The clinical presentation of visceral leishmaniasis possesses a long incubation period (ranging from a few weeks to even years), a nonspecific symptomatology, and a variable clinical course, and may pose a diagnostic challenge [1] [2] [3] [4]. The two main signs of visceral leishmaniasis are fever and pancytopenia, both being almost universally present in all patients who suffer from this type of leishmaniasis [1] [2]. Fever can range anywhere between 37-40°C and often has an irregular pattern of occurrence [5]. On the other hand, pancytopenia (including thrombocytopenia, anemia, and leukopenia) causes weakness and severe immunosuppression, thus promoting various superinfections of bacterial, viral, or parasitic origin [1] [2] [5]. Opportunistic infections are, in fact, the leading cause of death from visceral leishmaniasis, with mortality rates being as high as 75%-95% in the absence of an early diagnosis and appropriate therapy [1]. The term "kala-azar" (meaning black death) is used to describe visceral leishmaniasis that is restricted to the Old World and caused by Leishmania donovani [1]. Wasting and poor general condition induced by pancytopenia are seen in advanced stages of the disease [6]. In addition to fever and bone marrow suppression, hepatosplenomegaly is another important sign in visceral leishmaniasis, seen in up to 85-100% of patients in some studies [5]. Lymphadenitis is a less frequent manifestation [2] [5].

• Splenomegaly

  Infantile VL may begin suddenly, with high fever and vomiting, or insidiously, with irregular daily fever, anorexia, and marked splenomegaly. [ncbi.nlm.nih.gov]

  It can be difficult to diagnose this disease in endemic settings as several causes of febrile splenomegaly exist, notably malaria. [bmj.com]

  The US also confirmed splenomegaly with diffuse hypoechoic lesions (Figure 2). Figure 2. Splenomegaly with diffuse innumerable hypoechoic foci. [acgcasereports.gi.org]

  Clinical symptoms include fever, weight loss, and splenomegaly; pancytopenia and hypergammaglobulinemia are often present. [mayomedicallaboratories.com]

• Massive Splenomegaly

  Visceral leishmaniasis (VL), i.e., infection with Leishmania sp. associated with high fever, weight loss, massive splenomegaly and markedly altered laboratory parameters, is generally fatal if untreated. [ncbi.nlm.nih.gov]

  There are very few pediatric conditions that can stimulate massive splenomegaly, as observed in our patient and reported in VL [ 20 ]. [ispub.com]

  splenomegaly Laboratory tests may show pancytopenia and hypergammaglobulinaemia Complications include gastrointestinal bleeding, peripheral oedema, acute renal failure and secondary bacterial infections Generalised hyperpigmentation is a late feature [dermnetnz.org]

  VL caused by all species has five characteristic hallmark features that include organomegaly (e.g., massive splenomegaly and moderate hepatomegaly), fever, cachexia and weight loss, pancytopenia and hypergammaglobulinemia. [pedinfect.com]

• Generalized Lymphadenopathy

  lymphadenopathy, profound weakness and a wasting syndrome [11▪▪,13,14]. [journals.lww.com]

  Clinical manifestations of VL include recurrent fever, hepatosplenomegaly, generalized lymphadenopathy, pancytopenia, and anemia. Death occurs in the absence of appropriate chemotherapy ( 4 ). [doi.org]

• Fever

  Fever can range anywhere between 37-40°C and often has an irregular pattern of occurrence. [symptoma.com]

  Herein we report an 11 month-old male infant with diagnosis of kala-azar who presented with pallor, hepatosplenomegaly, failure to gain weight, and no history of fever. [ncbi.nlm.nih.gov]

  Visceral leishmaniasis, also known as kala-azar, is characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver, and anaemia (which may be serious). [who.int]

  FÖREDRAGEN TERM Leishmaniasis, Visceral HÄNVISNINGSTERMER Black Fever Fever, Black Kala Azar Kala-Azar ANMÄRKNING coordinate with NEGLECTED DISEASES if pertinent; do not confuse entry term BLACK FEVER with BLACKWATER FEVER or AMAZON BLACK FEVER see HEPATITIS [finto.fi]

