The following are the most important diseases or complications that may be contributed to by visceral leishmaniasis: Blood, blood-forming organs – Immune system (D50-D90). Anemia (anemia) Pancytopenia (synonym: tricytopenia) – reduction of all three cell series in the blood. Infectious and parasitic diseases (A00-B99). Bacterial infections (secondary infection; bacterial superinfections). Diarrhea (diarrhea) Symptoms and abnormal … Leishmaniasis: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight [cachexia (emaciation; severe emaciation)], body size; furthermore: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [anemia (anemia); lymphadenopathy (enlargement of lymph nodes); patchy dark pigmentation of the … Leishmaniasis: Examination
1st order laboratory parameters – obligatory laboratory tests. Pathogen detection (microscopy, PCR (polymerase chain reaction)) from material at the marginal wall of the ulcer or punctate from lymph nodes, spleen, liver, bone marrow* – in all forms, pathogen detection as well as species differentiation should be aimed for In visceral leishmaniasis: AK detection (antibody detection)Note: … Leishmaniasis: Test and Diagnosis
Therapy goals Elimination of the pathogens Avoidance of complications Therapy recommendations In visceral leishmaniasis, it is important to determine whether organ complications (especially spleen, liver) have already occurred before starting therapy. Liposomal amphotericin B (antifungal agent; first-line agent). Miltefosine (alkyphosphocholine) (second-line agent). Antimony preparation (pentavalent antimony) (reserve drug). Cutaneous leishmaniasis does not require treatment in … Leishmaniasis: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. Abdominal sonography (ultrasound examination of abdominal organs) – for basic diagnostics. Computed tomography (CT) of the abdomen (abdominal CT) – for advanced diagnostics.
Prevention of leishmaniasis requires attention to reducing individual risk factors. Behavioral risk factors Inadequate protection from crepuscular and nocturnal phlebotomes (sand or butterfly mosquitoes) that stay close to the ground. Mosquito nets are only useful if the mesh size does not exceed 1.2 mm. Note: Unlike many other species of mosquitoes, the flight of sandflies … Leishmaniasis: Prevention
The following symptoms and complaints may indicate visceral leishmaniasis (VL) (kala-azar): Sudden onset with high fever Increasingly reduced general condition Anemia (anemia) (due toaffection of the bone marrow: pancytopenia (synonym: tricytopenia): deficiency in all three cell series of hematopoiesis: leukocytopenia, anemia and thrombocytopenia)). Diarrhea (diarrhea) Possibly patchy dark pigmentation of the skin (“Kala Azar” = … Leishmaniasis: Symptoms, Complaints, Signs
Pathogenesis (disease development) Leishmaniasis is caused by the different species of Leishmania. These have a two-part developmental cycle, one part of which occurs in the female vector mosquito, the sandfly or butterfly mosquito (phlebotome), and the other in humans. In the blood of the biting insect, the approximately 10-15 µm long, flagellated parasites develop and … Leishmaniasis: Causes
General measures Observance of the general hygiene measures! When traveling, protect well against insect bites! Suitable clothing – long pants, long sleeves. Light-colored clothing provides more protection than dark – on it mosquitoes are easier to see Sleep under a mosquito net – the mesh size should not exceed 1.2 mm Sleep at night with … Leishmaniasis: Therapy
Medical history (history of illness) represents an important component in the diagnosis of leishmaniasis. Family history Social history Have you been on a trip abroad within the last year? If so, where were you on vacation? Do you work at the airport? Have you had contact with animals such as dogs and rodents brought from … Leishmaniasis: Medical History
Visceral Leishmaniasis Infectious and parasitic diseases (A00-B99). Paratyphoid fever – infectious disease caused by Salmonella paratyphi A, B, or C; attenuated clinical picture of typhoid fever. Shigellosis – infectious diarrhea (diarrhea) caused by shigella. Typhoid abdominalis – infectious disease caused by Salmonella typhi. Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87). Hepatosplenomegaly (enlargement … Leishmaniasis: Or something else? Differential Diagnosis
