Leishmaniasis Health Dictionary

Dum-dum fever. Kala-Azar. Delhi-boil. Oriental sore; a tropical infectious disease caused by protozoan parasites (usually caused by sandflies) manifesting as influenza with (1) internal visceral disturbance, or (2) skin eruptions with ulcerated nose and throat. Often a disease of Mediterranean infants. The case should be seen by a tropical diseases specialist. Until he arrives: decoction Barberry (Berberis vul); half an ounce to 1 pint warm water; steep 20 minutes. 1 cup or more every 2 hours.

Alternatives. Powders. Formula. Echinacea 2; Blue Flag 1; Senna leaf 1. Dose: 500mg (two 00 capsules or one-third teaspoon), every 3 hours.

Liquid Extracts. Formula. Echinacea 2; Burdock 1; Senna leaf 1. Dose: 30-60 drops in water or honey every 3 hours.

Tinctures. Formula. Echinacea 2; Myrrh 1; Goldenseal 1. Dose: one 5ml teaspoon every 3 hours.

Topical. Cleanse skin with washes or lotions of Aloe Vera, Comfrey, Marshmallow, Plantain, Witch Hazel, etc. Treat bite immediately. Do not walk in the bush at dusk. Always take insect repellent and antiseptic cream. 

Any of a variety of diseases caused by single-celled parasites called leishmania. These parasites are harboured by dogs and rodents and are transmitted by the bites of sandflies. The most serious form of leishmaniasis is called kala-azar or visceral leishmaniasis. This disease is prevalent in some parts of Asia, Africa, and South America, and also occurs in some Mediterranean countries. In addition, there are several types of cutaneous leishmaniasis, some of which are prevalent in the Middle East, North Africa, and in the Mediterranean. Kala-azar causes persistent fever, enlargement of the spleen, anaemia, and, later, darkening of the skin. The illness may develop any time up to 2 years after infection, and, if untreated, may be fatal. The cutaneous forms have the appearance of a persistent ulcer at the site of the sandfly bite.

All varieties of leishmaniasis can be treated with drugs, such as sodium stibogluconate, given by intramuscular or intravenous injection.

A group of infections caused by parasites transmitted to humans by sand?ies.

Visceral leishmaniasis (kala-azar) A systemic infection caused by Leishmania donovani which occurs in tropical and subtropical Africa, Asia, the Mediterranean littoral (and some islands), and in tropical South America. Onset is frequently insidious; incubation period is 2–6 months. Enlargement of spleen and liver may be gross; fever, anaemia, and generalised lymphadenopathy are usually present. Diagnosis is usually made from a bone-marrow specimen, splenic-aspirate, or liver-biopsy specimen; amastigotes (Leishman-Donovan bodies) of L. donovani can be visualised. Several serological tests are of value in diagnosis.

Untreated, the infection is fatal within two years, in approximately 70 per cent of patients. Treatment traditionally involved sodium stibogluconate, but other chemotherapeutic agents (including allupurinol, ketoconazole, and immunotherapy) are now in use, the most recently used being liposomal amphotericin B. Although immunointact persons usually respond satisfactorily, they are likely to relapse if they have HIV infection (see AIDS/HIV).

Cutaneous leishmaniasis This form is caused by infection with L. tropica, L. major,

L. aethiopica, and other species. The disease is widely distributed in the Mediterranean region, Middle East, Asia, Africa, Central and South America, and the former Soviet Union. It is characterised by localised cutaneous ulcers

– usually situated on exposed areas of the body. Diagnosis is by demonstration of the causative organism in a skin biopsy-specimen; the leishmanin skin test is of value. Most patients respond to sodium stibogluconate (see above); local heat therapy is also used. Paromomycin cream has been successfully applied locally.

Mucocutaneous leishmaniasis This form is caused by L. braziliensis and rarely L. mexicana. It is present in Central and South America, particularly the Amazon basin, and characterised by highly destructive, ulcerative, granulomatous lesions of the skin and mucous membranes, especially involving the mucocutaneous junctions of the mouth, nasopharynx, genitalia, and rectum. Infection is usually via a super?cial skin lesion at the site of a sand?y bite. However, spread is by haematogenous routes (usually after several years) to a mucocutaneous location. Diagnosis and treatment are the same as for cutaneous leishmaniasis.

n. a disease, common in the tropics and subtropics, caused by parasitic protozoans of the genus *Leishmania, which are transmitted by the bite of sandflies. There are two principal forms of the disease: visceral leishmaniasis, in which the cells of various internal organs are affected (see kala-azar); and cutaneous leishmaniasis, which affects the tissues of the skin. Cutaneous leishmaniasis itself has several different forms, depending on the region in which it occurs and the species of Leishmania involved. In Asia it is common in the form of *oriental sore. In America there are several forms of leishmaniasis (see chiclero’s ulcer; espundia). Leishmaniasis is treated with drugs containing antimony.