Related articles: Leishmaniasis
Definition
Leishmaniasis is a disease caused by protozoa of the genus Leishmania .
The infection is transmitted by insect vectors such as the pappatacio which, in turn, become infected by biting chronically infected animals (canids, rodents and other mammals).
Men usually contract leishmaniasis following contact with infected animals. Rarely, the disease is spread by transfusion, sexual, congenital or through the promiscuous use of needles.
Most common symptoms and signs *
- Anemia
- Asthenia
- Cachexia
- Bruising
- Hepatomegaly
- Ease of bleeding and bruising
- Temperature
- hypersplenism
- undernourishment
- Leukopenia
- Swollen lymph nodes
- Nodule
- Pancytopenia
- papules
- Weight loss
- thrombocytopenia
- splenomegaly
- Skin Ulcers
Further indications
Leishmaniasis has a wide spectrum of syndromes, both localized and systemic. The parasites, in fact, can remain localized in the skin or spread to the internal organs or mucosa of the nasopharynx, consequently causing different clinical forms of leishmaniasis: cutaneous, visceral and mucocutaneous.
Cutaneous leishmaniasis is the most common form. At the phlebotomus puncture site, generally within a few weeks to months, an initial well-defined and painless lesion appears, which often consists of a papule. This slowly increases its size before it gets ulcerated in the center. Ulcers do not cause systemic symptoms, except in cases of over-infection. Sometimes, cutaneous leishmaniasis occurs in diffuse form with multiple nodular skin lesions (similar to those of lepromatous leprosy). These signs can persist for months or years, before leaving permanent depressed scars, similar to burns.
Mucus-cutaneous leishmaniasis (or espundia) occurs in the form of destructive lesions of the mucous membranes of the nose, mouth and oral cavity. The disease begins with a primary skin ulcer, which heals spontaneously.
Subsequently, months or years later, the typical mucous lesions appear, which can sometimes lead to extensive mutilation of the nose and palate.
Visceral leishmaniasis, also known as kala-azar, is the most severe form; if left untreated, it is associated with high mortality. Symptoms develop gradually over weeks or months after inoculation of the parasite and include irregular fever, weight loss, enlarged liver and spleen and cachexia. In addition, visceral leishmaniasis involves polyclonal hypergammaglobulinemia and pancytopenia.
The presence of leishmaniasis is demonstrated by the finding, under a microscope, of causal parasites in smears or crops. Their identification can also be achieved by using specific DNA probes, isoenzymes or monoclonal antibodies. Serological tests for the determination of antibody titers also contribute to the diagnosis of visceral leishmaniasis.
Treatment depends on the clinical syndrome and the infecting species. Drug therapy may include the use of liposomal amphotericin B and pentavalent antimony compounds. For prevention, insect repellents containing DEET (dietiltoluamide), mosquito nets and clothing treated with permethrin or pyrethrum can help.
