Diagnosing visceral leishmaniasis

What you need to knowVisceral leishmaniasis can cause prolonged fever, massive splenomegaly, peripheral cytopenias, diffuse cutaneous hyperpigmentation, and, if untreated, death in people with a history of residence in, or travel from an endemic areaLow cost immunochromatographic serological tests are available and can assist in rapid diagnosis in resource limited settings.A man in his 60s who resides in Bihar in eastern India, presented to a district hospital with a one month history of fever (maximum oral temperature of 101°F (38°C)). Examination revealed mild skin pallor and moderate splenomegaly. Routine blood work-up showed pancytopenia and elevated globulin levels, and rapid immunochromatographic strip test (testing for antibodies against rK39 antigen) was positive. Bone marrow aspirate (performed because leishmaniasis was suspected) showed numerous intracellular Leishman-Donovan bodies (amastigotes).Visceral leishmaniasis (also known as kala-azar) is one of 20 neglected tropical diseases listed by the World Health Organization1 and can be fatal if left undiagnosed and…
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