Leishmania donovani is an intracellular protozoan parasite.
Visceral leishmaniasis, formerly called kala-azar, is one of the diseases caused by this parasite (the other being cutaneous leishmaniasis). Patients display spiking fevers, hepatosplenomegaly, skin discolorations, and pancytopenia.
Patients with visceral leishmaniasis develop spleen and liver dysfunction, which may manifest as hepatosplenomegaly.
Spiking fevers, or pyrexias, are seen with visceral leishmaniasis. These can be continuous or remittent, and are a distinguishing feature of this disease.
Darkened skin discoloration occurs with Leishmania donovani infection, hence the name kala-azar ("black fever").
Sandflies are the intermediate host for this protozoan infection, and humans are the definitive host. Infection is transmitted to humans when they are bitten by the sandfly.
Diagnosis of leishmaniasis is made when there is microscopic visualization of amastigotes within macrophages. This requires tissue biopsy (eg bone marrow).
Amphotericin B is the recommended treatment, especially for visceral leishmaniasis in India, South America and the Mediterranean, and has been shown to cure up to 95% of those treated.
Miltefosine is an oral medication which is also effective in treating leishmaniasis. It's use should be cautioned, as it can lead to birth defects.
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