CLINICAL PRESENTATION AND MANAGEMENT OF VISCERAL LEISHMANIASIS
Abstract
Background: Febrile illnesses like malaria, typhoid, and tuberculosis are the commonestproblems in our area, but visceral leishmaniasis (VL) is also one of the diseases presenting withfever in this part of the country. This study was conducted to evaluate its clinical spectrum andway of management. Methods: This study was conducted in Paediatric Department of Womenand Children Hospital and Ayub Teaching Hospital, Abbottabad from October 1985 to August1999 during which 70 cases of VL were diagnosed and managed. Results: All patients werebelow 10 years of age and were from Hazara division. Majority of them were from two specificlocalities, one in Abbottabad District (43%) and the other in Mansehra District (14%). Commonclinical features were Fever 99%, Splenomegaly (99%), Anaemia (96%), Hepatomegaly (86%),distension of abdomen (47%) and bleeding diathesis 14%. Haemoglobin was below 7.9 gm in82.86%, white cell count was below 4000/mm3 in 42.85%, Platelet count was below 100000/mm3in 67.14% and ESR was >50 mm at the end of first hour in 86% of the patients. All the patientsshowed Leishmania Donovani bodies in the bone marrow smears except one, where tap was dryand then trephine biopsy was performed to confirm the diagnosis. In 67 cases amastigote formwas found and only in 3 patients the promastigotes were found. Fifty two patients had receivedmeglumine antimoniate (glucantime) and 18 received sodium stibogluconate (pentostam) alongwith supportive therapy. Mortality was 11.43%. Conclusions: The disease is gradually spreadingsouthwards in the country. Children below 5 years are mainly affected. Bone marrowexamination is the most reliable and simple method of diagnosis. A high index of suspicion musthe kept in mind for all febrile cases coming from Hazara division, Northern areas, Azad Kashmir.Keywords: Leishmaniasis, Visceral Leishmaniasis, Febrile IllnessReferences
Hamen DJ, Wyler J, Hamer DH. Leishmaniasis In:
Behrman RE (editor). Nelson Textbook of Pediatrics,
th Edition. New York: WB Saunders Company, USA;
p. 972-2.
Saleem M, Anwar CM, Malik IA. Visceral
Leishmaniasis in children. A new focus in Azad
Kashmir. J Pak Med Assoc 1986;36:230-4.
Hassan K, Bhatti TAK, Akhtar MI. Veishmaniasis.
Clinico-hematological correlation in 18 patients, Rawal
Medical Journal 1990;21:22-7.
WHO-EM/PD/24-E. Report on the regional seminar on
approaches for Leishmanial control. Cairo, Egypt 1990;
-5.
Hassan K, Ikram N, Bukhari KP, Shah SH, Hassan M.
Visceral Leishmaniasis – A study of 38 cases on the
basis of geographical distribution. J Pak Med Assoc
;45:125-7.
Jadoon H, Khan NH, Afridi A, Sarwar G, Lodhi MS.
Visceral Leishmaniasis – an emerging public health
problem along silk route of Northern Pakistan. J Ayub
Med Coll Abbottabad 1998;10(2):49-50
Brycesson ADM, Chulay JD, Mujabsil M, Were JB.
Tran Roy. Soc. Trop. Med. Hyg. 1987; 79:705-14
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
