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Visceral leishmaniasis overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Visceral leishmaniasis (VL) is the most severe form of leishmaniasis, a disease caused by parasites of the Leishmania genus. It is the second-largest parasitic killer in the world (after malaria), responsible for an estimated 60 000 who die from the disease each year out of half-million infections worldwide.[1] The parasite migrates to the visceral organs such as liver, spleen and bone marrow and if left untreated will almost always result in the death of the mammalian host. Signs and symptoms include fever, weight loss, anemia and substantial swelling of the liver and spleen. Of particular concern, according to the World Health Organization (WHO), is the emerging problem of HIV/VL co-infection[2].

Causes

Several species of Leishmania are known to give rise to the visceral form of the disease. The “Old World” (Africa, Asia, Europe) species are L. donovani and L. infantum and the “New World” (South America) species is L. chagasi.

Diagnosis

History and Symptoms

When a human patient does develop visceral leishmaniasis, the most typical symptoms are fever and the enlargement of the spleen, or splenomegaly, with enlargement of the liver – hepatomegaly, sometimes being seen as well. The blackening of the skin that gave the disease its common name in India does not appear in most strains of the disease, and the other symptoms are very easy to mistake for those of malaria.

Other Diagnostic Studies

Other tests being developed include a latex agglutination test (KAtex), which is currently being tested in Asia and Africa. Another potential test detects erythrosalicylic acid.[2]

References

  1. A Small Charity Takes the Reins in Fighting a Neglected Disease, New York Times, July 31, 2006.
  2. Lockwood DNJ, Sundar S. (2006). “Serological tests for visceral leishmaniasis”. Brit Med J. 333: 711&ndash, 12.


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