• KALA-AZAR

    (Leishmaniasis)

    DEFINITION
    It  is a Protozoal infection caused by leishmania donovani and Characterised by Chronic irregular fever pigmentation orogressive wasting hepato splenomegaly, anaemia and leucopenia.

     

     

    CLINCIAL FEATURES
    Symptoms
    Onset : insidious.

    ETIOLOGY (Causes)

    Distribution
    –   Endemic in India, China Africa

    Causative organism
    –  Leishmania donovani

    Transmission
    –  Bite of femaie sandfil (phlebotomus argentipes)

    Incubation period
    –  4-10 months.
    –  Fever.
    –  Chill and rigro.
    –  Patient is active,
    –  Good appetite.
    –  Dark pigmentation of skin
    –  Weight loss in late stages.

    Signs:

    Temperature: Double rise of temperature(morning and evening)
    Pulse: Fast
    Blood pressure:  Normal or low
    Anaemia: Mild to moderate.

    Dark pigmentation:
    –   of face hands and feet.
    –   Skin:
    –   Shiny.
    –   Scaly
    –   Hair
    –   Brittle
    –   Lustreless.
    –   Pedal oedema:
    –   Bilateral
    –   Pitting
    –   Splenomegaly:
    –   Mode rate to severe.
    –   Hepatomegaly:
    –   Mild to moderate
    –   Emaaciation
    –   in late stages
    –   Complications
    –   Dermal leishmaniasis
    –   Haemorrhages
    –   Severe anaemia
    –   Agranulocytosis.
    –   Severe anaemia
    –   Agranulocytosis
    –   Secondary infections, e,g
    –   Tuberculosis.
    –   pneumonia

    INVESTIGATIONS

    Blood:
    Hb% Low Normocytic normochrmic anemia.
    TLC: Leucopenia (3000/cu mm)
    DLC Relative lymphocytosis
    Bone marrow
    Positive for L.D.Bodies
    Splenic Puncture
    Positive for L.D.Bodies
    ELISA test:
    Sensitive and specific
    Prognosis
    good with efficient treatment
    Relapses are common.

    THERAPEUTIC AIM
    To cure
    To prevent complications
    To prevent relapse.

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