Background: Leishmaniasis is a group of diseases caused by the intracellular protozoa of the genus Leishmania which are transmitted by sand flies. Visceral leishmaniasis (Kala-azar) is usually caused by Leishmania infantum and Leishmania tropica in children less than 5 years of age living in large areas of the Mediterranean basin, including Iran. Such disease accompanied by significant morbidity and mortality if not treated it would have a mortality of 85-90%.

Case Report: The patient is an 18-month-old boy from the Nashalj village in Kashan, Iran, who suffered from occasional fevers of unknown origin, associated with pallor and decreased appetite since 2 months before admission. One week before the admission, he had persistent fever which was associated with splenomegaly and finally during the disease follow-up and after the two hospitalizations, the diagnosis of visceral leishmaniasis was established and he was fully recovered.

Conclusion: Cutaneous leishmaniasis (salak) is considered to be an endemic disease in Kashan, but so far no cases of visceral leishmaniasis have been reported in this city. This case is the first case of the disease in the region and considering the serious complications and mortality of the visceral form of the disease, careful follow-up is needed to detect the contaminated people or resources and to properly treat them.