leishmaniasis
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Introduction
A disease of the reticuloendothelial system caused by protozoa of the genus Leishmania.
Epidemiology
Laboratory
(also see visceral leishmaniasis)
- light microscopy for visualization of amastigotes in smears, imprints or biopsies
- amastigotes
- 2-4 um in size
- delicate cytoplasm, a nucleus & a kinetoplast
- may appear smaller due to shrinkage with fixation
- Leishmania have a kinetoplast, but no cell wall
- distingush from Histoplasma capsulatum & Toxoplasma gondii
- different species of Leishmania cannot be distinquished by direct examination
- amastigotes
- growth of promastigotes in culture
- Novy-MacNeal-Nicolle's medium
- Schneider's Drosophila media supplemented with fetal calf serum
- cultures show promastigotes in 2-5 days, but should be held for 4 weeks
- immunohistochemistry with monoclonal antibodies is species-specific
- Leishmania serology
- Leishmania DNA
- Leishmania rRNA
- also see specific Leishmania species
Management
- sodium stibogluconate
- available from CDC (404 639-3670)
- 20 mg Sb[V]/kg IM/IV for 20 days (cutaneous) & 28 days visceral leishmaniasis
- amphotericin B
- pentamidine
- miltefosine (Impavido)
(also see cutaneous, mucocutaneous & visceral leishmaniasis)
More general terms
More specific terms
- cutaneous leishmaniasis (oriental sore)
- mucocutaneous leishmaniasis (espundia)
- visceral leishmaniasis (kala-azar)
Additional terms
References
- ↑ Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 1266-68
- ↑ DeGowin & DeGowin's Diagnostic Examination, 6th edition, RL DeGowin (ed), McGraw Hill, NY 1994, pg 902-3
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 1189-93