Leishmaniasis

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Antibodies	Leishmania panamensis - close-up	Leishmania panamensis on the foot	Leishmaniasis
Leishmaniasis, mexicana - lesion on the cheek	Leishmaniasis on the finger

Kala-azar

• history of exposure to the bite of sandflies
• history of being in an area known for leishmaniasis

Systemic illness (visceral leishmaniasis):

• Fever, persistent, long duration (weeks), may cycle irregularly
• Night sweats
• Fatigue
• Weakness
• Appetite loss
• Weight loss
• Abdominal discomfort, vague
• Vomiting (children)
• Diarrhea (children)
• Cough (children)
• Scaly skin
• Gray, dark, ashen skin
• Thinning hair

Skin disease (cutaneous leishmaniasis):

Symptoms on the skin include:

• Macule or papule , erythematous
• Skin ulcer, forms at site of original lesion
• Ulcer heals very slowly over a matter of months
• Smaller lesions may form around the ulcer (satellite lesions)

Symptoms on mucous membranes include:

• Nasal stuffiness
• Runny nose
• Nosebleed
• Ulcers and erosion of tissue (mouth, tongue, gums, lips, nose, nasal septum)
• Swallowing difficulty (dysphagia) with esophageal involvement
• Breathing difficulty, with tracheal involvement

SIGNS

• Enlarged spleen
• Enlarged liver (less common than enlarged spleen)
• Enlarged lymph nodes (less common than enlarged spleen)

TESTS

Systemic disease:

• Skin test, called the Montenegro skin test
• Skin biopsy
• Biopsy of the spleen
• Bone marrow biopsy
• Lymph node biopsy
• Culture (testing to see if microorganisms grow) of biopsy material
• Indirect immunofluorescent antibody test
• Direct agglutination assay

Other tests (complementary to the diagnosis)

• CBC (shows decreased cellular material in the blood)
• Hemoglobin (shows signs of anemia )
• Serum protein (decreased)
• Serum albumin (decreased)
• Immunoglobulins (antibodies; increased)

Review Date: 03/06/2006
Reviewed By: Monica Gandhi MD, MPH, Assistant Professor, Division of Infectious Diseases,UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.