Visceral leishmaniasis in 26 HIV-negative adults

Abstract

BackgroundVisceral leishmaniasis is a notifiable parasitic disease that had increased in incidence in our region on the past few years. It is common in children. In adults, it occurs more on a background of immunodeficiency, and frequently with incomplete clinical manifestations, making the diagnosis complicated.FindingsThe aim of our study is to reveal different features of visceral leishmaniasis in adults, through the analysis of its epidemiological, clinical and biological parameters, in a group of 26 patients. No one was infected with HIV or under immunosuppressive therapy Clinical presentation was generally conservative, but there was few differences in adults compared to children, concerning both the clinical symptoms and the laboratory parameters. Diagnosis was provided by direct examination of bone marrow smears in 24 cases (sensitivity 92%), and anti-leishmanial serology in the others.ConclusionWe should think to the diagnosis of VL even if the patient is not known immunocompromised, and even if the clinical is incomplete, to avoid a delay of care which can lead to serious complications.

Hepatomegaly Associated with Non-Obstructive Sinusoidal Dilation in Experimental Visceral Leishmaniasis

“…The low prevalence may suggest that sinusoidal dilation is a characteristic of not mild but severe VL. Hepatomegaly itself may also be an indicator of more advanced VL as its prevalence in human cases is generally lower than that of anemia or splenomegaly [2,3,6,7,27]. In our study, hepatomegaly accompanied by an increase in water weight became evident at 24 weeks post infection in mice, but not 12 weeks (Figures 1 and 3).…”

Identifying asymptomatic Leishmania infections in non-endemic villages in Gedaref state, Sudan

“…The disease is endemic in southern Europe, Latin America, Asia, and Africa with an estimated burden of 875; 3668; 45,119; and 8569 cases per annum, respectively [1]. Individuals with VL are clinically defined as symptomatic when there is a prolonged, persistent fever (i.e., longer than 2 weeks) and wasting with progressive spleen enlargement [2, 3]. However, subclinical infections can as well advance to apparent illness [4].…”

Identifying asymptomatic Leishmania infections in non-endemic villages in Gedaref state, Sudan.

“…The disease is endemic in southern Europe, Latin America, Asia, and Africa with an estimated burden of 875; 3,668; 45,119; and 8,569 cases per annum, respectively [1]. Individuals with VL are clinically defined as symptomatic when there is a prolonged, persistent fever (i.e., longer than 2 weeks) and wasting with progressive spleen enlargement [2,3]. However, subclinical infections can as well advance to apparent illness [4].…”