Leishmaniasis

Leishmaniasis: Description, Causes and Risk Factors:Commonly known as kala azar.Other Names Include: Dum Dum Fever, Black Disease, Sand fly Disease, Espundia.LeishmaniasisTerminology: American leishmaniasis, acute cutaneous, canine, chronic cutaneous, anergic, anthroponotic cutaneous, cutaneous, diffuse cutaneous leishmaniasis, diffuse, disseminated cutaneous, dry cutaneous, infantile, recidivans, tegumentaria diffusa, lupoid, mucocutaneous, nasopharyngeal, New World, Old World leishmaniasis, pseudolepromatous, rural cutaneous, urban cutaneous, visceral, wet cutaneous, zoonotic cutaneous.Leishmaniasis is a parasitic disease spread by the bite of infected sand flies. There are several different forms of leishmaniasis. The most common forms are cutaneous, which causes skin sores, and visceral, which affects some of the internal organs of the body (spleen, liver, bone marrow).The number of new cases of cutaneous leishmaniasis each year in the world is thought to be about 1.5 million. Most of the affected countries are in the tropics and subtropics. The settings in which leishmaniasis is found range from rain forests in Central and South America to deserts in West Asia. More than 90 percent of the world's cases of visceral leishmaniasis are in India, Bangladesh, Nepal, Sudan, and Brazil.It is caused by protozoan parasites of the genus Leishmania.It is spread by the bite of some types of phlebotomine sand flies. Sand flies become infected by biting an infected animal (for example, a rodent or dog) or person. Since sand flies do not make noise when they fly, people may not realize they are present. Sand flies are very small and may be hard to see; they are only about one-third the size of typical mosquitoes. Sand flies usually are most active in twilight, evening, and night-time hours (from dusk to dawn). Sand flies are less active during the hottest time of the day. However, they will bite if they are disturbed, such as when a person brushes up against the trunk of a tree where sand flies are resting. Rarely, leishmaniasis is spread from a pregnant woman to her baby. Leishmaniasis also can be spread by blood transfusions or contaminated needles.People of all ages are at risk for it if they live or travel where leishmaniasis is found. It usually is more common in rural than urban areas; but it is found in the outskirts of some cities. The risk for it is highest from dusk to dawn because this is when sand flies are the most active.Symptoms:People who have cutaneous leishmaniasis have one or more sores on their skin. The sores can changein size and appearance over time. They often end up looking somewhat like a volcano, with a raised edgeand central crater. Some sores are covered by a scab. The sores can be painless or painful. Somepeople have swollen glands near the sores.People who have visceral leishmaniasis usually have fever, cough, diarrhea, vomiting, weight loss, and an enlarged spleen and liver.Diagnosis:A physical exam may show signs of an enlarged spleen, liver, and lymph nodes.A key to making the diagnosis is learning whether the patient has traveled to a country where leishmaniasis occurs. During the physical examination, the doctor also checks the patient's body for the types of sores seen with the infection. The doctor may take blood samples and tissue samples from any sores that are found. These samples will be culturedTests that may be done to diagnose the condition include:Direct Diagnosis: Giemsa or leishmanstain of biopsy or fluid(amastigat form).
  • Culture off pus or blood.
  • Montenegro test.
  • ELISA method.
Other tests Include:Biopsy of the spleen and culture.
  • Lymph node biopsy and culture.
  • Bone marrow biopsy and culture.
  • Direct agglutination assay.
  • Indirect immunofluorescent antibody test.
Treatment:Doctors treat the infection with prescription medications; many of these medicines contain antimony. Cutaneous cases usually can be treated at home, but visceral disease may require hospitalization and supportive care, such as intravenous fluids. Patients who have severe disfigurement from cutaneous, and especially mucocutaneous, leishmaniasis often need reconstructive surgery to regain a normal appearance.Preventive Measures:Stay in well-screened or air-conditioned areas as much as possible. Avoid outdoor activities, especially from dusk to dawn, when sand flies are the most active.
  • When outside, wear long-sleeved shirts, long pants, and socks. Tuck your shirt into your pants.
  • Apply insect repellent on uncovered skin and under the ends of sleeves and pant legs.
  • Spray clothing with permethrin-containing insecticides. The insecticide should be reapplied after every five washings.
  • Spray living and sleeping areas with an insecticide to kill insects.
Disclaimer: The above information is just informative purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 

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