Visceral Leishmaniasis, A Tropical Disease

Visceral Leishmaniasis (or Kala-Azar, as it is known in North Africa) is an endemic parasitic disease caused by infection with Leishmania donovani or Leishmania infantum (or L. chagasi, as the african strain is known).

The patient becomes infected by the female of the Phlebotomus and Lutzomyia sandflies in the endemic areas of South America, Africa and Central Asia. Incidence of the disease is increasing.

First signs of an acute infection are usual a dry cough, nosebleeds and a rapidly enlarging spleen, associated with anaemia.

Diagnosis is best established microscopically with splenic aspirate or marrow.

Prevention is as usual the best weapon and should be established by reducing the sandflies in the area.

Treatment is normally initiated with pentavalent antimony or pentamidine, but unfortunately often too late, especially in immunocompromised patients in rural areas.

Source: Oxford Handbook of Tropical Medicine