• Weight Loss

  Visceral leishmaniasis, also known as kala-azar, is characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver, and anaemia (which may be serious). [who.int]

  A type of leishmaniasis occurring chiefly in India, caused by the protozoan parasite Leishmania donovani and characterized by fever, enlargement of the spleen and liver, progressive anemia and leukopenia, and weight loss. [medical-dictionary.thefreedictionary.com]

  Clinical symptoms include fever, weight loss, and splenomegaly; pancytopenia and hypergammaglobulinemia are often present. [mayomedicallaboratories.com]

  It clinically manifests as fever, weight loss, swelling, hepatosplenomegaly, paleness, and edema. [ncbi.nlm.nih.gov]

• Anemia

  Infection is characterized by pancytopenia (anemia, thrombocytopenia, neutropenia), hepatosplenomegaly, fever, and severe immunosuppression that can lead to fatal opportunistic diseases without early recognition. [symptoma.com]

  A type of leishmaniasis occurring chiefly in India, caused by the protozoan parasite Leishmania donovani and characterized by fever, enlargement of the spleen and liver, progressive anemia and leukopenia, and weight loss. [medical-dictionary.thefreedictionary.com]

  […] ka·la-azar | \ ˌkä-lə-ə-ˈzär, ˌka- \ : a severe parasitic disease chiefly of tropical areas that is marked by fever, progressive anemia, leukopenia, and enlargement of the spleen and liver and caused by a leishmania ( Leishmania donovani ) transmitted [merriam-webster.com]

  Adverse events in the liposomal-therapy group were infusion-related fever or rigors (in 40%) and increased anemia or thrombocytopenia (in 2%); such events in the conventional-therapy group were fever or rigors (in 64%), increased anemia (in 19%), and [ncbi.nlm.nih.gov]

• Pain

  On the 13 th day of treatment, he presented with abdominal pain and vomiting. The biochemical, hematological, and radiological features were suggestive of acute pancreatitis. [ncbi.nlm.nih.gov]

  [Urdu kālā āzār : kālā, black (from Sanskrit kāla- ; see Kali ) + āzār, disease (from Persian, from Middle Persian, pain, torment, from āzārdan, āzār-, to torment : ā-, to + -zār-, to make angry ).] kala-azar ( ˌkɑːləəˈzɑː ) n (Pathology) a tropical infectious [medical-dictionary.thefreedictionary.com]

  joint pain, epistaxis, diarrhoea 6.neurological affects are rare 14. signs Splenomegaly (soft, non tender),can be massive Hepatomegaly Peripheral lymphadenopathy Dark skin anemia 15. complications Sec. bact.infections - pneumonia, dysentery, pulm.Tb [slideshare.net]

  Limitations of the study include high variation at the study sites in reporting injection-site pain, ranging from 2% to 97%. The data collection was not standardized for this specific outcome. [nejm.org]

• Weakness

  Considering the persistent clinical features and weak response to conventional treatment, a combination therapy with liposomal amphotericin B (ambisome), n-methylglucamine antimoniate (glucantime), and pentamidine isethionate was initiated, and response [ncbi.nlm.nih.gov]

  On the other hand, pancytopenia (including thrombocytopenia, anemia, and leukopenia) causes weakness and severe immunosuppression, thus promoting various superinfections of bacterial, viral, or parasitic origin. [symptoma.com]

• Pneumonia

  After presenting with typical Pneumocystis jiroveci pneumonia, which was treated appropriately, the patient was started on antiretroviral therapy. Shortly thereafter, however, he developed fever of unknown origin. [ncbi.nlm.nih.gov]

  Five pneumonia cases associated with visceral leishmaniasis in Turkey. Int Pediatr. 2003;18(3):185-7. 10. Kotsifas K, Metaxas E, Koutsouvelis I, Skoutelis A, Kara P, Tatsis G. [intjinfection.com]

  […] en Leishmaniasis doesn't cause pneumonia, and filariasis- tr Sadece kontrol için kullanılan kristalleri yok etmemiz gerek en Last year, hundreds of volunteer biology and chemistry researchers around the world worked together to sequence the genome of [tr.glosbe.com]

