✓ It is also called intermittent fever /Dum dum fever /biphasic fever leishmanias fever /black fever/ camel hump fever.
✓in Nepal Kala Azar mainly caused by leishmania donovani
Other species of leishmania are
1. Leishmania tropica (cutaneous leishmaniasis)
2. Leishmania braziliensis (mucosal leishmaniasis)
✓the vector of Kala Azar is sandfly (phlebotomus argentipes)
Morphology
Two stages are present
a. Amastigote stage (leishmania)
• round or oval in shape
•a flagellar
•it is found in reticuloendothelial system of man
b. Promastigote stage( leptomonal)
•spindle in shape
•flagellar
•it is found in digestive tract and salivary gland of sandfly.
✓incubation period=one to four month or it may exist up to 1-2year
✓infective stage=promastigote stage
✓habitat=reticuloendothelial system
✓mode of transmission=by the bite of infected sand fly
•blood transmission
•mother to foetus
✓it is a digenetic parasite
Primary host is man and secondary host is sandfly
Clinical feature
Fever
Splenomegaly and hepatomegaly
Cochexia with marked anaemia :-decrease of muscle mass
Skin dry and hair brittle
Dark skin pigmentation
Voracious appetite
Lab diagnosis
sample collection from spleen liver bone marrow and lymph node
1. Microscopic examination
2. RK 39 test (early morning sample collection from saliva sputum and urine)
3. Aldehyde test
4. Antimony test
Treatment
1. Liposomal amphotericin is drug of choice
BD× 0.75mg-1mg/kg/day×10-15days
2. Miltefosine BD×50mg×28days
3. Sodium stibogluconate 20mg/kg/day×28days
Complication
Epistaxis
Dysentery
Pneumonia
Pulmonary tuberculosis
