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TM: Leishmania (ii) (Visceral (Dx (Histopathology (biopsy + impression…
TM: Leishmania (ii)
Visceral
can cause large-scale epidemics with high case-fatality rates (e.g. Ethiopia, Kenya, upper Nile, S Sudan)
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90% occurs in Bangladesh, Brazil, India, Nepal + Sudan
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endemically scatter across 5 continents in 98 countries (here many people have asymptomatic infection)
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systemic infection of the liver (massive hepatomegaly), spleen (splenomegaly) + BM (mimics leukaemia)
pentad: fever, weightloss, hepatosplenomegaly,, pancytopenia, hypergammaglobulinaemia (increased plasma Ig)
night sweats, weakness, anorexia, characteristic skin hyperpigmentation
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Disease of poverty, mainly of children, in Bangladesh, India, Sudan
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Tx
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alternatives = stibogluconate, paromomycin (cheaper), miltefosine (oral)
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Prevention
Long sleeves, long trousers, socks
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