Bosne 90, 71000 Sarajevo, Bosnia and Herzegovina. E-mail address: amer.alic@vfs.unsa.ba (A. Alić). Veterinary Parasitology: Regional Studies and Reports 15 (2019) 100260 Available online 27 December 2018 2405-9390/ © 2018 Elsevier B.V. All rights reserved. T