Abstract: This case report summarize the experience from diagnosis and treatment of a patient with repeated high fever, hepatosplenomegaly and pancytopenia. Following exclusion of bacterial, viral, fungal infections and hematological diseases, metagenomic next⁃generation sequencing of the patient’s peripheral blood revealed Leishmania infantum infection, and rK39 rapid diagnostic test showed positive for anti⁃Leishmania antibody, while microscopic examination of bone marrow smears identified Leishmania amastigotes. Therefore, the case was definitively diagnosed as visceral leishmaniasis, and given anti⁃infective treatment with sodium antimony gluconate and hormone, hepatoprotection, elevation of white blood cell counts and personalized nursing. Then, the case was cured and discharged from hospital. Metagenomic next⁃generation sequencing is of great value in etiological detection of fever patients with unknown causes, which deserves widespread clinical applications.

Key words: Visceral leishmaniasis, Metagenomic next?generation sequencing, Auxiliary diagnosis, Etiological detection

摘要： 1例患者因“反复高热、肝脾肿大、伴全血细胞减少待查”收住入院，排除细菌、病毒、真菌感染及血液系统疾病后，采集患者外周血行宏基因组二代测序，结果显示婴儿利什曼原虫感染。rk39快速诊断试剂检测显示抗利什曼原虫抗体阳性，骨髓涂片检出利什曼原虫无鞭毛体，最终确诊为内脏利什曼病。给予葡萄糖酸锑钠、激素进行抗感染、保肝、升白细胞等治疗及个性化护理后，患者康复出院。宏基因组测序技术在不明原因发热患者病因检测中具有重要价值，值得临床推广应用。 　

关键词: 内脏利什曼病, 宏基因组二代测序, 辅助诊断, 病因检测