Leishmaniasis or Kala-azar vector-borne disease by protozoa called Leish­mania Diagnosis Treatment

 all about Leishmaniasis or Kala-azar Diagnosis signs and symptoms

  • with treatment and classification of Leishmaniasis or Kala-azar

 

Visceral Leishmaniasis3
Leishmaniasis or Kala-azar Diagnosis signs and symptoms with treatment
  • Leishmaniasis or Kala-azar is a disease caused by protozoa called Leish­mania.
  • Leishmaniasis or Kala-azar is a vector-borne disease.
  • Rodents are reservoir hosts and humans are inciden­tal hosts for Leishmaniasis or Kala-azar .

Types Classification of Leishmaniasis or Kala-azar —

 

Types Classification of Leishmaniasis or Kala-azar Visceral Leishmaniasi
Types Classification of Leishmaniasis or Kala-azar Visceral Leishmaniasi

 

1. Visceral Leishmaniasis –

 

  • due to infection of macrophages in reticuloendothelial system by Leishmania donovani.
Classification of Leishmaniasis or Kala-azar Cutaneous Leishmaniasis
Classification of Leishmaniasis or Kala-azar Cutaneous Leishmaniasis

2. Cutaneous Leishmaniasis –

 

  • due to infection of macrophages in skin by Leishmania mexicana.
Mucosal Leishmaniasis Classification of Leishmaniasis or Kala-azar
Mucosal Leishmaniasis Classification of Leishmaniasis or Kala-azar

 

3. Mucosal Leishmaniasis

  • due to infection of nasopharyngeal mucosa by Leishmania amazonensis.

Etiology of Leishmaniasis or Kala-azar —

 

  • Leishmaniasis is caused by Leishmania or Viannia.
Leishmaniasis is caused by Leishmania or Viannia

 

  • The female sand fly (Phlebotomus) bites the host and injects promastigotes which enter the macrophages.
The female sand fly (Phlebotomus)
  • They multiply, and when the macrophages rupture, amastigotes are liberated into the blood which are again ingested by sandflies.
  • and the life cycle of Leishmaniasis or Kala-azar will continue to next to next.
life cycle of Leishmaniasis or Kala-azar

 

Diagnosis of Leishmaniasis —

  • The amastigotes can be seen under the microscope in a thin smear or histology section.
  • Skin testing for delayed type hypersensitivity reac­tions are also useful.
Visceral Leishmaniasis

Visceral Leishmaniasis —

  • Visceral Leishmaniasis  Occurs through bite of sandfly, by blood transfusion, or needle sharing. The disease may be acute, sub­acute or chronic.
  • Incubation period of Visceral Leishmaniasis  may be weeks, months or years. This disease is also called Kala-azar or Black fever as the patients appear grey.
  • There is fever, splenomegaly, hepatomegaly, periph­eral lymphadenopathy. Spleen may be very big, soft and non-tender.
  • There is pancytopenia – anaemia, leukopenia, lym­phocytosis, monocytosis, thrombocytopenia, hypergammaglobulinaemia, hypoalbuminemia.
  • Some patients may have dermal leishmaniasis in Kala­azar.

Diagnosis of Visceral Leishmaniasis —

  • Parasites may be seen in peripheral smear, tissue aspirates, biopsy specimen of spleen, liver, bone­marrow or lymph node.
  • Presence of Visceral Leishmaniasis is seen as a nucleus and a kinetoplast (extra nuclear DNA) called LD bodies, which is very typical of kala-azar.
  • Patients of florid kala-azar have high titers of LD an­tibodies (Leishmanin or Montenegro test). ,

Leishmaniasis or Kala-azar Treatment —

  • Pentavalent antimonial compound – 20 mgjkg daily for 28 days.
  • Amphotericin B – 15 to 20 mgjkg daily.
  • r;.-/ Paromom cin (amino I coside – 15 to 20 mgj kg daily for 21 days.
  • Miltefosine – Dose 50-100 mg daily for 28 days. Visceral leishmaniasis is common in persons with HIV and need HAART (highly active antiretroviral therapy).
Leishmaniasis or Kala-azar Cutaneous Leishmaniasis

 

Cutaneous Leishmaniasis –

  • incubation period is from weeks to months.
  • There is a papule at the site of bite, and lymphaden­opathy.
  • There may be change of papule to nodule and ulcer­ative lesion with central depression and raised bor­der several cms. in size.
  • in Cutaneous Leishmaniasis Satellite lesions and secondary bacterial infection may occur.

Treatment  Cutaneous Leishmaniasis  —

  • Amphotericin B
  • Miltefosine
Mucosal Leishmaniasis

Mucosal Leishmaniasis —

  • Mucosal Leishmaniasis Nasopharyngeal mucosa is infected and is quite dis­figuring.
  • Mucosal Leishmaniasis is caused by Viannia. There are persistent nasal symptoms, and epistaxis.

Treatment of Mucosal Leishmaniasis —

  • Amphotericin,
  • Antimonial compounds
  • and glucocorticoids.
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