  The clinical manifestations most often related to death were bleeding, edema (anasarca and ascites), and pneumonia. In the third and fourth weeks, 17 deaths were registered, with a predominance of pneumonia as a probable cause of death. [intechopen.com]

  Advanced untreated visceral leishmaniasis can be fatal, particularly if other pre-existing conditions such as tuberculosis, pneumonia, and dysentry are present. Prevention Avoid outdoor activities from dusk to dawn. [iamat.org]

• Cough

  An 18-year-old immunocompetent patient was referred to a local hospital with submandibular lymphadenopathy, nonproductive cough, and occasional fever. [intjinfection.com]

  We present a case of a 12-year-old girl with a history of recurrent fever, anorexia, cachexia, chronic fatigue, weight loss, left palpebral unilateral edema, persistent cough and pancytopenia. [ncbi.nlm.nih.gov]

  Side-effects include abdominal pain, vomiting, nausea, fatigue, headache, increase of liver enzymes, nephrotoxicity, arthralgia, fever, rash, cough, pneumonia, pancytopenia and reversible peripheral neuropathy. [clinicalmicrobiologyandinfection.com]

• Diarrhea

  When admitted to the hospital, the patient presented fever, hepatosplenomegaly, weight loss, and diarrhea. Since then, six additional episodes of VL occurred, with a frequency rate of one per year (2005-2012, except in 2008). [ncbi.nlm.nih.gov]

  In half of patients, diarrhea is constant; in the rest, diarrhea severity varies over time. About 33% of patients have diarrhea < 1 year before diagnosis, but 25% have diarrhea ≥ 5 years before diagnosis. [msdmanuals.com]

  […] along with metabolic acidosis and hypokalemia may prompt investigation for VIPoma • Severe secretory diarrhea, elevated serum VIP level and pancreatic mass suggests diagnosis • Patients who complain of severe diarrhea must be evaluated carefully for [accesssurgery.mhmedical.com]

• Vomiting

  On the 13 th day of treatment, he presented with abdominal pain and vomiting. The biochemical, hematological, and radiological features were suggestive of acute pancreatitis. [ncbi.nlm.nih.gov]

  Allopurinol *may be used to treat VL patients who have AIDS Inhibits xantine oxidase and the production of uric acid Oral, IV 20 mg/kg 3x day Gas, nausea, vomiting, risk of renal impairment Lesion healing Amphotericin B (Fungizone) *preferred treatment [web.stanford.edu]

  Children <5 years old were particularly susceptible, with 59% developing diarrhea, 49% experiencing vomiting, and 35% experiencing both. Female subjects were more frequently affected by vomiting than were male subjects. [academic.oup.com]

  It is commonly characterized by fever, chills, vomiting, anemia, hepatosplenomegaly, leukopenia, hypergammaglobulinemia, emaciation, and an earth-gray color of the skin. [finto.fi]

• Abdominal Pain

  On the 13 th day of treatment, he presented with abdominal pain and vomiting. The biochemical, hematological, and radiological features were suggestive of acute pancreatitis. [ncbi.nlm.nih.gov]

  Sign In A 49-year-old man presented with fever, abdominal pain, and unintentional weight loss. He had an enlarged liver and spleen, and examination of a bone marrow aspirate revealed amastigotes. A diagnosis of visceral leishmaniasis was made. [nejm.org]

  pain and cramping, severe watery diarrhea, dehydration, flushing of the face, muscle cramps due to low potassium levels (hypokalemia), and weight loss.[1][2] When a person has a VIPoma and these associated symptoms, it is referred to as VIPoma syndrome [rarediseases.info.nih.gov]

• Nausea

  Allopurinol *may be used to treat VL patients who have AIDS Inhibits xantine oxidase and the production of uric acid Oral, IV 20 mg/kg 3x day Gas, nausea, vomiting, risk of renal impairment Lesion healing Amphotericin B (Fungizone) *preferred treatment [web.stanford.edu]

  Nausea and anorexia, and changes in serum creatinine and potassium, became normal in 2 weeks. Immediate withdrawal of the drug and restart after 10 days cured 2 patients who developed acute renal failure. [ncbi.nlm.nih.gov]

