患者，男，46岁，农民，宁夏中卫市中宁县人。自述2013—2021年的每年3—10月至甘肃省酒泉市玉门市四道沟村种植和采摘枸杞，并收养一条流浪犬。于2022年2月18日无明显诱因出现发热、大汗、关节疼痛不适等症状，体温最高超过40 ℃，就诊于当地诊所，诊断为“肺部感染”，予青霉素、头孢治疗，效果不佳。3月6日就诊于宁夏医科大学总医院。患者入院查体：神志清楚，腹部平软，未触及腹部包块，肝脏肋下未触及。血常规示：白细胞计数2.61 × 10⁹/L，血红蛋白122.0 g/L，血小板计数114.0 × 10⁹/L。3月17日行腹部彩超示：肝脏肿大，实质回声减低、均匀，血管影像欠清晰；脾脏肿大，未见明显病变。3月21日将血样外送至予果生物科技有限公司行宏基因组第二代测序，结果显示利什曼原虫属序列数420条，其中杜氏利什曼原虫序列数418条。结合流行病学调查结果、临床症状和实验室检查结果，诊断为内脏利什曼病。予两性霉素B（5 mg）静脉滴注连续8 d，病情有好转，体温降至36.2 ℃，第9天予葡萄糖酸锑钠（6 ml）静脉滴注1天后出院。出院后，改为肌肉注射葡萄糖酸锑钠（6 ml/d，连续注射6 d后，间隔2周，再继续注射9 d），其他症状予对症处理。出院1个月后电话随访，身体轻感乏力；出院2个月后电话随访，恢复良好。

The patient, a 46-year-old male, was a farmer from Zhongning County, Zhongwei City, Ningxia. The patient worked as a Gogie berry farmer and picker in Sidaogou Village, Yumen City, Jiuquan City, Gansu Province during 2013—2021 March to October. The patient showed fever, sweating and joint pain with no obvious causes on February 18, 2022. The highest body temperature exceeded 40 ℃ and the patient was diagnosed with a“lung infection” at a local clinic. Penicillin and cephalosporin were administrated but unsuccessful. On March 6, the patient was treated at the General Hospital of Ningxia Medical University. The patient’s physical examination upon admission showed clear consciousness, a flat and soft abdomen, no palpable abdominal mass, and no palpable subcostal liver. Blood routine showed: white blood cell count was 2.61 × 10⁹/L, hemoglobin level was 122.0 g/L, platelet count was 114.0 × 10⁹/L. On March 17, abdominal ultrasound showed liver enlargement, reduced and uniform echo in the paren-chyma, and unclear vascular imaging. Spleen enlargement without obvious lesions. On March 21, blood samples were sent to Yugok Biotechnology Co. Ltd. for the second-generation sequencing of the macro genome. The results showed 420 sequences of the Leishmania genus, including 418 sequences of L. donovani. Based on the clinical symptoms and laboratory examination results, it was diagnosed as visceral leishmaniasis. Amphotericin B (5 mg) was administered intravenously for 8 consecutive days, and the condition improved. The body temperature dropped to 36.2 ℃. On day 9, she was discharged after 1 day of intravenous drip with antimony sodium gluconate (6 ml). After discharge, the patient was given an intramuscular injection of antimony sodium gluconate (6 ml/d, suspended for 2 weeks after continuous injection for 6 days, and continued for 9 days), and other symptoms were treated accordingly. After one month of discharge, there was a phone follow-up, and the body felt light and weak; two months after discharge, the telephone follow-up showed good recovery.