kALA AZAR

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KALA AZAR:

KALA AZAR

Visceral Leishmaniasis:

Visceral Leishmaniasis Leishmania species – L. Donovani (Protozoa) Female Sandflies Nocturnal Limited flight range Small

Visceral Leishmaniasis:

Congenital / Parenteral (Blood transfusion / needle sharing) India (Bihar / NE States) Spleen / Liver / Lymphnode / Bone Marrow – Primary involvement Visceral Leishmaniasis

Clinical Features:

Clinical Features Adults and children equally affected Incubation period – week – months (years) Chronic / Subacute / acute onset Malnutrition – risk factor

Clinical Features:

Prolonged fever Splenomegaly Hepatomegaly Lymphadenopathy - rare Blackish discolouration of skin – advanced disease – rarely seen Clinical Features

Lab Investigations:

Lab Investigations Anaemia Leukopenia Neutropenia Marked Eosinopenia Relative Lymphocytosis and Monocytosis Thrombocytopenia Hypergammaglobulinemia (Chiefly IgG) Hypoalbuminemia

Diagnosis:

Diagnosis Clinical Demonstration of amastigotes / promastigotes Serology Aspirates / Biopsy specimen (Spleen, Bone Marrow, Lymphnode) Heavy parasite burden High level antibody responses Visceral Leishmaniasis

Treatment:

Treatment Supportive Malnutrition Anaemia Bleeding Intercurrent infections Antimony compounds

Treatment:

Treatment Amphotericin B Conventional Lipid formulations Miltefosine – oral drug HIV co-infection Responds well but toxicity increased No vaccine available yet

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