  Symptoms associated with dehydration and hypokalemia include lethargy, nausea, vomiting, muscle weakness, and muscle cramps. Abdominal pain is mild or absent. [cancertherapyadvisor.com]

  Adverse effects include nausea, vomiting, transient elevations in aminotransferases, and dizziness. Miltefosine is contraindicated during pregnancy; women of childbearing age who are taking this drug must use effective birth control measures. [merckmanuals.com]

  Side-effects include abdominal pain, vomiting, nausea, fatigue, headache, increase of liver enzymes, nephrotoxicity, arthralgia, fever, rash, cough, pneumonia, pancytopenia and reversible peripheral neuropathy. [clinicalmicrobiologyandinfection.com]

• Abdominal Distension

  On general physical examination, the patient was found to be thin built, pale, and afebrile with abdominal distension. Left submandibular and left axillary lymph nodes were enlarged and measured 1.5 cm in diameter. [cytojournal.com]

  Fifty-seven percent of the patients had abdominal distension, and 49% had anorexia. Fever and splenomegaly were present in more than 95% of the patients. [pedinfect.com]

  distension, abdominal pain, vomiting, nausea, bleeding tendency, paleness, jaundice, lymph node enlargement, palpable spleen and palpable liver, only a few weakly significant differences appeared. [doi.org]

• Hepatosplenomegaly

  Infection is characterized by pancytopenia (anemia, thrombocytopenia, neutropenia), hepatosplenomegaly, fever, and severe immunosuppression that can lead to fatal opportunistic diseases without early recognition. [symptoma.com]

  VL should be considered in the differential diagnosis in returning travellers presenting with prolonged fever, hepatosplenomegaly and/or pancytopenia. [ncbi.nlm.nih.gov]

• Hepatomegaly

  The features of VL may be different in immunosuppressed patients, with more fever and less hepatomegaly and leukopenia than in HIV-infected patients. [ncbi.nlm.nih.gov]

  After assessing the course of symptoms and their progression during the interview, a meticulous physical examination, particularly abdominal palpation, will reveal either hepatomegaly, splenomegaly, or both. [symptoma.com]

• Liver Fibrosis

  The differential diagnosis includes liver fibrosis, abnormal blood flow due to splenic vein thrombosis or portal vein obstruction, and liver cirrhosis due to chronic viral hepatitis B or C, fatty liver, and alcohol use. [acgcasereports.gi.org]

• Myalgia

  […] pentad of fever, weight loss, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia Viscerotropic leishmaniasis: Nonspecific abdominal tenderness; fever, rigors, fatigue, malaise, nonproductive cough, intermittent diarrhea, headache, arthralgias, myalgias [medscape.com]

  Arthralgia and myalgia and elevated hepatic and pancreatic enzymes are other common adverse events. Antimonials are more toxic in HIV patients, and a significant proportion of them has chemical pancreatitis. [journals.lww.com]

• Skin Disease

  References[edit] External links[edit] Sand Flies – Beaufort County Library (via Internet Archive) Infectious skin disease found in Texas September 15, 2007 Breaking News – Sandfly may carry parasites that will cause infectious skin disease called leishmaniasis [en.wikipedia.org]

  Old World cutaneous leishmaniasis is a mostly self-limiting skin disease in adults, but depending on the species, infected infants and children can develop the visceral form of the disease. [iamat.org]

  On DermNet NZ Bugs Arthopod bites and stings Tropical skin diseases Other websites Leishmaniasis – pathology Leishmaniasis – Medline Plus Leishmaniasis – World Health Organization (WHO) Leishmaniasis – Medscape Reference Books about skin diseases See [dermnetnz.org]

  diseases in Poland, including parasitic infections. [pbn-test.opi.org.pl]

  Elliot Weiss, Adam Joseph Mamelak, Stephania La Morgia, Binghe Wang, Claudio Feliciani, Antonio Tulli and Daniel Nathan Sauder, The role of interleukin 10 in the pathogenesis and potential treatment of skin diseases, Journal of the American Academy of [doi.org]

