Leishmaniasis: Test and Diagnosis

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: Serological tests fail completely in cutaneous leishmaniasis, at least in the “Old World” type (L. tropica major, L. tropica minor, L. donovani, L. donovani infantum, L. archibaldi) with only one focus.* Bone marrow aspiration – considered the gold standard in diagnostics for detection of intracellular parasites.
  • Giemsa stain from the smear of a cutaneous lesion – used for direct detection of promastigote (flagellated) Leishmania.
  • HIV test – to exclude HIV co-infection.
  • Small blood count [pancytopenia (synonym: tricytopenia): deficiency in all three cell series of hematopoiesis: leukocytopenia, anemia, and thrombocytopenia]
  • Differential blood count
  • Inflammatory parameter – CRP (C-reactive protein)
  • Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance).
  • Fasting glucose (fasting blood glucose), if necessary oral glucose tolerance test (oGTT).
  • Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT) [transaminase elevation].
  • Renal parameters – urea, creatinine, cystatin C or creatinine clearance, as appropriate.