Visceral leishmaniasis (VL) is caused by the protozoan parasite Leishmania 
donovani and transmitted by the bite of infected sandfly Phlebotomus argentipes. 
The protozoa is obliged intracellularly and causes a wide spectrum of clinical 
syndromes: VL ('kala azar'), cutaneous leishmaniasis and mucocutaneous 
leishmaniasis (espundia). Kala azar is the most aggressive form and if untreated 
causes high mortality. Here, we describe a case of VL that presented to us with 
high-grade fever and found to have Roth spots that were resolved after 15 days 
of therapy.