• Insect Bite

  These nocturnal insects bite from dusk to dawn and are often found in forests, stone and mud walls cracks, and animal burrows. They are very tiny silent flyers – they do not hum – and their bite might go unnoticed. [iamat.org]

  Prevention of insect bites Infection can be prevented by avoidance of sandfly bites. [dermnetnz.org]

  A detailed clinical history was obtained, including tribe, residence, occupation, marital status, medical treatment, abdominal pain, vomiting, nausea, previous history of bleeding tendency, urinary tract infection and insect bites, and family history [doi.org]

  According to these records, the mission had the opportunity to observe the existence of people with ulcers in legs and arms, related to insect bites, resulting in destructive lesions of the mouth and nose. [scielo.br]

• Headache

  Results Sodium Stibogluconate (Pentostam) *Not licensed for use in the US Cause parasite death by inhibiting glycolytic enzymes and fatty acid oxidation Administered intravenously or intra-muscularly 20 mg/kg body weight daily for 28 days Coughing, headache [web.stanford.edu]

  Dehydration Dehydration can cause: thirst dry skin a dry mouth tiredness headaches and dizziness More than 8 out of every 10 people (more than 80%) have dehydration. [cancerresearchuk.org]

  Side-effects include abdominal pain, vomiting, nausea, fatigue, headache, increase of liver enzymes, nephrotoxicity, arthralgia, fever, rash, cough, pneumonia, pancytopenia and reversible peripheral neuropathy. [clinicalmicrobiologyandinfection.com]

  […] skin as well as the pentad of fever, weight loss, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia Viscerotropic leishmaniasis: Nonspecific abdominal tenderness; fever, rigors, fatigue, malaise, nonproductive cough, intermittent diarrhea, headache [medscape.com]

  Other less common adverse events include myasthenia gravis, kidney damage, enterocolitis, malabsorption syndrome, eosinophilia, headache, hearing loss, ringing in the ear, itching, severe dizziness and pancreatitis. 2.1.3. [intechopen.com]

• Asthenia

  After acute debut with fever, dyspepsia, asthenia, patient subjected conventional treatment for such situations. Because of the lack of the well outcome she underwent sternal punction. [ibn.idsi.md]

  The initial signs include persistent or intermittent fever, diarrhea, asthenia, adynamia, nonproductive cough, somnolence, and progressive weight loss. [omicsonline.org]

  Clinical manifestations Number of patients % Hepatomegaly 633 98.0 Splenomegaly 632 97.8 Fever 628 97.7 Pallor 533 82.5 Increased lymph nodes 500 77.5 Increased abdominal volume 463 71.7 Weight loss 462 71.5 Long eyelashes 454 70.3 Dry hair 450 69.7 Asthenia [intechopen.com]

• Kidney Failure

  The signs vary but may include skin lesions, weight loss, reluctance to exercise, lethargy, poor appetite, local or generalized disease of the lymph nodes, eye lesions, kidney failure, nosebleed, lameness, and anemia. [msdvetmanual.com]

  In dogs, it invariably spreads throughout the body to most organs; renal (kidney) failure is the most common cause of death, and virtually all infected dogs develop visceral or systemic disease. [petmd.com]

  Licensed veterinarians established leishmaniasis-related deaths by previous Leishmania-specific diagnostic results, history, and clinical signs as well as immediate cause of death (kidney failure etc.). [parasitesandvectors.biomedcentral.com]

• Renal Insufficiency

  Such adverse reactions (e.g., renal insufficiency, hypokalemia, and/or decreased hemoglobin level [ 16 ]), typically associated with lengthy administration of amphotericin B deoxycholate, developed in 21 (41%) of 51 patients in group A. [cid.oxfordjournals.org]

  One patient developed severe diarrhoea and renal insufficiency and died on day 21. At the end of four weeks, 29 of 30 patients were apparently cured, and by 8 months, 18 of 19 patients treated daily appeared to be cured. [jpgmonline.com]

