Background: Kala azar is a chronic parasitic disease which is prevalent in children such as adults, however, the number of in detail reports about the clinical manifestations, diagnostic methods and the treatment options in small babies are very limited. In this study, an under 6- month- old male and his characteristics have been described. 

Case presentation: A five month and 6 days male has admitted to the pediatric ward, because of 12 days’ fever, anorexia, weight loss and weakness. His physical examination findings included malaise and splenomegaly. Remarkable results in his laboratory tests have contained pancytopenia, negative results of all the performed related cultures and serologic tests. The diagnosis has been made by observing the bone marrow smear which included lots of Leishman body as extracellular and intracellular parasites within macrophages. He has responded to daily 3mg/kg Amphotericin B Liposomal for 7 doses as cumulative doses of 21mg/kg without occurring any adverse reactions or recurrence. 

Conclusion: It sounds that the clinical presentation, diagnosis and treatment protocols for Kala azar disease in infants should be more studied and reported because of the several challenges this age group of children confronted to, such as different combinations of clinical presentations, diagnostic methods as well as therapeutic protocols.