A detailed patient history and a thorough physical examination are the first and perhaps crucial steps for making an initial diagnosis of visceral leishmaniasis. The vast majority of patients (> 90%) who suffer from visceral leishmaniasis come from six countries of the world: India, Bangladesh, Sudan, South Sudan, Ethiopia, and Brazil [6] [7] [8]. For this reason, the physician should conduct a detailed patient history that will cover recent travel to endemic countries, as well as possible exposure to sand flies in the last few years. After assessing the course of symptoms and their progression during the interview, a meticulous physical examination, particularly abdominal palpation, will reveal either hepatomegaly, splenomegaly, or both. In order to solidify the diagnosis, laboratory and microbiological tests need to be conducted. A basic complete blood count (CBC) is sufficient to detect pancytopenia, while directed diagnostic testing for Leishmania is broadly divided into indirect and direct methods. Serological testing (specifically enzyme-linked immunosorbent assay, or ELISA, and fluorescence antibody testing) is widely used as the main indirect test that has good sensitivity/specificity [1] [2] [3] [4]. Detection of antigen rk39 through ELISA is a very reliable procedure and is used by many laboratories over the world [3] Conversely, identification of the parasite by light microscopy and Giemsa staining from blood samples is a relatively easy and effective procedure, while lymph node, liver, spleen, or even bone marrow samples might be used for evaluation, but the risks of bleeding (particularly in the case of spleen and bone marrow) often outweigh the benefit of confirming the diagnosis histologically [1] [2] [3] [4].

• Hyperglobulinemia

  In active VL, macrophages host the replicating amastigotes in phagolysosomal compartments leading to splenomegaly, hepatomegaly, hyperglobulinemia, anemia, weight-loss, incessant fever and ultimately death if not treated. [books.google.com]

  The most consistent serum biochemistry findings in dogs with clinical canine leishmaniosis are serum hyperproteinemia with hyperglobulinemia and hypoalbuminemia, frequently expressed by a decreased albumin:globulin ratio. [msdvetmanual.com]

  Serum biochemistry revealed hyperproteinemia 100.0 g/L [54.0 – 82.0 g/L], hyperglobulinemia 83.0 g/L [23.0 – 52.0 g/L] and hypoalbuminemia 18.0 g/L [25.0 – 44.0 g/L]. [parasitesandvectors.biomedcentral.com]

Research Treatment of Indian... [bmj.com]

[…] variables, serum chemistry, body weight, and the size of the spleen and liver every week during treatment, at the end of treatment, and at 6 months after the treatment ended. [nejm.org]

Liposomal amphotericin B is FDA-approved for treatment of visceral leishmaniasis and generally is the treatment of choice for U.S. patients. [cdc.gov]

Your doctor may recommend other treatments based on the type of leishmaniasis you have. Cutaneous leishmaniasis Cutaneous ulcers will often heal without treatment. [healthline.com]

Visceral leishmaniasis, associated with HIV/AIDS coinfection, is becoming a more aggressive disease, complicating an accurate prognosis. [ncbi.nlm.nih.gov]

References:[3][6][7] Leishmaniasis Summary Epidemiology Etiology Cutaneous leishmaniasis Clinical features Diagnostics Treatment Prognosis Visceral leishmaniasis Clinical features Diagnostics Treatment [amboss.com]

Prognosis Prognosis is highly variable and is dependent on many factors. In those with benign, surgically resectable tumors, the reported 5-year survival rate is almost 95%. [orpha.net]

Some researchers have noted that patients with jaundice had worse prognosis [21]. [intechopen.com]

Treatment and prognosis Acute management includes fluid and electrolyte replacement, as well as symptomatic management of diarrhea with agents such as octreotide which inhibit VIP secretion 4. [radiopaedia.org]

However, a strong clinical suspicion compelled further evaluation by polymerase chain reaction (PCR), which validated the etiology. This short report highlights the usefulness of PCR in diagnosing cases of suspected smear-negative VL recurrence. [ncbi.nlm.nih.gov]

All the common etiologies were excluded in our patient, but her travel history triggered an extended work-up to investigate parasitic etiologies such as Leishmania, which are otherwise unusual to the United States. [acgcasereports.gi.org]

References:[3][6][7] Leishmaniasis Summary Epidemiology Etiology Cutaneous leishmaniasis Clinical features Diagnostics Treatment Prognosis Visceral leishmaniasis Clinical features Diagnostics Treatment [amboss.com]

/epidemiology* DNA, Intergenic/genetics DNA, Protozoan/blood DNA, Protozoan/genetics Enzyme-Linked Immunosorbent Assay Female HIV Infections/complications HIV Infections/epidemiology* Humans Iran/epidemiology Leishmania infantum/immunology Leishmania [ncbi.nlm.nih.gov]

Ref: WHO/CTD/LEISH/98.23 Leishmania/HIV co-infection - Epidemiological analysis of 692 retrospective cases. [who.int]

This phenomenon has its origins in environmental [ 19 ] and epidemiological [ 5 ] alterations. [omicsonline.org]

Describe the cause of visceral leishmaniasis, the way it is transmitted and the basic epidemiology of the disease. [lshtm.ac.uk]

Useful For Suggests clinical disorders or settings where the test may be helpful Diagnosis of active visceral leishmaniasis Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Visceral [mayomedicallaboratories.com]

Knowledge gaps were identified in relation to pathophysiology, risk factors, and the role of PKDL patients in transmission. [dndi.org]

This two-page spread overviews the pathophysiology of visceral leishmaniasis—also known as Kala Azar, or black fever. [inessaskaya.com]

Verner–Morrison syndrome and WDHA syndrome (watery diarrhea, hypokalemia, achlorhydria) (Rom J Morphol Embryol 2017;58:371) ICD coding ICD-10: C7A.8 - other malignant neuroendocrine tumors ICD-10: E16.8 - other specified disorders of pancreatic internal secretion Pathophysiology [pathologyoutlines.com]

Pathophysiology and Etiology VIP has a molecular weight of 3381, consists of 28 amino acids, and belongs to the secretin-glucagon family. The VIP gene is located on chromosome 6. [emedicine.medscape.com]

One is liposomal amphotericin B (AmBisome) and the other is an antimonial compound called pentostam. [2] Prevention There is no vaccines available to prevent people from visceral leishmaniasis It is important for people to avoid outdoor activities, especially [microbewiki.kenyon.edu]

PREVENTION No vaccines or drugs to prevent infection are available. [wwwnc.cdc.gov]

Key strategies for prevention are listed below: Early diagnosis and effective prompt treatment reduces the prevalence of the disease and prevents disabilities and death. [who.int]

The only way to prevent leishmaniasis is to avoid getting bitten by a sand fly. Follow these steps to help prevent being bitten by a sand fly: Wear clothing that covers as much skin as possible. [healthline.com]

[…] and Prevention, Zhengzhou 450016, China [jsczz.cn]

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2. Barrett MP, Croft SL. Management of trypanosomiasis and leishmaniasis. Br Med Bull. 2012;104:175–196.
3. Srivastava P, Dayama A, Mehrotra S, Sundar S. Diagnosis of visceral leishmaniasis. Trans R Soc Trop Med Hyg. 2011;105(1):1-6.
4. Sassi A, Louzir H, Ben Salah A, Mokni M, Ben Osman A, Dellagi K. Leishmanin skin test lymphoproliferative responses and cytokine production after symptomatic or asymptomatic Leishmania major infection in Tunisia. Clin Exp Immunol. 1999;116:127–132.
5. Harizanov RN, Kaftandjiev IT, Jordanova DP, Marinova IB, Tsvetkova ND. Clinical features, diagnostic tools, and treatment regimens for visceral leishmaniasis in Bulgaria. Pathog Glob Health. 2013;107(5):260-266.
6. Singh OP, Sundar S. Developments in Diagnosis of Visceral Leishmaniasis in the Elimination Era. J Parasitol Res. 2015;2015:239469.
7. Gawade S, Nanaware M, Gokhale R, Adhav P. Visceral leishmaniasis: A case report. Australas Med J. 2012;5(2):130-134.
8. Alvar J, Vélez ID, Bern C, et al. Leishmaniasis worldwide and global estimates of its incidence. PLoS ONE. 2012;7(5)